RU2365395C1 - Method of adenoid vegetation treatment - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention concerns medicine, photodynamic therapy, and can be used for treatment of adenoid vegetation. For this purpose 0.1% Radachlorin gel is administered into the area of adenoid vegetation on the basis of 0.2 g per 1 cm² of a surface. In 2 hours of an exposition a surface of a nose mucous coat and adenoid vegetations are treated with laser light with 662 nanometers wavelength within 20 minutes. The dose of light energy makes 50 J/cm². Course of treatment makes 5-8 sessions with a 2-3 days interval. The diode laser apparatus for photodynamic therapy "LAKHTA-MILON" can be used as a source of laser radiation.

EFFECT: achievement of fast and steady disappearance of inflammatory reactions, elimination of hypertrophic growth of tissues, restoration of nasal breath, prevention of postoperative complications and relapses, decrease in a dose of applied antibiotics.

2 cl, 2 ex

Description

The invention relates to medicine, namely to photodynamic therapy, and can be used to treat adenoid vegetation.

A known method of treating adenoid vegetation, including under the control of an endoscope, pre-treating adenoid vegetation tissue with a 0.01% miramistin solution, and then introducing 8-10 ml of a 0.1% solution of levamisole into the crypts of adenoids (patent RU 2306926, 2007).

The prototype of the invention is a method for the treatment of adenoid vegetation, which consists in the use of laser radiation supplied through the fiber to the adenoids with a specific radiation power sufficient for photodestruction and coagulation of the tissue, while the fiber through the nasal opening is directed into the area of the supporting connective tissue of the adenoids and moved inward along the entire length of the adenoids parallel to the nasopharyngeal arch in the sagittal plane, forming a hollow channel, use radiation from the wavelength range from 0.94 to 1.0 μm, and If necessary, the operation is repeated at the new point, the distance between the centers of the channel openings should be at least 3 mm (Patent RU 2242947, 2004 YG). The method improves the quality of treatment by reducing blood loss and eliminating cicatricial obliteration of the nasopharynx, preserving the immune organ of the nasopharynx - pharyngeal tonsil and, accordingly, the immune functions of the body. The disadvantages of the method are its invasiveness and complexity, the possibility of developing complications in the form of bleeding.

The objective of the invention is to develop a treatment method that ensures non-invasiveness of the intervention, reducing the need for surgical treatment, preventing postoperative complications and relapses, reducing the dose of antibiotics used.

EFFECT: quick and steady disappearance of inflammatory reactions, termination of hypertrophic tissue proliferation, restoration of nasal breathing.

The specified technical result is achieved due to the fact that in a method involving the use of laser radiation supplied through the fiber to the adenoids, 0.1% Radachlorin gel is introduced into the adenoid vegetation area at the rate of 0.2 g per 1 cm ² surface, after 2 hours exposures treat the surface of the nasal mucosa and adenoid vegetation with laser light at a wavelength of 662 nm at a dose of light energy of 50 J / cm ² for 20 minutes, in a course of 5-8 sessions with an interval of 2-3 days. In this case, as a source of laser radiation using a diode laser apparatus for photodynamic therapy "LAHTA-MILON".

The proposed method for the treatment of adenoid vegetation is carried out as follows: a 0.1% gel photosensitizer Radachlorin gel (RadaFarma LLC, Russia) is introduced into the adenoid vegetation area through the nasal passages at the rate of 0.2 g per 1 cm ² surface. After 2 hours of exposure, a transparent elastic plastic disposable light guide filled with light guide gel is alternately introduced into the nasal passages (CJSC Polironik, Russia). The light guide is connected to the light guide of the laser apparatus (LAHTA-MILON apparatus, Russia) and the entire surface of the nasal mucosa and adenoid vegetations is treated with laser light at a wavelength of 662 nm at a dose of light energy of 50 J / cm ² for 20 minutes. The course of treatment is carried out from 5 to 8 sessions with an interval of 2-3 days. Dynamic monitoring is carried out after 1 week, 10 days, 1 month, 6 months and 12 months after treatment.

