Previous Next

ARCHIVE

№1' 2021

OTORHINOLARYNGOLOGY

International Medical Journal, Vol. 27., Iss. 1, 2021, P. 76−82.

DOI (https://doi.org/10.37436/2308-5274-2021-1-14)

DACRYOCYSTITIS AS AN OTOLARYNGOLOGICAL PROBLEM: OWN TREATMENT EXPERIENCE

Municipal Non−Profit Enterprise "City Clinical Hospital № 30 of Kharkiv City Council", Kharkiv
Kharkiv Medical Academy of Postgraduate Education, Ukraine

The urgency of improving the effectiveness of dacryocystitis treatment is determined by: their stable proportion among eye diseases, a high percentage of post−traumatic, iatrogenic and chronic forms, ability to be a source of dangerous complications and social significance. Existing anatomical and physiological relations and values of rhinogenic factors determine the involvement of otolaryngologists in dacryocystitis treatment. In order to determine the characteristics of the contingent of patients with dacryocystitis, structure of rhinogenic factors, methods of examination, surgical treatment and principles of postoperative management of patients, a study was conducted with 107 patients with chronic disease. The clinical effectiveness in diagnosis and planning of surgical intervention of the combination of endonasal optical rhinoscopy, probing and contrast of the nasolacrimal pathway with triombrast with subsequent radiological and (or) CT examination was determined. It is shown that the correction of endonasal structures should be performed simultaneously with dacryocystorhinostomy. The efficiency of the classical West−Bokstein surgery has been determined, the necessity of an individual approach to its planning has been shown. The main tasks of each stage of the surgery, which significantly affect its outcome, are established. When performed correctly, the effectiveness of "plastic" and "simple" rhinostomy, management of patients with and without stenting is almost the same. It has been proven that the use of radio wave and shaver techniques can greatly simplify the stages of the surgery and improve healing. Based on the obtained results, a conclusion was made about the expediency of involving an otolaryngologist in the consultation of patients with chronic dacryocystitis in each case. The criterion for choosing treatment tactics in favor of endonasal endoscopic dacryocystorhinostomy is the presence of rhinogenic factors of dacryocystitis.

Key words: dacryocystitis, endonasal endoscopic dacryocystorhinostomy, rhinogenic factors, stenting, surgical treatment, epiphora, lacrimation.

REFERENCES

1. 1. Khamidov B. Kh., Ochildiev M. B., Khudoerov N. Kh. The significance of some physical methods to optimize the treatment process for diseases ear, throat and nose. European research: Innovation in science, education and technology. London, 2018. P. 142−143.

2. Khirurgicheskoe lechenie zabolevanii polosti nosa i okolonosovykh pazukh s ispol'zovaniem KT−navigatsii u detei / N. S. Grachov i dr. // Rossiiskaya rinologiya. 2014. № 3 (70). S. 40−43.

3. Kosakіvs'ka І. A., Kras'ko O. P. Rezul'tati doslіdzhennya bakteritsidnoї dії visokochastotnogo strumu pri vikoristannі bіpolyarnikh otolaringologіchnikh elektroіnstrumentіv // Zhurn. vushnikh, nosovikh ta gorlovikh khvorob. 2017. № 3. S. 68−69.

4. Kostrovs'kii A. N., Kostrovs'ka K. O. Efektivnіst' endonazal'noї endoskopіchnoї dakrіotsistorinostomії z bіkanalіkulyarnim drenuvannyam // Zhurn. vushnikh, nosovikh ta gorlovikh khvorob. 2018. №3. S. 54.

5. Levits'ka S. A. Sindrom nіmogo sinusu // Zhurn. vushnikh, nosovikh ta gorlovikh khvorob. 2018. № 3. S. 61−62.

6. Codere F., Denton P., Corona J. Endonasal dacryocystorhinostomy: a modified techniq with preservation of the nasal and lacrimal mucosa // Ophthal. Plast. Reconstr. Surg. 2010. Vol. 26, № 3. P. 161−164. https://doi.org/10.1097/iop.0b013e3181b80af6

7. Bharangar S., Singh N., Lal V. Endoscopic Endonasal Dacryocystorhinostomy: Best Surgical Management for DCR // Indian J. Otolaryngol. Head Neck Surg. 2012. № 64 (4). R. 366−369. doi: 10.1007/s12070−011−0345−0

8. Shimko Yu. N. Optimizatsiya diagnostiki i lecheniya patologii slezootvodyashchei sistemy na poliklinicheskom etape: avtoref. dis. ... kand. med. nauk: 14.01.03. Moskva, 2011. 23 s.

9. Valieva G. N. Analiz zabolevaemosti, pervichnoi obrashchaemosti i sostava gospitalizirovannykh bol'nykh s patologiei sleznykh organov // Problemy sovremennoi oftal'mologii: sb. nauch. tr. Ufimskogo NII glaznykh boleznei. Ufa, 2006. S. 88−89.

10. Shchuruk O. Z., Shchuruk G. Z., Shchuruk Z. S. Dosvіd khіrurgіchnogo lіkuvannya naslіdkіv stenozu abo obstruktsії nososl'oznogo protoku rіznoї etіologії metodom endonazal'noї endoskopіchnoї dakrіotsistorinostomії // Zhurn. vushnikh, nosovikh ta gorlovikh khvorob. 2018. № 1. S. 83−86.

11. Obodov V. A. Travmaticheskie dakriotsistity // Endoskopicheskaya khirurgiya. Vestn. Orenburgsk. gos. un−ta. 2009. № 12. S. 105−108.

