| 摘要 |
FIELD: medicine. ^ SUBSTANCE: invention concerns medicine area, namely to otorhinolaryngology, application in surgical treatment of acute and chronic frontal sinusitises. The essence of the way consists in carrying out of a puncture of frontal sinuses by applying of an aperture with the subsequent drainage of a cavity of a sinus and introduction in it of medicinal preparations. Thus definition of anatomo-topographical features of a thickness of an orbital wall of a frontal sinus of the patient is preliminary carried out, then the local infiltration anaesthesia of soft tissues of frontal area by introduction of a solution of lidocaine of a hydrochloride of 2% in amount of 2 ml is carried out. The puncture is spent by introduction of a hollow needle with external diametre 1-2 mm and with an angle of sharpening of an edge peer 60 to frontal sinuses through an orbital wall in a point located on the middle of distance between an average line of a forehead of the patient and a supraorbital cutting and on 0.5 cm of more low most acting part of a superciliary arch of the patient, or in a point located medial at not diffusion of a frontal sinus to a supraorbital cutting. The aperture in an orbital wall of a frontal sinus is carried out by rotation of a hollow needle, and then the hollow needle is entered with fixative use into an aperture of an orbital wall of a frontal sinus. The opening of the frontal sinus is cleared of an osteal shaving and the radiographic control of a locating of a hollow needle in a frontal sinus is carried out, the discharge from a frontal sinus through a hollow needle with simultaneous bacteriological research separated for definition of its sensitivity to antibiotics leaves. The lavage released from the separated frontal sinus is carried out through a hollow needle by a normal saline solution with temperature of 35-36C and then a stream of air plasma with the nitrogen monoxide, cooled to temperature of 35-45C, is entered through a hollow needle into a frontal sinus as an antibacterial preparation with a wide spectrum of influence on a pathogenic microflora within 150-240 seconds. The hollow needle leaves from an opening of the frontal sinus and the aseptic bandage is imposed. Then within 6-10 days after operation the cooled stream of air plasma with the nitrogen monoxide is entered into a frontal sinus within 150-240 seconds in a day, through the hollow needle, repeatedly placed each time in an opening of the frontal sinus, with its subsequent excision and applying of an aseptic bandage. ^ EFFECT: use of the given invention allows reaching full liquidation of the centre of an inflammation, to provide full excision separated of a frontal sine, to provide effective delivery of medicinal preparations in the inflammation centre, to restore a physiological condition of a sinus and restoration of patency of the frontonasal channel. ^ 2 cl, 3 ex |
