Method for audiologic rehabilitation with use of ultrasonic radiation
SUBSTANCE: cochlea is exposed to contact ultrasonic radiation (UR) through a postaural surface of the individual's head. Ultrasound amplitude is modulated by electric signal generated by microphone sound receiver. The microphone is arranged close to an ultrasonic transmitter providing the binarual effect. The electric output signals of the microphone are filtered within the frequency range of 0.5÷5 kHz; an ultrasonic oscillation frequency is set at a value of at least 100 kHz; an ultrasound intensity is set at a value of no more than 0.1 Wt/cm2; a radiation pressure is generated in the cochlea of not less than 2·10-4 Pa.
EFFECT: method enables restoring the sound sensation and compensating the middle ear dysfunction that is ensured by ultrasound modulation by the audio signal generated by the microphone and providing the required pressure in the cochlea.
We propose a method of rehabilitation of auditory sensations person when otosclerosis, based on the effects of radiation pressure (EP) ultrasonic radiation directly to the inner ear.
Known[1, 2, 3, 4, 5, 6, 7], that otosclerosis is bilateral focal process in the bony labyrinth of the ear, accompanied by proliferation and impaired mobility of the auditory ossicles can lead to complete hearing loss.
Community ENT-specialists currently have formed a strong opinion that medical treatment of otosclerosis does not exist. All activities for the rehabilitation of hearing loss caused by otosclerosis, are surgical in the middle ear, called scapegoating or calibrated stapedia. During this operation removes pathological stone fireplace, which is replaced by a prosthetic head and the arch of the stapes.
There is an opinion [7, 8] that the occurrence of otosclerosis is associated with hereditary inferiority ear labyrinth, which is expressed in increased sensitivity to ULTRASOUND. As in patients with otosclerosis revealed a decrease in the content of many of bioactive elements in the bone substance, in particular in the stirrup, then appeared the proposal and drug support body in the treatment of otosclerosis. The authors of medication stauts the followers and surgical treatment, considering it the most effective. This position is explained by the fact that the duration of medication treatment (oral administration of bone calcium supplements, phosphorus, fluoride sodium 20 mg 2 times a day) for 1-2 years to keep up with the chronic development of otosclerosis, impairing hearing.
It should also lead the list of contraindications for surgical treatment of otosclerosis and a list of possible postoperative complications, which acquaint patients in an Israeli hospital Ichilov .
Contraindications for surgical treatment:
- the General condition of the patient,
one hearing ear,
- low reserve function of the cochlea of the inner ear,
- tinnitus or dizziness,
- the presence of active foci of otosclerosis.
The list of possible postoperative complications:
- paralysis of half of the face,
- vertigo in the postoperative period,
- allocation of perilymph from the ear,
- damage to the sound of the labyrinth of the middle ear,
- inflammation of the structures of the inner ear.
Despite well done operation may subsequently manifest complications in the form:
- complete deafness in the operated ear,
- long vertigo,
- the constant feeling of noise or hum in the operated ear,
- paralysis of half of the face in the form of damage the Affairs of the branches of the facial nerve.
Because according to statistics, the otosclerosis affects about 1-2% of the world population , it becomes obvious that to provide surgical care to many patients is impossible. But those patients for whom such assistance is provided, suffer from uncertainty and fear to lose hearing due to the lack of guarantee of statistical data on the service life specified in Kostochka prosthesis, membrane input of the ear and the oval window of the cochlea.
Thus, a method of rehabilitation of hearing in otosclerosis, based on the surgical procedure for replacing stone system prosthesis, can be considered as an analogue of the proposed method.
The technical solution of the proposed method is an exception surgery in the rehabilitation process (recovery) of auditory sensation in otosclerosis.
In accordance with the proposed method of rehabilitation of hearing in otosclerosis with the use of ULTRASONIC radiation to the cochlea of the inner ear is exposed to contact, through the ear the surface of a human head, the amplitude of the ULTRASONIC radiation modulate an electric microphone signal receiver of sound, and the microphone feature near the ULTRASONIC emitter, providing binaurality hearing, while the electrical output signals of the microphone is filtered to form the modulation signals in the frequency range of 0.5÷5.0 kHz, the frequency At which oscillations are set not less than 100 kHz, and the value of the intensity of the ULTRASONIC emitter is not higher than 0.1 W/cm2ensuring the formation of KMG in the cochlea of the inner ear not less than 2·10-4PA.
