EFFICIENCY OF SIMULTANEOUS OPERATIONS OF CHRONIC DACRYOCYSTITIS IN COMBINATION WITH PATHOLOGY OF INTRA-NASAL STRUCTURES
SHAMSIDINOV B.N., SHODIEV N.SH., KURBANOVA F.I.
Department of Otorhinolaryngology of State Educational Establishment «Institute of Postgraduate Education in Health Sphere of the Republic of Tajikistan»
International Clinic «Ibn Sino»
State Establishment «City health center №7», Dushanbe
Aim. To increase the efficiency of surgical treatment of chronic dacryocystitis in combination with various pathologies of the nasal cavity by the method of simultaneous surgery.
Material and Methods. 17 patients (25 eyes) with chronic dacryocystitis in combination with various pathologies of the nasal cavity and paranasal sinuses were examined. The age of the patients was from 19 to 51 years, the average age was 38±2,5. From a concomitant pathology of the nasal cavity and paranasal sinuses, 6 patients had a nasal septum curvature, 4 nasal turbinate hypertrophy, a nasal septum hypertrophy and a combination of the middle turbinate hypertrophy, in 3 patients. Darkening of various severities of the maxillary sinuses was revealed on X-ray of the paranasal sinuses. and ethmoid sinuses.
Results. For all patients with nasal septum deformation and turbinate hypertrophy, surgical intervention was started with their elimination in the form of septoplasty, conchotomy, or lateral position of the middle turbinate. Intervention on the tear ducts began after preliminary anemization with 0.1% adrenaline under the control of the Karl Stors 0 and 30 ° endoscope. The operation was performed according to the method proposed by the authors. In order to prevent the development of synechia of the nasal septum from the lateral wall, films were introduced from both sides of the nasal cavity and fixed with through sutures to the nasal septum for up to 10 days. In the area of the formed dacryocystorhinostomy and in the nasal cavity, loose ointment swabs were inserted, which were removed after 1-2 days.
In the postoperative period, systemic antibiotic therapy was prescribed for 5-7 days, antihistamines, nasal and eye drops containing antibiotics, corticosteroids and a daily toilet of the nasal cavity for 7-10 days. Stents were removed after 3 months. In 1 patient, a relapse was noted after a year, and he underwent a second operation.
Conclusion. Careful preoperative preparation, combined simultaneous operations that prevent the development of synechia using modern technologies and good postoperative care are the main factors in the effectiveness of the treatment of this pathology.
Key words: chronic dacryocystitis, dacryocystorinotomy, simultaneous operations, synechiae, intranasal structures
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Information about authors:
Shamsidinov Bobonazar Nasridinovich – Head of the Department of Otorhinolaryngology of the State Educational Establishment “Institute of Postgraduate Education in Health Sphere of the Republic of Tajikistan”, Candidate of Medical Sciences; Associate Professor; tel.: (+992)917 44 17 44; e-mail: bobonazar_67@ mail.ru
Shodiev Nozim Shokirovich – otorhinolaryngologist of the International Clinic «Ibni Sino»; tel. +7 (992) 918 42 88 05
Kurbanova Firuza Iskandarovna – ophthalmologist at the City Health Center №7; tel. +7 (992) 93452 97 62