Method for performing plasty of perforation foramen in nasal septum

FIELD: medicine, ORL-surgery.

SUBSTANCE: one should apply a cartilaginous transplant out of human fetal nasal septum twisted around with human fetal dura mater towards perforation foramen of nasal septum. Moreover, transplant's sizes should be 5-7 mm higher against the diameter of perforation foramen Human fetal dura mater should be fixed to the edges of perforation foramen due to laser biological welding in 8-10 points from each side due to contact technique in impulse mode. The suggested innovation enables to achieve tight fixation of a transplant to the edges of perforation foramen without applying catgut sutures onto its surface.

EFFECT: higher efficiency of plasty.

1 ex

 

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

There are ways to restore the anatomical integrity of the septum of the nose after a previously completed her surgical interventions with subsequent formation directly during surgery or in the remote terms after perforating holes by means of a variety of types of operations with the use of grafts. In ENT surgery, there are reports of the use of demineralized bone allografts for closing perforating holes in the septum of the nose in animals (1).

As the plastic material for closure of defect of septum of the nose was used demineralized a allobone in the experiment at 25 rabbits. Through the front wall of the nose, without entering into its cavity, resellable plot skeleton septum of the nose 0.7×0.7 cm, followed by its replacement plate allogeneic demineralized bone. After 3 months all planted plate demineralized bone was reconstructed and consisted of new spongy bone of the recipient, closing the operating perforation. Bone region of the former operational defect was soldered end-to-end" with the newly formed bone and differed from it by a greater degree of calcification.

The disadvantages of analogue I have is:

1. Demineralized a allobone loses its osteoinductive properties in the process of its treatment by hydrochloric acid solutions of different concentrations.

2. Due to the fact that the implantable human tissue is genetically alien to the animal, there are frequent transplant rejection with his suppuration (2).

As the prototype was taken way to close the perforations in the septum of the nose deionized allobone covered Autopista temporal muscle (3, 4).

In place of the perforated openings in the septum of the nose after ofseparate sheets mucosa and Nadirashvili was used vinyl demineralized of allocate, exceeding the length value of the replaced defective 8-10 mm, locking bone plate by forming a "rags-languages" in the front and rear sections of the graft, with which he pushed for the remaining plots bone-krasivoe the skeleton of the septum of the nose. When large perforating holes in the septum of the nose is exposed wall of the graft was covered with outofarea temporal muscle, which together with allobone was placed between the split on the edge of the perforated sheets of the mucous membrane of the septum of the nose.

The disadvantages of the prototype is:

1. Demineralized a allobone loses its osteoinductive properties after treatment is otci solutions of hydrochloric acid of different concentrations.

2. Hydrochloric acid helps to wash away from the bone graft mineral salts, which leads to the loss of frame options.

3. The deionized allobone a long time does not undergo rearrangement with the formation of new bone, it may be suppuration and resorption (2).

4. The necessity of using autopaste temporal muscle for plastics perforations of the septum of the nose will result in the need to perform additional surgery in the patient with the aim of taking his transplant.

The purpose of this invention is the fixation of the graft (cartilage of nasal septum and Dura mater of the human fetus) to the edges of the perforations of the septum of the nose laser "biological" welding (lbs) using a semiconductor laser "ATCUS-15" contact method.

This objective is solved in that between Tsaparang opposite sheets of the mucous membrane of the septum of the nose to the perforation hole in the septum of the nose down the graft of cartilage of nasal septum of the human fetus, wrapped in a graft of Dura mater of the human fetus in excess of 5-7 mm diameter perforations. The Dura mater of the fetal human is fixed to the edges of the perforations biological laser welding 8-10 points on each side of the contact way is the distal part of the end face of the optical fiber, the semiconductor laser "ATCUS-15" with output power of laser radiation 8,0 W in pulsed mode with a pulse duration of 600 MS. Contact laser "biological" welding allowed to obtain thorough fixation of the graft of cartilage of the septum of the nose of the fetus and the Dura mater of the human fetus to the edges of the perforations without imposing on its surface kathodavid seams.