The essence of the proposed method is illustrated by the following drawings.
Fig.1 - family of curves of equal loudness depending on the frequency of the sound;
Fig.2 is A functional diagram of the device that implements the proposed method, where 1 is the power source device 2 to the ultrasonic oscillator with emitter and focusing system of knots, 3 - microphone, 4 - frequency filter and shaper of the modulation signal; the direction of the arrows indicates the functional dependence of the blocks; "B" - illustration affecting ULTRASONIC radiation modulated acoustic electric signal indicating the maximum power of the emitter.
As follows from the description, the proposed method is based on the phenomenon that is called RD and which occurs on the obstacles to the propagation of ULTRASONIC radiation. The mechanism of occurrence of RD are examined in detail in the works [9, 10, 11, 12] and refers to the sound effects of the 2nd order. The authors found no known literature publications on the practical application of this effect.
Sound vibrations, e.g. ULTRASONIC as a phenomenon of the 1st order are alternating compressions and razrjazhenie in the distribution environment. While the adoption is about to consider, the amount of compression and rarefaction, creating BONDS, equal and form two points of the medium located two from each other at a distance of λSV/2 (λSV- wavelength ULTRASONIC), the maximum voltage. It is this tension and use when exposed to ULTRASOUND on tissues and organs in medical diagnostic and therapeutic practice.
However, the ULTRASONIC oscillation as a phenomenon of the 1st order on the surface of the obstacle does not create constantly directed force (in the direction of propagation of the ULTRASONIC).
KMG is reflected in the fact that the surface of the obstacles ULTRASONIC experiencing constant pressure in magnitude and direction, which is directly proportional to the intensity of ULTRASONIC radiation and, like a light pressure, open Lebedev b.p. in 1903
The power of this constant RD 103 times smaller than the power of the ULTRASONIC radiation.
The physical interpretation of the occurrence of RD is given in [10, 11] and is associated with the phenomena, in which the resistance to movement of the particles of the medium in the region of suction from the region of compression will be less than in the case when particles move from a region of suction in the region of compression. It is this difference in the resistance of the medium and is the cause of constant pressure in the direction of propagation of the sound wave.
The authors agree with the physical interpretation of the above causes of RD.
Thus, the proposed with the persons is based on two physical assumptions associated with the use of ULTRASONIC radiation:
the dependence of RD on the intensity of ULTRASONIC radiation;
- the use of ULTRASOUND as a carrier for delivery to the desired internal body pressure, changing the amplitude and frequency according to a certain law, the alarm.
The presence of bone bone conduction in the auditory system of a person practically used in the diagnosis of hearing loss of a person. Bone conduction of sound waves in air exposed to significantly less bone conduction of the same sound at the contact effect on the bones of the skull. This is due to a significant difference of acoustic impedance of air and the bones of the skull (it is clear that the equality of the acoustic impedance of the sound transmission is carried out freely).
In  it is shown that the reflection of sound waves at the boundary of two media with different values of acoustic impedance is determined by dependence
where Zpadand ZRefaccordingly acoustic impedance of the medium with the incident and the reflected wave, and ΔPpadand ΔRefaccordingly, the pressure p is the giver and reflected waves.
For example, the passage of ULTRASONIC radiation from air to water and from water in the air to show the role of the values of acoustic impedance (ZAK=ρcf·SVwhere ρcfthe density of the propagation medium, withSV- the speed of propagation of sound in the medium). So ρd=1.29 kg/m3withSV.the hcpa.=340 m/s, ρwater=103kg/m3withSV.water=1500 m/s and αRef=0,999.
Indeed experience shows that out of the water in the air from the air into the water, the sound almost all is due to total reflection at the boundary of these environments.
The inner ear of humans, which is located in the temporal region of the head, combines the organ of equilibrium and the organ of hearing is the cochlea. The bony canal of the cochlea is a tapering tube, rolled into 2.5 turns of a coil in the shape of a snail.