12. Poritskii Yu. V., Boiko E. V. Diagnostika i khirurgicheskoe lechenie zabolevanii i povrezhdenii slezootvodyashchikh putei. SPb, 2013. S. 54−59.

13. Yatrogenії, obumovlenі pomilkami ta pogrіshnostyami v obstezhennі khvorikh z LOR−patologієyu / R. A. Abizov, Ya. V. Shkoba, V. R. Abizov, O. V. Bukhenko // Otorinolaringologіya. 2019. № 1 (2). S. 5−6.

14. Osobennosti lecheniya perelomov stenok lobnykh pazukh u patsientov s travmaticheskimi povrezhdeniyami litsevogo skeleta / R. N. Padalka i dr. // Zhurn. vushnikh, nosovikh і gorlovikh khvorob. 2016. № 5. S. 100.

15. Obodov V. A., Borzenkova E. S., Shlyakhtov M. I. Otdalennye rezul'taty endokhirurgicheskogo lecheniya flegmon sleznogo meshka // Sibirskoe meditsinskoe obozrenie. 2006. № 5. S. 61−62.

16. Izuchenie kachestva zhizni patsientov pri provedenii oftal'mokhirurgicheskikh vmeshatel'stv / A. V. Malyshev i dr. // Sovremennye problemy nauki i obrazovaniya. 2014. № 5. S. 440.

17. Protokol nadannya medichnoї dopomogi khvorim z gostrim dakrіotsistitom. Dodatok do nakazu MOZ Ukraїni vіd 15.03.2007 № 117. URL: http://medstandart.net/browse/2336

18. Bezshapochnii S. B., Loburets' V. V. Oshchadliva endomіkrorinokhіrurgіya v lіkuvannі porushen' prokhіdnostі sl'ozovіdvіdnikh shlyakhіv // Rinologіya. 2006. № 4. S. 26−33.

19. Bezega N. M., Ryadnova V. V. Otsіnka metodіv ta suchasnii stan khіrurgіchnogo lіkuvannya khronіchnogo dakrіotsistitu // Aktual'nі problemi suchasnoї meditsini. 2018. T. 18, vip. 3. S. 284−288. URL: http://nbuv.gov.ua/UJRN/apsm_2018_18_3_62

20. Motornyi V. V., Malinovskii G. F. Rol' rinopatologii v etiologii slezotecheniya i zabolevaniya slezootvodyashchikh putei // Zdravookhranenie Belorussii. 1991. № 8. S. 22−24.

21. Baimenov A. Zh. Obosnovanie klinicheskoi effektivnosti maloinvazivnykh endonazal'nykh khirurgicheskikh podkhodov k sleznomu meshku: avtoref. dis. ... d−ra med. nauk: 14.01.03. Moskva, 2017. 24 s.

22. Nasyrov V. A., Islamov I. M., Medvedev M. A. Sovremennye tendentsii v khirurgicheskom lechenii khronicheskogo gnoinogo dakriotsistita // Prakticheskaya meditsina. 2012. № 6 (12). URL: http://pmarchive.ru/sovremennye−tendencii−v−xirurgicheskom−lechenii−xronicheskogo−gnoinkgo−dakriocistita/

23. Morfologicheskie osobennosti slizistoi obolochki polosti nosa i sleznogo meshka pri neprokhodimosti slezootvodyashchikh putei / G. M. Nikol'skaya, G. A. Abdurakhmanov, V. G. Beloglazov E. L. At'kova // Vestn. oftal'mologii. 2006. № 5. S. 10−12.

24. Maloinvazivnye vmeshatel'stva pri dakriostenoze: sovremennye tendentsii / E. L. At'kova, V. D. Yartsev, N. N. Krakhovetskii, A. O. Root // Vestn. oftal'mologii. 2014. T. 130. № 6. S. 89−97.

25. Wang L., Chen D., Wang Z. New technique for lacrimal system intubation // Am. J. Ophthalmol. 2006. Vol. 142. P. 252−258.

26. Znachennya zmіn vnutrіshn'onosovikh struktur u patogenezі khronіchnogo dakrіotsistitu і osoblivostі endoskopіchnogo khіrurgіchnogo lіkuvannya / S. K. Boєnko, O. І. Klimov, O. O. Talalaєnko, O. O. Mіnaєv // Meditsina transportu Ukraїni. 2010. № 3 (35). URL: http://www.mztu.com.ua/svizhij_nomer.php?nid=35

27. Barinova N. P. Dakriotsistity u detei: sovremennyi algoritm lecheniya. 2015. URL: http://health−ua.com/wp−content/uploads/2015/11/28−29.pdf

28. Morfologicheskii analiz protsessov reparatsii v oblasti dakriostomy posle endoskopicheskoi endonazal'noi dakriotsistorinostomii / E. L. At'kova i dr. // Vestn. oftal'mologii. 2016. № 6. S. 89−97.

29. Bezshapochnii S. B., Loburets' A. V., Loburets' V. V. Optimіzatsіya vedennya patsієntіv z khronіchnim rinosinusitom, shcho zaznali endoskopіchnogo rinosinusokhіrurgіchnogo vtruchannya // Otorinolaringologіya. 2018. № 1 (1). S. 26.

30. Outcomes after endoscopic dacryocystorhinostomy without mucosal flap preservation: Vijay // R. Ramakrishnan et al. // Amer. J. Rhinol. 2007. Vol. 21, № 6. P. 753−755. https://doi.org/10.2500/ajr.2007.21.3095