An example of a specific implementation.

Under supervision there were 5 patients in the age from 15 to 43 years with perforating holes in the septum of the nose. All operations were performed under local infiltration anesthesia.

Our proposed method of closure of perforated holes in the septum of the nose transplant from flat allowreboot and Dura mater of the human fetus using laser "biological" welding (LBC) was preceded by a comparative assessment of different existing up to the present time how perforating holes in the septum of the nose with the use of grafts, different methods of preparation and preservation used donor tissue that subsequently when conducting experimental studies have confirmed the feasibility of using cartilage of the septum of the nose of the fetus and the Dura mater of the human fetus and LBC with the aim of restoring the anatomical integrity of the septum of the nose.

When transplanted cartilage of nasal septum and Dura mater of the fruit of man recorded the and some staging. So 10 days of implantation on the border of the mucosa and cartilage in place of the laser fixing the formed cavity is filled with degenerating cells. Epithelial cells swell in their cytoplasm contains a large number of vacuoles. The process of degeneration in the epithelial cavities continues until the 30th day of the experiment and concludes with the formation of strips of connective tissue infiltrated by lymphocytes on the border of the cartilaginous plate and underlying loose connective tissue. In this zone, the stimulation of collagenopathy fibroblasts, therefore, to the 40-th day of the experiment, the area of contact of the graft presents an increased number of loose connective tissue, with isolated groups of lymphoid infiltrates. Implantable Dura two weeks after implantation, and lbs subject to razvlecheniy and degeneration of the collagen fibers of the graft. The process ends with the introduction of new cellular elements (fibroblasts)that are involved in the education of their collagen fibers to the 40-th day after implantation. It should be emphasized that in the area of lbs the old structure of the graft is not restored, and is only stimulating matrix to form their own loose irregular connective tissue.

Example. Patient L., 15 years to find the camping hospitalized with a diagnosis of perforation of nasal septum. After the examination the patient underwent an operation - allobetulin perforating holes in the septum of the nose using a laser "biological" welding (lbs).

After incision of the mucous membrane of nasal septum to the right, some distance 0.5 cm from the front edge perforating holes, was carried out the separation of the opposite sheets of the mucous membrane and Nadirashvili across the diameter perforated holes, which achieved a size of 2.0×1.5 cm Then the graft of cartilage of the septum of the nose of the fetus and the Dura mater of the human fetus, exceeding the size of the perforation 0.5 cm (2,5×2.0 cm), was introduced between the sheets of the mucous membrane and Nadirashvili in place of the perforated holes and fixed to the edges of the split of the mucous membrane of nasal septum using LBC. The distal end of the optical fiber, the semiconductor laser "ATCUS-15" was mounted directly on the border of the contact surface of the graft with the mucous membrane of the septum of the nose, which was applied laser radiation power of 8.0 W in pulsed mode, the pulse duration was 600 MS, 8 points on each side that provided the welding of the mucous membrane of the septum of the nose to the meninges and the cartilage of nasal septum of the human fetus. Lbs allowed to reach full detent transpl ntata around its diameter, that excludes offset and education again through perforated holes in the nasal septum. Given the short duration of laser irradiation on the graft and the mucous membrane of nasal septum, was completely excluded factor charring of the graft in its contact with the distal part of the end face of the fiber with the formation of subsequent coagulation necrosis. Incision of the mucosa before perforating hole usuals with catgut and additionally the edges of the incision were fixed to each other using LBC. Control over the restructuring of the transplant was carried out dynamically conducted inspections with videoendoscopic control performed biochemical and immunological studies. So after 3.5 months after implantation of the cartilage of the septum of the nose of the fetus and the Dura mater of the human fetus in place of the perforated holes, noted the complete replacement of the Dura mater graft own mucous membrane of nasal septum, which covered the entire defect. In the postoperative period the patient received anti-inflammatory therapy, relapse perforations were observed.