The proposed method is based on the reflection of ULTRASONIC radiation from the border of the bone of the cochlea, the fluid inside the cochlea, which generates RD.
The acoustic impedance of the external bone basics snails can be taken equal to 160·105kg/m2·and the acoustic impedance of perilymph snails equal to 15·105kg/m2·C. In this case, the reflection coefficient at the boundary of the bone of the cochlea, its liquid, calculated by (1), will be ~0,7.
The effect of excitation of the fluid of the cochlea RD similar to her excitement when bone is the conduction of sound. This excitation provides the occurrence of resonance phenomena on the surface of the primary membrane, located along the cochlea in the form of "relief". This "relief" stimulates the nerve hair cells located at the base membrane in multiple layers, forming the organ of Corti. The result of the interaction of "relief" primary membrane with elements of the organ of Corti is the conversion of acoustic signals into electrical. Electrical signals in the auditory nerves are transmitted to the auditory areas of the brain, causing the sense of hearing.
It should again be noted that the proportion of sound energy entering the cochlea through bone conduction at the contact impact is much more energy entering the cochlea through the air.
Estimate the value of the intensity of ULTRASONIC radiation aimed at a snail that provides the perilymph of the cochlea RD, is equal to 2·10-4PA. As shown in Fig.1, this pressure exceeds the minimum threshold of human audibility, equal to 2·10-5PA, in the frequency range of 0.5÷5.0 kHz. These values are typical for normal functioning of the entire auditory system of a person.
The auditory ossicles in the ear canal and middle ear are a kind of transformer sound pressure. The leverage effect increases pressure force when transferring it from moloto the ka to the stapes in ~1.3 times. In addition, the effective area of the input surface of the eardrum lot more surface of the stirrup, which also leads to the increase of pressure, providing the total value of the transformation ratio of the pressure (according to the békésy) equal to(15÷20):1 .
Thus, the strengthening of the middle ear sound pressure 20 times must be taken into account when calculating the power of the ULTRASONIC radiation, and by the pressure of 2·10-4PA should be increased to 4·10-3PA. Since RD is three orders of magnitude less than the pressure of the ULTRASONIC radiation, the magnitude of the pressure source should be taken equal to 4 PA, which corresponds to the intensity of ~0.1 W/m2or 10-5W/cm2. The resulting intensity value should be increased according to the authors of two orders of magnitude due to:
the small values of the coefficient of the useful area of the cochlea 0,25÷0,35, which determines the proportion of the total flow of ULTRASONIC radiation interacting with the perilymph of the cochlea;
- possible loss of ULTRASONIC radiation in the bones on the way to the cochlea.
The working is the power of the Ultrasonic radiation should be not less than 10-3W/cm2.
In numerous outdoor publications requests "Biological effects of ULTRASOUND", "Treatment of otosclerosis, Hearing loss and other level of ULTRASONIC emitters not to exceed 0.5 W/cm2referred to small intensity values, to the which are widely used in medical practice [15, 16, 17, 18, 19, 20].
This allows the authors to argue that the working intensity of the ULTRASONIC emitters for the implementation of the proposed method are safe for humans.
The choice of frequency of the ULTRASONIC emitter in the proposed method is determined by the need to meet the following requirements:
- frequency ULTRASONIC radiation as a "carrier" shall not be less than 20 times greater than the upper frequency of the modulation signal (the authors proposed a frequency fcentury fashion.=5 kHz);
the frequency must provide a minimum absorption of the bones of the skull when the contact method effects;
- to have the possibility of small linear dimensions, taking into account the physiological characteristics of head sizes.
According to the authors, the lower bound of the frequency range of the ULTRASONIC radiator must be equal to 100 kHz, and the upper value can be set in the process of experimental studies of the dependence of the losses of the ULTRASONIC waves from the ULTRASONIC frequency in the bones. During these studies, the frequency range may have an upper limit of ~1 GHz.
It should be noted that the frequency of 100 kHz is used in the ULTRASONIC stimulation of the human brain [21, 22]. In particular in  was used, the intensity of the ULTRASONIC radiation of about 1÷2 W/cm2that is 100 times greater than the calculated intensity recommended in the proposed CSP is both.
