The way plastics defect eardrum

(57) Abstract:

The invention relates to medicine, namely to ENT surgery. Over a sprocket hole in the eardrum after it decapitalization stack a graft of Dura mater of the human fetus in excess of 2 mm diameter perforations. The graft is fixed to the edges of the perforations of the tympanic membrane, the distal part of the end face of the optical fiber, the semiconductor laser "ATCUS-15" contact method in pulsed mode, with pulse duration of 600-700 MS and the output power of laser radiation 8.5 watts. The method allows to increase the effectiveness of the treatment, which is achieved by thorough fixation of allbritton to the edges of the perforations.

The invention relates to medicine, namely to laser ENT surgery.

There are ways to restore the anatomic integrity of the eardrum by means of various types of operations with the use of grafts. In ENT surgery, there are reports of the use of autopaste temporal muscle (1).

Over a sprocket hole in the eardrum after decapitalization its surface layer across the entire diameter of perforation Lancet fixed to the eardrum perforated rubber gasket for 20-25 days on top of which was laid 5-6 cotton balls on a string dipped penicillin-vaseline mixture.

The disadvantages are the counterpart:

1. Duration tamponade external ear canal.

2. The lack of control over the condition of the graft.

3. The inability to perform in the early postoperative period due to tamponade of external ear canal secondary fixation of the graft at its offset.

4. Insufficient fixation of the graft leads to the displacement of the implanted graft (1, 2).

As the prototype was taken way to close the perforated holes in the eardrum automatcially flap and its fixation was carried out in 4-8 points laser YAG-Nd laser (3).

The disadvantages of the prototype are:

1. In areas of prolonged exposure of laser radiation to graft can occur coagulation necrosis with subsequent resorption.

2. Tamponade external ear canal limits the possibility of monitoring the transplant, and it was fixed.

3. It is difficult to conduct in the early postoperative period additionally is podani (Dura fetal human) to the edges of the perforations of the drum peristiany necrosis with subsequent resorption.

2. Duration tamponade external ear canal reached 10-12 days after surgery.

3. There is no possibility of monitoring the transplant, and it was fixed.

4. It is difficult to conduct in the early postoperative period additional stimulation of regeneration processes (4).

The purpose of this invention is to commit allbritton (Dura fetal human) to the edges of the perforations of the eardrum laser “biological” welding using a semiconductor laser “ATCUS-15” contact method.

This objective is solved by the fact that over a sprocket hole in the eardrum after it decapitalization fit the graft of Dura mater of the human fetus in excess of 2 mm diameter perforations, the graft is fixed to the edges of the perforations of the tympanic membrane by the method of lbs, the distal part of the end face of the optical fiber, the semiconductor laser “ATCUS-15” contact method in pulsed mode, with pulse duration of 600-700 MS and the output power of laser radiation 8.5 W, carried out the welding of allbritton to the edges of p is CI enabled to achieve thorough fixation of allbritton to the edges of the perforations without fixing foam or cotton swabs, impregnated with antibiotics and steroids, were completely excluded the possibility of penetration of the microflora in the tympanic cavity through the external auditory meatus, significantly improved the conduction of sound through the drum cavity toward the inner ear.

Specific example:

Under supervision there were 7 patients in the age from 20 to 52 years with a chronic one - and two-sided mesotympanum and lack of relapse from 4 to 6 months. All operations were performed under local infiltration anesthesia.

Our proposed method of closure of perforated holes in the eardrum Dura mater of the human fetus using laser “biological” welding (lbs), was preceded by a comparative assessment of different existing up to the present time of closure of the perforating defects in the ear-drum, different methods of preparation and preservation of donor tissue that subsequently when conducting experimental studies have confirmed the feasibility of using LBC in complex with the Dura mater of the human fetus to restore the anatomic integrity of the eardrum.

Example. Patient S., 42, was in outpatient treatment with a diagnosis of Chronic left mesotympanic, without exacerbation. After the examination of the patient performed the surgery Tympanoplasty Dura mater of the fruit of the man on the left with the help of laser “biological” welding (lbs) contact method.

Over a sprocket hole in the eardrum with a size of 0.2×0.3 cm after its decapitalization across the diameter of the perforation holes fit the graft of Dura mater of the human fetus in excess of once using LBC contact method. At the distal portion of the end face of the optical fiber, the semiconductor laser “ATCUS-15”, mounted directly on the graft perpendicular to its surface, was applied laser radiation power of 8.5 W in pulsed mode with a pulse duration of 600 to 700 MS, which provided the welding of graft in place of touch with the end face of the light guide. Point welding transplant was 8. Lbs allowed to achieve thorough fixation of the graft around its diameter, preclude the use of additional fixation of the graft from the ear. Given the short duration of laser irradiation (pulse width 600-700 MS) in the Dura mater of the fetal human and subject to the ear drum, they were bonding, were excluded factor expressed coagulation of tissue with subsequent development of coagulation necrosis and melting of the graft in its contact with the distal part of the end face of the light guide. In the postoperative period to prevent pressure build-up in the tympanic cavity through the wound secretion was conducted short course of dehydration therapy. For the reconstruction of the graft was performed dynamically ongoing biokhimicheskii postoperative period after 3 months, the patient relapse perforations were observed.

Sources of information

1. Mechaniken N. In. Issues of clinical presentation, diagnosis and treatment of chronic otitis. - Omsk, 1979.

2. Kanzaki J. //J. Arch. Oto-Rhinno-Laring (Basel). - 1979. 25:3. - P. 181-184.

3. EN 2143934 from 10.01.2000.

4. Moles Y. A. Myringoplasty with extensive perforations of the eardrum //Bulletin of otorhinolaryngology. 2001. No. 5. - S. 57-59.

The way plastics defect eardrums, including fixation of the graft to the edges of the perforations biological welding laser radiation in 6-8 points, characterized in that the quality of the graft use the Dura mater of the fetus and the fixing is performed by the radiation of a semiconductor laser "ATOX-15" in a pulsed mode with pulse duration 600-700 MS, the output radiation power of 8.5 W, the contact method.