Sources of information:

1. Pokotilenko A.K., Gorbachev V.N., Makashev V.E. // Ukr. USN., of throats. and nose. bol. - 1991. No. 5. - P.44-46.

2. Toriumi D.M., Larrabee W.F., Walike J.W. t al. // Arch. Otolaryngol. Head Neck Surg. - 1990. - Vol.116. No. 6. - R-680.

3. Gorbachev V.N., Sushko Y.A., B. I. Pavlik et al. // Orthopaedics, traumatology and prosthetics. - K.: Health, 1990. - S.138-140.

4. Gorbachev V.N., Makashev V.E., Minin J.V. // Ukr. USN., nose. and throats. bol. - 1991. No. 2. - Pp.33-38.

How plastic the perforations of the septum of the nose transplant, characterized in that the perforation hole in the septum of the nose down the graft of cartilage of nasal septum of the human fetus, wrapped in a graft of Dura mater of the human fetus in excess of 5-7 mm diameter perforations, with the Dura mater of the fetal human is fixed to the edges of the perforations biological laser welding 8-10 points on each side of the contact, the distal part of the end face of the optical fiber, the semiconductor laser with the output power of laser radiation 8,0 W in pulsed mode with a pulse duration of 600 MS.



 

Same patents:

FIELD: medicine, ORL-surgery.

SUBSTANCE: one should apply a transplant out of human fetal nasal septum into perforation foramen of nasal septum. Moreover, transplant's sizes should be 5 mm higher against the diameter of perforation foramen. Fixation to mucosa of nasal septum should be performed due to laser biological welding in 7-8 points being around perforation foramen due to contact technique. The suggested innovation enables to achieve tight fixation of a transplant to mucosa of nasal septum without separating opposite mucosal leaves and perichondrium.

EFFECT: higher efficiency of plasty.

1 ex

FIELD: medicine, oncology.

SUBSTANCE: one should perform laser treatment for the surface of intercostals muscles and tissues in subclavicular and axillary areas at the distance of 4-6 mm against the wound, replace light guide's emitter with circular and liner-reciprocating movements, affect with focused laser beam at wave length being 1.06 mcm, at output power of 10-25 W, diameter of laser spot being 5 mm for 2-8 sec depending upon the dose of irradiation and power density. The method enables to decrease the volume of postoperational lymphorrhea and prevent the development of postoperational infectious complications.

EFFECT: higher accuracy and efficiency.

1 dwg, 1 ex, 1 tbl

FIELD: medicine, ophthalmosurgery.

SUBSTANCE: one should affect patient's cornea with radiation of eximer laser: at first, at bundle's diameter being 8 mm, energy of 175 mJ/sq. cm and Gauss' energy distribution. Then, the edges of ablation area should be treated with circular scanning eximer laser's ray at diameter of 3.5 mm at the same energy up to peripheral area being at the distance of 0.5 mm against the limbus. The method enables to decrease the possibility for postoperative complication as bullous keratopathy in peripheral area.

EFFECT: higher efficiency of therapy.

2 dwg, 3 ex

FIELD: medicine, ORL-surgery.

SUBSTANCE: one should apply a thin layer of 10%-Syntomycin emulsion onto the edges of perforation foramen, then one should apply a transplant out of a flat bone of human fetal cranial arch. The transplant mentioned should be of 1 mm width, 0.1 mm thickness and its length being 2 mm higher against the size of perforation foramen. Fixation should be fulfilled due to laser biological welding in two points to the edges of perforation foramen with distal part of light guide's edge in impulse mode. One should put a fragment out of fetal dura mater above an osseous transplant being 2 mm higher against perforation foramen. Distal part of light guide's edge of semiconductor laser should be put on the transplant perpendicularly its surface. Welding should be carried out by contact technique in impulse mode at impulse duration being 600-700 msec in 6-8 points. The method enables to achieve transplant's tight fixation, exclude its shift and excessive coagulation of tympanic membrane in the site of light guide's edge application.