Currently, the achieved level of ULTRASONIC instrumentation as the variety of application and parameters (intensity, frequency, focus, mode and others) allows authors hope that when creating a device that implements the proposed method can be used parts, elements and circuits from the existing ULTRASONIC devices. Therefore, the authors believe that it is enough to cause functional diagram of a device in simplified form, is shown in Fig.2. In Fig.2 "A" power supply 1 provides power to the ULTRASONIC emitter 2, the microphone 3 and the shaper of the modulation signal 4. The direction of the arrows connecting the blocks, indicates their functional dependence. Fig.2 "B" illustrates a view of influencing the ULTRASONIC radiation, modulated acoustic electric signal indicating the operating values of the radiation intensity.
As already noted, the ULTRASONIC emitter is placed in the ear of the head, and the irradiation of the cochlea provide a contact way. The microphone should be placed near the ULTRASONIC emitter for providing binaural properties of sound perception, allowing us to determine the direction to the sound source. Such an arrangement of the ULTRASONIC transducer and the microphone should be observed in the case of disease otosclerosis in both ears of the patient.
According to the authors, the device may be provided for the network disabling the ULTRASONIC emitter in the absence of the output of the microphone output signal (absence of an acoustic signal).
Thus, the proposed method of rehabilitation of hearing in otosclerosis eliminates the conventional surgical method of treatment of this disease.
1. Transfiguration B., J. Temkin, A. Likhachev, "diseases of the ear, throat, nose. - M.: Medicine, 1968
2. http://www.krasotaimedicina.ru (SEE clinic) "Hearing loss".
3. http://www.diagnos.ru "Otosclerosis", 2012
4. http://www.gutaclinic.ru "Otosclerosis. Treatment of otosclerosis", 2012
5. http://www.lechim-uxo.ru "Treat the ear. Signs, treatment, surgery of otosclerosis", 2013
6. http://www.ichilov./net/ENT disease/otosclerosis (Ichilov hospital, Israel) "Otosclerosis", 2012
7. http://www.XServer.ru "Otosclerosis".
8. Soldatov, I. B. "Lectures on otolaryngology", textbook. - M.: Medicine, 1994
9. Rosenberg, L. D., "Application of ultrasound." - M.: Union RAS, 1957
10. Krasilnikov C. A., Krylov, C. C., "Introduction to physical acoustics". - M.: Nauka, 1984
11. Prokhorov, A. M. (editor) "the encyclopedia of physics". - M.: Nauka, 1983
12. Kolesnikov A. I. "ULTRASONIC measurement". - M.: Nauka, 1970
13. Edited Sapozhkova A. M. "Acoustics" directory. - M.: Radio communication, 1989
14. Vahitov W. J., Kavalhin Y. A. Fadeev A. A., the administration renin Nikolay Dmitrievich Y. P. "Acoustics" e-mail for technical Colleges. - M.: The Mountains. line - Telecom, 2009
15. GOST 12.1.003-86 SBT "Noise, General safety requirements", section "the Influence of ULTRASONIC radiation."
16. http://www.avicena.narod.ru/techno/ultrasound.htm "ultrasound Treatment", 2008,
18. GOST 12.2.051-80 SSBT "System of occupational safety standards. ULTRASONIC technological equipment. Safety requirements".
19. Hygienic norms Saint Pin 2.2.4/188.8.131.522-96 "Hygienic requirements for work with sources of air and contact ULTRASONIC industrial, medical and domestic use".
20. http://www.readitall.ru/medezine/0038/htm "Biological effects of ULTRASOUND".
21. Karkishchenko N. N., Ivanov D. B., A. Vartanov P. "About the effectiveness and safety of ULTRASOUND-th transcranial stimulation of the human brain". - M.: Biomechanica, No. 2, 2011
22. http://bt-test.ru/advices/ultrazvukom_lechat_ne_tolko_delfiny/ "Ultrasound treated not only dolphins, Almazov Y., 2012
The method of rehabilitation of hearing in otosclerosis using ultrasonic radiation, characterized in that through the ear the surface of a human head contact, carry out the irradiation of the cochlea of the inner ear focused ultrasonic radiation, the amplitude of which modulate an electric microphone signal receiver of sound, and the microphone feature near the ultrasonic transducer, providing binaurality hearing, while the electrical output signals of the microphone is filtered in the frequency range 0,5÷5 kHz, the frequency of ultrasonic vibrations set not less than 100 kHz, and the values of the intensity of the ultrasonic radiation is set not higher than 0.1 W/cm 2and ensure the formation of radiation pressure in the cochlea of the inner ear not less than 2·10-4PA.
