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


REFERENCES

1. Isaev E. V., Svistushkin V. M., Egorov V. I., Isaev V. M., Mustafaev D. M. Endoskopicheskaya endonazal­naya dakriotsistorinostomiya s primeneniem radio­chastotnoy khirurgii [Radiofrequency surgery-aided endoscopic endonasal dacryocystorhinostomy]. Rossi­yskaya otorinolaringologiya [Russian Otorhinolaryngology]. 2016; 4: 14-21.

2. Garashchenko T. I. Sovremennye podkhody k lecheniyu rinosinusitov i otitov kak oslozhneniy ostrykh zabolevaniy verkhnikh dykhatelnykh putey u detey [Mod­ern conception of pediatric acute upper respiratory tract diseases treatment]. Rossiyskaya otorinolaringologiya [Russian Otorhinolaryngology]. 2010; 1 (44): 168-172.

3. Krasnozhan V.N. Primenenie koblatsii v lechenii khronicheskogo dakriotsistita [Coblation in chronic da­cryocystitis treatment]. Rossiyskaya otorinolaringologiya [Russian Otorhinolaryngology]. 2016.- №2.- S.134-136.

4. Makhmudnazarov M. I., Murodov Sh. D., Shoev M. D., Nazarov Z. Kh., Tuydiev Sh. Sh. Sovremennoe sostoyanie lecheniya i deformatsiy nosovoy peregorodki, sochetannykh s allergicheskim rinitom [Current approach­es to combination treatment for allergic rhinitis in children]. Zdravookhranenie Tadzhikistana [Healthcare of Tajikistan]. 2019; 1: 74-83.

5. Pankova V. B., Fedina I. N., Serebryakov P. V., Preobrazhenskaya E. A., Grishin O. N. Metodicheskie podkhody k otsenke riska formirovaniya patologii verkh­nikh dykhatelnykh putey u rabotnikov pyleopasnykh proizvodstv [Methodological approaches to assessing the risk of upper respiratory tract pathology in employees of dust-hazardous industries]. Vestnik otorinolaringologii [Herald of Otorhinolaryngology]. 2014; 3: 28-31.

6. Tulebaev R. K., Baymenov A. Zh. Effektivnost sovremennykh metodov funktsionalnoy endoskopich­eskoy dakriotsistorinostomii [Effective modern methods of functional endoscopic dacryocystorhinostomy]. Rossi­yskaya otorinolaringologiya [Russian Otorhinolaryngology]. 2015; 3:137-140.

7. Abu-Ghamen S. et al. Outcomes of endonazal endoscopic dacryocystorhinostomy after maxillectomy in patients with paranasal sinus and skull base tumors. [European Archives of Oto-Rhino-Laryngology]. 2013; 20.

8. Beloglazov V. G. et al. Prevention of ostial obstruc­tion after microendoscopic endonaza ldacryocystorhinos­tomy. Vestnik oftalmologii [Bulletin of ophthalmology]. 2013; 129(2): 20-23.

9. Meyer-Rusenberg H. W., Emmerich K. H. Modern lacrimal duct surgery from the ophthalmological perspec­tive. [Deutsches Ärzteblatt International]. 2010; Vol. 107(14): 254-258.

10. Sameh M., Ragab., Mona S., el-Koddousy., Moham­med Badr. Endocanalicular, high-Pressure balloon catheter, endoscopic dacryocystorhinostomy: a randomized con­trolled trial. [Otolaryngology Heat and Neck Surgery]. 2011; Vol. 145(4): 683-688.


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


Pages: 56-61

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