EFFECT: higher efficiency of plasty.

1 ex

FIELD: medicine, ORL-surgery.

SUBSTANCE: the present innovation deals with treating the lesions of tympanic membrane. For this purpose one should fix a transplant out of a flat bone of human fetal cranial arch. The transplant mentioned should be of 1 mm width, 0.1 mm thickness and its length being 2 mm higher against the size of perforation foramen. Fixation should be fulfilled due to laser biological welding in two points. One should put a fragment out of fetal dura mater above an osseous transplant being 2 mm higher against perforation foramen. Distal part of light guide's edge of semiconductor laser should be put on the transplant perpendicularly its surface. Welding should be carried out by contact technique in impulse mode at impulse duration being 450 msec and output laser radiation power being 8.5 W in 8 points. The method enables to achieve transplant's tight fixation, exclude its shift and prevent penetration of infection into tympanic membrane and keep sound passage through tympanic membrane.

EFFECT: higher efficiency of plasty.

1 ex

FIELD: medicine, cardiology, surgery.

SUBSTANCE: one should perform myocardial revascularization with laser radiation. Moreover, one should intravenously inject Photosens solution at 1.4-2.0 mg/kg body weight to irradiate boundary areas of myocardial ischemia with laser radiation at wave length being 675 nm, output power 150 mW, fiber's diameter being 0.6 mm, for 3-5 sec at 1-3 light impact/myocardial sq. cm. The innovation enables to decrease side effects.

EFFECT: higher efficiency of therapy.

FIELD: medicine.

SUBSTANCE: method involves closing passability of intramural portion of uterine tube. Intermittent photocoagulation is carried out of isthmus and intramural portion of uterine tube in subablation mode with a sort of solder alloy being applied to irradiation area, scattered laser radiation in moving laser light guide from isthmus lumen through intramural portion of the uterine tube in the uterus cavity direction making pause for irradiation, creating solid partitions on the traveling path and forming closed sections in cavities of cervix and intramural portion of the uterine tube.

EFFECT: enhanced effectiveness of treatment; retained areas of transit tube and uterus epithelium.

1 dwg

FIELD: medicine, otorhinolaryngology.

SUBSTANCE: one should perform local anesthesia to make deformed part of curved cartilage be anemic. Mechanical impact upon the cartilage of deformed part of nasal septum should be carried out after its distance heating due to laser radiation. Impact should be performed due to successive smoothing out the parts with a curved manual holder with thickening at its end to be then coincide with distance-contact additional heating due to laser radiation of adjacent cartilaginous parts. Treated part of nasal septum should be heated along the perimeter and kept with Killian's speculum. The innovation broadens technological abilities and simplifies therapy.

EFFECT: higher efficiency of therapy.

3 cl, 1 dwg, 3 ex

FIELD: medicine.

SUBSTANCE: method involves carrying out instrumentally controlled intervention with high intensity laser radiation being supplied to thyroid gland node via light guide brought into thyroid gland node body with a conductor through soft tissues. Dynamic temperature control is carried out 0.2-0.7 cm laterally far from nodal form boundary as the instrumental control in performing laser radiation treatment. 37-40°C being reached, laser radiation treatment is to be stopped. Laser light guide is introduced into the thyroid gland node 2-3 cm far from conductor end.

EFFECT: enhanced effectiveness of non-invasive, organ-saving treatment without narcosis being applied.

2 cl

FIELD: medicine; medical engineering.

SUBSTANCE: method involves exposure to laser radiation by moving scanning laser beam over biological object surface under treatment. Spatial object position is varied concurrently with scanning laser beam radially and circumferentially moving over surface under treatment and changing inclination angle with respect to biological object surface. State of surface under treatment is controlled by recording its temperature, comparing the temperature to maximum permissible level. Radiation power is adjusted. Device has casing, laser, objective and guide. The objective is radially and circumferentially movable and inclination angle variable with respect to objective surface The objective is radially and circumferentially movable. Computer, control unit, power control unit and scanning device are also available.