The authors in the patent and scientific literature did not find information about the fame of the proposed method for the treatment of adenoid vegetation using photodynamic therapy. Thus, the claimed invention meets the criterion of "novelty."

The authors found for the first time that the above set of distinguishing features of the method causes a rapid and stable disappearance of the inflammatory reaction, the cessation of hypertrophic tissue proliferation, ensures the absence of relapse of the disease. Thus, the claimed invention meets the criterion of "inventive step".

The proposed method is illustrated by the following clinical examples.

Example 1. Patient K., 5 years old. Complaints with admission to difficulty in nasal breathing, frequent relapses of the disease. Considers himself ill for about 3 years. Based on the history and clinical picture, the patient was diagnosed with adenoid vegetation, II tbsp. The patient was treated as follows. Through the nasal passages, a gel photosensitizer of 0.1% Radachlorin gel was introduced into the adenoid vegetation area at the rate of 0.2 g per 1 cm ² surface. After 2 hours of exposure, a transparent elastic plastic disposable light guide filled with a light guide gel connected to the light guide of the laser apparatus was alternately introduced into the nasal passages, and the entire surface of the nasal mucosa and adenoid vegetations was treated with 662 nm laser light at a light energy dose of 50 J / cm ² (apparatus "LAHTA-MILON") for 20 minutes. The course of treatment consisted of 8 sessions with an interval of 3 days.

At the control examination 1 week after the course of treatment, the patient does not show complaints. Free nasal breathing, no discharge from the nasal passages, body temperature 36.6 °, general condition of the patient is satisfactory. Control inspection after 10 days. The patient does not show complaints. Breathing through the nose is free, there is no discharge. A follow-up examination after 1 month - no complaints, nasal breathing free, the entire treated surface without signs of inflammation and hypertrophic growths. At the follow-up examination after 6 months, the patient has no complaints, breathing is free. Control examination 12 months after treatment - no complaints, nasal breathing free, with no signs of activation of the process.

Example 2. Patient S., 4 years. Complaints with admission to difficulty in nasal breathing, frequent relapses of the disease. Considers himself ill for about 2 years. Based on the medical history and clinical picture, the patient was diagnosed with adenoid vegetation. The patient was treated according to the following technology. Through the nasal passages, a gel photosensitizer of 0.1% Radachlorin gel was introduced into the adenoid vegetation area at the rate of 0.2 g per 1 cm ² surface. After 2 hours of exposure, a transparent elastic plastic disposable light guide filled with a light guide gel connected to the light guide of the laser apparatus was alternately inserted into the nasal passages, and the entire surface of the nasal mucosa and adenoid vegetation was treated with 662 nm laser light at a light energy dose of 50 J / cm ² for 20 minutes. The course of treatment consisted of 5 sessions with an interval of 2 days.

At the control examination 1 week after the course of treatment, the patient does not show complaints. Nasal breathing is free, there is no discharge from the nasal passages, body temperature is within normal limits, and the general condition of the patient is satisfactory. Control inspection after 10 days. The patient does not show complaints. Breathing through the nose is free, there is no discharge. A follow-up examination after 1 month - no complaints, nasal breathing free, the entire treated surface without signs of inflammation and hypertrophic growths. At the follow-up examination after 6 months, the patient has no complaints, breathing is free. Control examination 12 months after treatment - no complaints, nasal breathing free, with no signs of activation of the process.

This method treated 12 patients with adenoid vegetation. In all cases, the specified technical result was achieved. The proposed method is easily reproducible in a hospital environment. Thus, the claimed invention meets the criterion of "industrial applicability".

Claims (2)

1. A method of treating adenoid vegetation by using laser radiation supplied through the fiber to the adenoids, characterized in that 0.1% radachlorin gel is first introduced into the adenoid vegetation region at a rate of 0.2 g per 1 cm ² surface, after 2 h exposure expose the surface of the nasal mucosa and adenoid vegetation with laser light at a wavelength of 662 nm at a dose of light energy of 50 J / cm ² for 20 minutes, a course of 5-8 sessions with an interval of 2-3 days. 2. The method according to claim 1, characterized in that as a source of laser radiation using a diode laser apparatus for photodynamic therapy "LAHTA-MILON".