RU2315640C1 - Method for carrying out complex treatment of chronic maxillary sinusitis cases - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: method involves washing sinus cavity with Furacilin solution via artificially created anastomosis after having catheter catheterized the sinus. Then, sinus cavity is filled with 0.5% Dihydroquercetin solution. Distal end of flexible light guide is introduced into the solution and photodiode therapy is carried out with wavelength of 0.53 mcm and radiation power of 60 mW. Light spot diameter is equal to 3-5 cm, exposure time is 5 min. The total treatment course is 5 sessions long.

EFFECT: reducing inflammation process in the sinus; inhibiting lipid peroxidation processes; high antioxidative protection of tissues.

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Description

The invention relates to medicine, namely to a physiotherapeutic method of treating chronic sinusitis using LED phototherapy in combination with an antioxidant in otorhinolaryngology.

Known methods of intracavitary low-energy irradiation of the sinus with a helium-neon laser (GNL) [1].

Intracavitary laser physiotherapy was performed after washing the paranasal sinuses with a monofilament fiber, the distal end of which was inserted into the sinus (maxillary or frontal) through a catheter, as well as into the nasal cavity and nasopharynx. Laser physiotherapy was carried out using commercially available GNL LG-38 with a wavelength of 0.633 μm and an energy exposure of 10 J / cm. The course of treatment ranged from 2 to 9 sessions (an average of 5).

The disadvantages of the analogue are:

1. The effect of an intracavitary helium-neon laser is not effective enough without its simultaneous use with antibiotics, sulfonamides, desensitizing agents, antioxidants, and other means.

2. With laser physiotherapy, a later normalization of blood biochemical parameters in patients with chronic sinusitis was noted as a criterion for effective treatment.

As a prototype taken the method of LED phototherapy in the treatment of diseases of the ear, throat and nose [2]. We performed LED therapy with the AFS apparatus in the treatment of allergic rhinitis, both using projection techniques for exposing the skin of the external nose and the projection area of its sinuses, as well as endonasal, irradiating the mucous membrane of the nasal cavity and nasopharynx.

The disadvantages of the prototype are:

1. The exposure to radiation from the LED device of the AFS of various wavelengths affects the skin of the projection region of the maxillary sinus is almost impossible due to the powerful barrier to LED radiation in the form of its bone front wall.

The aim of this invention is to enhance the antioxidant effect of a 0.5% solution of dihydroquercetin by exposing the green light spectrum to the mucous membrane of the maxillary sinus cavity using LED phototherapy with an APS / 3 device.

This goal is solved by the fact that after performing an endonasal maxillary sinusotomy and applying an artificial anastomosis in the lower nasal passage connecting the maxillary sinus cavity with the nasal cavity, in the early postoperative period, the maxillary sinus cavity was washed with a solution of furatsillin and then filled with a 0.5% solution of dihydroquercetin into the solution of the distal end of the flexible fiber of the AFS / 3 LED device with a wavelength of 0.53 μm, a maximum output radiation power of 60 mW, the diameter of the light spot from 3 to 5 cm to enhance the antioxidant effect of a 0.5% solution of dihydroquercetin on the mucous membrane of the maxillary sinus under the influence of the green emission spectrum of LED phototherapy, the duration of exposure is 5 minutes, the treatment course was 5 sessions.

Concrete example

Under observation were 11 patients aged 21 to 45 years with various forms of chronic sinusitis.

Example. Patient Sh., 41 years old, was hospitalized in the ENT department of AOKB with a diagnosis of Chronic bilateral sinusitis, purulent form. After the examination, the patient underwent surgery - Bilateral endonasal sinusotomy with the imposition of an artificial anastomosis in the lower nasal passage connecting the maxillary sinus cavity with the nasal cavity, on both sides, through which the sinus was flushed with furacilin solution and the cavity filled with 0.5% dihydroquercetin solution with into the sinus cavity of the distal end of the flexible fiber of the LED device AFS / 3 with a wavelength of 0.53 μm, a maximum output radiation power of 60 mW, the diameter of the light it is clear from 3 to 5 cm, the solution of dihydroquercetin and the mucous membrane of the maxillary sinus was illuminated, the exposure time was 5 minutes, the course of treatment was 5 sessions. The procedure is carried out in the position of the patient lying on the right and left side in the dressing room.

Simultaneously with the LED phototherapy of the maxillary sinus cavity, a study was made of the dynamics of serum lipid peroxidation indicators to assess the effectiveness of the treatment compared with patients who underwent intracavitary LED phototherapy of the maxillary sinus with a red light spectrum (Table 1).

Dihydroquercetin and LED phototherapy helped to reduce the inflammatory process in the maxillary sinus, which was confirmed by inhibition of lipid peroxidation and increased the level of antioxidant protection of tissues (Table 2).

Table 1. Indicators in nmol / l Indicators before treatment in nmol / l Intracavitary LED therapy Intracavitary LED therapy + dihydroquercetin Lipid hydroperoxides (normal - 28.5 ± 0.6) 32.82 ± 0.10 30.79 ± 0.10 28.98 ± 0.11 Diene conjugates (norm - 29.98 ± 0.61) 32.47 ± 0.11 30.81 ± 0.10 30.16 ± 0.11 Malondialdehyde (normal - 5.79 ± 0.12) 7.53 ± 0.10 6.42 ± 0.11 5.92 ± 0.12

The dynamics of antioxidant defense after treatment (table 2).

Table 2. Indicators in mcg / ml Indicators before treatment in mcg / ml Intracavitary LED therapy Intracavitary LED therapy + dihydroquercetin Tocopherol acetate (normal - 22.05 ± 0.55) 19.28 ± 0.11 21.12 ± 0.11 21.61 ± 0.11 Ceruloplasmin (normal - 22.0 ± 0.37) 20.11 ± 0.12 21.59 ± 0.11 21.73 ± 0.11

Information sources

1. Pluzhnikov MS, Lopotko A.I. Low-energy laser radiation in rhinology // Russian rhinology. - 1995. - No. 3-4. - p. 42-47.

2. Nasedkin A.N., Grachev S.V., Abrahamyan J.N. et al. Comparison of clinical indicators of the effectiveness of the use of laser therapy and LED phototherapy in the treatment of diseases of the ear, throat and nose // Health and medical equipment. - 2005. - No. 3 (22). - p. 45.

Claims (1)

A method for the complex treatment of chronic sinusitis, including LED therapy, characterized in that after catheterization of the maxillary sinus, the sinus cavity is washed with furacilin solution through artificially imposed anastomosis, then the sinus cavity is filled with a 0.5% solution of dihydroquercytin, and the distal end face of the flexible light is introduced into the solution LED therapy is carried out with a wavelength of 0.53 μm, a radiation power of 60 mW, a diameter of the light spot from 3 to 5 cm, an exposure of 5 minutes, a treatment course of 5 sessions.