EFFECT: accelerated surgical intervention procedure; save action of laser radiation beam.

2 cl, 1 dwg

FIELD: medicine, ORL-surgery.

SUBSTANCE: one should apply a transplant out of human fetal nasal septum into perforation foramen of nasal septum. Moreover, transplant's sizes should be 5 mm higher against the diameter of perforation foramen. Fixation to mucosa of nasal septum should be performed due to laser biological welding in 7-8 points being around perforation foramen due to contact technique. The suggested innovation enables to achieve tight fixation of a transplant to mucosa of nasal septum without separating opposite mucosal leaves and perichondrium.

EFFECT: higher efficiency of plasty.

1 ex

FIELD: medicine, surgery.

SUBSTANCE: about 2-3 h before operation one should lymphotropically inject antibacterial preparation into pre-tracheal fiber. One should form an access to thyroid gland due to cervical incision without separating cutaneous-fatty fragments so, that wound angles should be the level of median edges of sterno-clavicular-mastoid muscles. One should divide at different levels: right and left sterno-hyoid muscles - being nearer at the upper edge of the wound, and right and left sterno-thyroid - at the lower edge. One should thoroughly isolate, tighten and cross the upper, at first, and then the lower thyroid veins, arteries and lymph vessels by keeping branches that feed parathyroid glands before the onset of thyroid manipulations. One should loose at first the upper and then the lower thyroid pole at mobilization of which one should visualize and isolate, if necessary, the lower parathyroid glands. One should isolate partially reflexive laryngeal nerve at the length of 1-1.5 cm, in area of its juncture with posterior-lateral thyroid surface and transition to a larynx. Moreover, one should visualize and, if necessary, isolate the upper parathyroid glands. After removing pathologically altered thyroid tissue one should perform the connection of crossed sterno-thyroid and sterno-hyoid muscles with longitudinal sutures. In cross-sectional direction by forming a trachea-covering muscular-fascial carcass. The method enables to avoid relapse of pathological process and, also, prevent the onset of specific complications such as laryngeal paresis and paralysis, transitory or constant hypoparathyreasis, intra- and postoperational hemorrhages.

EFFECT: higher efficiency of therapy.

2 cl, 1 ex

FIELD: medicine, urology.

SUBSTANCE: one should perform radical cystectomy and chemotherapy, in case of prolonged hemorrhage one should tighten internal iliac artery being below the branching of the upper gluteal artery. Ureters should be crossed at the level of the upper cystic vessels. Then one should treat dorsal venous complex: one should isolate the complex followed by bandaging and suturing its elements. Distal urethral end should be sutured with uninterrupted suture. In women one should carry out radical cystectomy at resecting the uterus with adnexa and vaginal resection. In case of affected bladder's collum one should resect the urethra, as well. Uretherocutaneostoma should be formed as a ureter's cuff. One should perform systemic chemotherapy in adjuvant mode. One month later it is necessary to develop either orthotopic or heterotopic urinary reservoir. The method enables to prolong duration and quality of life in patients with complicated invasive forms of urinary bladder cancer.

EFFECT: higher efficiency of therapy.

1 ex

FIELD: general surgery methods and facilities.

SUBSTANCE: material for various genesis, localization, and configuration defect grafting is made from thin (up to 100 mcm in diameter) titanium nickelid wire weaved into porous-permeable structure according to knitted-fabric and textile technology or by felting. Thanks to plasticity of titanium nickelid and quasiplasticity of woven structure, effective plasticity of material is many times superior to that in nonwoven porous sheet materials and meets requirements of congruent disposition of materials in organs and tissues to be operated.

EFFECT: increased plasticity of grafting material.

7 dwg

FIELD: medicine, traumatology, orthopedics.

