| 摘要 |
FIELD: medicine. ^ SUBSTANCE: invention relates to field of medicine, namely to otolaryngology. Essence of method includes opening, revision and washing of frontal sinus, formation of frontonasal fistula, introduction of drainage. Trepanation of bone of sinus anterior wall is carried out with its opening 7 mm in diameter. Through trepanation hole into sinus introduced is rhinoscope with 5 mm diameter with butt end and lateral lenses, with angle 30 and 70. Into nasal cavity into middle nasal passage passed is curved bulbous-end metal probe. After that rhinoscope with 5 mm diameter with butt end lenses is introduced into nasal cavity, in middle nasal passage metal probe is identified and by it natural frontal sinus fistula. Upper part of hamulus is ablated, then, after turning endoscope end with 30 viewing angle upwards, identified is floor of agger nasi cell, its cavity is opened, bottom and posterior walls are ablates, ethmoidal bulla is opened and ablated, pathologic content from cells of ethmoidal labyrinth is removed. Frontonasal fistula with 7 mm diameter is formed. As drainage, silicon tube for endotracheal intubation with cuff with external diameter 6.0 mm is used. In silicon tube cuff perforation in all directions with 15-20 holes 1 mm in diameter is made. On proximal end of tube 5 mm long cuts directed towards cuff are made. Tube is installed into frontonasal fistula in such a way that upper 3-5 mm long end of tube protruded into sinus lumen and perforated cuff fitted closely to the surface of formed wound canal of fistula. Distal part of silicon tube and output canal of cuff are brought into nose vestibule and fixed. In post-operative period daily, starting from the second day, washing of sinus through silicon tube is carried out. Sinus through drainage tube is filled with perfluorane in volume 10 ml. Washing of frontonasal canal of fistula is performed with 5 ml of perfluorane, which is supplied through outlet canal of perforated cuff. Introduction of perfluorane into sinus and washing of frontonasal canal are carried out daily for 14 days. ^ EFFECT: application of claimed invention makes it possible to form stable frontonasal fistula and restore functions of frontal sinus in process of complex treatment of chronic frontitis, as well as to reduce terms of treatment and rehabilitation of patients with said pathology. ^ 2 ex, 1 dwg |
