A method of treating ganglionitis maxillofacial area

 

(57) Abstract:

The invention relates to medicine, namely to dentistry. The method consists in the fact that the influence exercised by single pulses holmium laser with a pulse energy of 0.1 j, frequency of 1-7 Hz, exposure time is 15-60, daily for 8-10 days. The method reduces relapses.

The invention relates to medicine, namely to methods for treating General relativity and somatoneurological diseases using the methods of physiotherapy. There is a method of treatment of neuralgia of the trigeminal nerve (N. T. N.) helium-neon laser (Katz A., and others in the book: proceedings of the "Pain and vegetative trophic disorders of the face and oral cavity", Moscow, 1982, S. 64-65).

Treatment with the laser power of 1 mW, a wavelength of 0.63 µm. Laser therapy begins after rehabilitation of the maxillofacial area. A continuous laser beam is directed at a right angle to the skin in the exit area of the peripheral branches of the trigeminal nerve (so-called). The procedure lasts from 4 to 10 min at a power density of 1 mW/cm2.

The disadvantages of this method include the fact that it provides p adversely affects the patient.

Closest to the present invention is a method of treating ganglionitis maxillofacial region, including contact effects of laser radiation on the area of the pterygopalatine node (K. N. W.)(ed. St. N 1444989, class A 61 N 5/00, 1987).

The method is as follows. Monovacancy quartz fiber set on the area of the K. N. W. the average sink endonasal access. The irradiation zone K. N. W. is carried out at a power density of radiation 20-40 mW/cm2. The exposure time on the affected side is 1-5 minutes the Course consists of 10-12 daily procedures. Laser irradiation is subjected to no nerve endings, and K. N. W., which plays the primary role in the innervation and the tropism of the nasal cavity, paranasal sinuses and maxillofacial region and has extensive contacts with other cranial nerves and opletenii. With the so-called through 2 branches so-called, with the facial nerve through the great superficial petrosal nerve, sympathetic plexus carotid artery through the deep petrosal nerve, as well as with the cervical sympathetic plexus, and other vegetative nodes of the maxillofacial area. This relationship, K. N. in other cranial nerves allows the use of laser irradiation with LECHEBNO maxillo-facial area.

The disadvantage of this method is also quite prolonged treatment at high laser power.

The task is to improve results by excluding relapses after treatment and reducing treatment time.

This object is achieved in that in the method of treating ganglionitis maxillofacial region, including contact effects of laser radiation on the area of the pterygopalatine node, the influence exercised by single pulses holmium laser with a pulse energy of 0.1 j, frequency of 1-7 Hz, exposure time is 15-60, daily for 8-10 days.

The method is as follows. On the area of projection of K. N. W. effect radiation holmium (wavelength of 2.09 μm), which is broadcast to the place by a flexible optical fiber (diameter of fiber 400-600 μm). Flexible light guide is passed through a hollow metal protector length of 120 mm, curved on the end angle 120ounder the control of lead at the rear end of the middle turbinate and promote it on another 3-5 mm (to the point of projection of the K. N. y.). Contact the irradiation region K. N. W. carried out in a pulsed mode (pulse time is 2-5 μs), the pulse energy of 0.1 j, SS="ptx2">

The choice of these parameters of laser irradiation due to the severity of facial pain (prosopalgia). When pronounced pain syndrome with frequent attacks or when the availability of sensitive, vasomotor and secretory disorders use maximum energy dose exposure exposure. In all other cases, use the minimum dose exposure of laser radiation.

Specific examples.

Example 1. Patient A. , 37 years old, and N1178/89, has complained of paroxysmal pain in the right half of the face is a "hot" character in the upper jaw extending to the eyes, nose and fronto-temporal part of the head. During the attack marked the debt right half of the nose, lacrimation and redness conjuctiva right eye, palpitations, feeling of shortage of air, the overall sweating. Pain occurs spontaneously and lasts from 4 to 6 hours, repeated daily, mainly in the evening hours.

Ill for about a year. The beginning of the disease relates to the flu. Was treated by a dentist, then a neurologist. The disease was regarded as N. T. N., effect of treatment was not. Repeatedly held procaine blockade with short effeciently no symptoms. Symptom of garner and reduction of corneal reflex rim, pastos right side of her face.

Craniogramms skull without pathology, x-ray of the paranasal sinuses: proteaceae thickening of the mucosa of the right maxillary sinus, with control puncture pus is not received. When the front rinoskopii during the attack abundant transparent selection of the right half of the nose, nasal turbinates right edematous, with a bluish tinge. After anemizatsii of 0.1% solution of epinephrine nasal passages become wider, cocaine test gave a positive reaction.

Patient diagnosed with "Ganglioneuritis right K. N. (syndrome Cladera). A course of laser irradiation of the right of K. N. at NCI-But laser (wavelength of 2.09 μm) mode: pulse energy of 0.1 j, the frequency of 5 Hz for 30 s on a daily basis. The attacks stopped after 4 sessions. Treatment consisted of 8 sessions. After 7 months of attacks of pain didn't bother.

Example 2. Patient N. , 40 years, and 2048/00, directed with a diagnosis of "Ganglioneuritis right K. N.", complaining of attacks of acute pain in the right half of the face, upper jaw in the eyeball with irradiation in the right temporal region, the neck, sometimes the upper limb. The attacks of the I, rhinorrhea, hypersalivation and "burning" in the right half of the face, swelling of the eyelids.

Ill for 6 years. About 2 months episodes of pain became more prolonged, frequent, began to wear heavy, cutting in nature. Moved the cold. It was treated at the neuropathologist. Had a course of acupuncture treatment takes Finlepsin up to 5 tablets per day. The drug does not help during an attack.

In CT examination of the brain and paranasal sinuses is marked wall thickening of the mucosa of the right maxillary sinus and cells of the ethmoid labyrinth, in the lumen of the maxillary sinus in a small amount of liquid content. When viewed from a little soreness at the point of output 2 branch of the so-called right. Hammer zone no. Determined hypesthesia of skin on the right side of her face. After anemizatsii nasal passage on the right received scant Muco-purulent discharge. Cocaine test positive. Produced by puncture of the right maxillary sinus, in the wash liquid scarce Muco-purulent discharge.

Given the presence of mild sinusitis, decided to start laser therapy K. N. W. in parallel with the puncture and lavage of the maxillary pasta, after 5 sessions of laser therapy pain attacks have become shorter. After 10 sessions of laser therapy seizures stopped and not worry sick for 8 months. During the observation period of acute sinusitis was not observed.

Example 3. Patient Z., 70, passed endonasal exposure K. N. at about neuralgia 2 branches of the so-called right, disease duration 6 years. To this end monovacancy quartz fiber cross-section fiber optic strands to 600 μm was introduced into the nasal cavity. Follow the upper surface of the lower turbinate, the working face of the light guide promoted further 3-5 mm. Irradiation region K. N. we performed YAG But the laser with the following parameters: pulse energy of 0.1 j, the frequency of 5 Hz. The exposure time is on the side was 45 C. the Rate of 8 daily procedures. After 4 treatments the patient has stopped taking Finlepsin, attacks of pain decreased. To the end of treatment, the patient noted the lack of episodic pain. When viewed in a year no complaints.

Using this method will ensure a fast and reliable treatment of ganglionitis maxillofacial area.

A method of treating ganglionitis maxillofacial region, including contact exposure lalami holmium laser with a pulse energy of 0.1 j, frequency of 1-7 Hz, exposure time is 15-60, daily for 8-10 days.

 

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1 ex

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