SUBSTANCE: one should introduce per 1 immersible element into proximal and distal fragments, apply a middle immersible element through distal and proximal fragments, fix immersible elements in external supports. In peculiar case, one should apply needles as immersible elements applied at an angle to each other. In peculiar case, as a middle immersible element one should apply a needle with central spiral curvature at altering pace of coils. In peculiar case, as immersible elements one should apply needles with central spiral section. In peculiar case, one should apply unthreaded rods as immersible elements being at an angle to each other. In peculiar case, as immersible elements one should apply threaded rods.

EFFECT: higher efficiency.

5 cl, 6 dwg

FIELD: medicine, orthopedics.

SUBSTANCE: the method deals with an access to the caput and bottom of the 1st metatarsal bone, removal of osseous-cartilaginous growth in area of metatarso-phalangeal joint, cut a fragment out of articular capsule with its bottom being on proximal phalanx, suturing a cut fragment at tension towards soft tissues in area of distal metaepiphysis of the 1st metatarsal bone to withdraw the great toe out of defective position, resection of the bottom of proximal phalanx in a hammer-like toe, osteotomy of the bottom of the 1st metatarsal bone, forming wedge-like autotransplants out of resected bottom of proximal phalanx of the second toe followed by their introduction into area of osteotomy of the bottom of the 1st metatarsal bone to prevent the relapse of deformation.

EFFECT: higher efficiency of therapy.

2 dwg, 1 ex

FIELD: medicine, orthopedics, traumatology.

SUBSTANCE: one should remove nonviable tissues, apply femoral end into the edges of both opposite shin bones, perform fixation till fusion with the help of compression-distraction apparatus. In peculiar case, at treating affected articular ends one should dissect and keep proximal fibular end. In peculiar case, at bringing together opposite ends of the bones the area of their contact should be overlapped with dissected fibular fragment and patella. The method enables to increase mechanical strength of fusion.

EFFECT: shortened terms of therapy.

2 cl, 4 dwg, 1 ex

FIELD: medicine.

SUBSTANCE: one should bring together pubic bones with a polymeric monofilament by successively applying double-curved monofilament through an obturator foramen from one side by developing a loop around pubis, then, similarly one should develop a loop around another pubis to apply conductors out of flexible nonabsorbable material under the loops developed to be then tightened into a knot, due to applying metallic tightening under knots one should introduce a one-tooth hook into foramen between the knots of monofilaments to twist them together, thus, performing a juncture of pubic bones up to desired distance with effort of 35 kg, not more, then monofilaments should be fixed due to twisting the ends with a pre-applied octagonal wire loop being under their knots by closing it as the tightening.

EFFECT: higher efficiency in preventing post-operational complications.

7 dwg, 3 ex, 2 tbl

FIELD: medicine, orthopedic roentgenology.

SUBSTANCE: the present innovation deals with predicting the relapses of perosseous osteosynthesis for treating children with Blount's disease due to performing roentgenograms, measuring the angle of axial deviation in deformed limb and that of dysplasia before therapy which should totally correspond to the angle of deformation correction being the important condition to prevent the relapse.

EFFECT: higher accuracy and efficiency of prophylaxis.

6 dwg, 1 ex

FIELD: medicine, orthopedics, traumatology.

SUBSTANCE: one should osteotomize the end of distal osseous fragment along the line coming oblique-cross-sectionally through its sclerosed and healthy sections, center at reposition opposite ends of the main fragments by keeping the isolated fragment as intact one, perform stable fixation till restoring osseous integrity with the help of compression-distraction apparatus. The method enables to stimulate osteogenesis in area of healing.

EFFECT: shortened period for therapy.

4 dwg, 1 ex

FIELD: medicine.

SUBSTANCE: method involves applying one or two parallel through draining tubes having lateral perforations. Flow lavage of the retroperitoneal space with antiseptic solutions is carried out via the perforations at room temperature and cooled solutions are administered concurrently with vacuum suction. Omental bursa is concurrently drained using the two parallel through draining tubes. Flow lavage of the omental bursa is carried out using these tubes.

EFFECT: enhanced effectiveness of treatment in healing pyo-inflammation foci.

5 cl, 1 dwg

Up!