SUBSTANCE: group of inventions refers to medicine and medical equipment, namely to obstetrics and gynaecology, and can be used for the local treatment of inflammatory diseases of the uterine cavity. The method is implemented by inserting a waveguide of a presented device in a protection enclosure into the uterine cavity. A taper base of a narrow portion of the enclosure leans on an external orifice of the cervical uterus to prevent accidental perforation of the uterus. An infusion system regulator is used to set the spray supply of a therapeutic solution into an irrigation canal of the ultrasonic device. Thereafter ultrasonic vibrations are generated, and the uterine cavity is treated with the sounded therapeutic solution. The exposure length is 3-5 minutes at the ultrasonic vibration frequency of 25 kHz, infusion rate approximately 100-150 ml/min. The total infusion volume is not less than 300 ml. The ultrasonic treatment enables providing the continuous outflow of the uterine discharge. The device comprises an US generator, an acoustic assembly, the waveguide with the protection enclosure, the infusion system for the therapeutic solution supply. The acoustic assembly and waveguide comprises the irrigation canal. A working tip of the waveguide represents a short cylinder having a diameter greater than the rest portion. The irrigation canal of the waveguide has a diameter of 2 mm. The protection metal thin-wall enclosure has a crimped distal end and drain holes and represents two cylindrical elements of various diameters connected by a taper junction with milled grooves arranged so that to enable the fluid access to the working tip cylinder, the length of which makes no more than 3 mm.
EFFECT: inventions provide the effective cleansing of the uterine cavity from infected and necrotised tissues with improved comfort and safety of the procedure with using no endoscopic equipment, cervical dilation manipulations and uterine pre-probing.
2 cl, 3 dwg, 3 ex
SUBSTANCE: composition 16-21ml consisting of a mixture of therapeutic preparations: Dona glucosamine sulphate 3.0 ml; ChondroGuard, or Mucosatum, or Chondrolon chondroitin sulphate - 2.0 ml; Alflutop 2.0 ml; Actovegin 4.0-5.0 ml; glucocorticosteroids Depo-Medrol 1.0-2.0 ml in the concentration of 40 mg/ml, or Diprospane 1.0-2.0 ml in the concentration of 7 mg/ml, or Metipred 1.0-2.0 ml in the concentration of 62.5 mg/ml; vitamins B1, B6, B12 Combilipen 2.0 ml, or Milgamma 2.0 ml, or Neurobion 3.0 ml; 95% or 70% ethanol 2.0-4.0 ml, is administered into a pathologically changed region. That is immediately followed by exposing the pathologically changed region and adjoining segments to a session of A shock-wave therapy in the following mode: pressure 1.2 - 4.0 bar, frequency 7-12 Hz, beat quantity 8000-14000 for 20-40 minutes. The complex procedures are performed within the course of 1-6 times every 7-10 days.
EFFECT: method enables the direct exposure on the pathologically changed region to achieve the optimum concentration of drug preparations therein with avoiding systemic prescription and preventing a risk of side effects.
3 tbl, 2 ex
SUBSTANCE: method involves a course of 5-7 pulse ultrasonic procedures having an intensity of 0.2-0.4 W/cm2 of 5-7 minutes daily. That is combined with enzyme therapy with Longidaza 3,000 units 2 times a week for 1 month. Besides, Trilon B rectal suppositories 1,000 mg and Dimexidum 200 mg are administered daily for the night for 3 months. The bacteria are detected by a microscopic and microbiologic examination of ejaculate that is followed by a 4-6-week antibacterial therapy by administering an antibacterial preparation taking into account the microflora sensitivity.
EFFECT: such implementation of the method provides removing the prostate stones or decreasing the number thereof, reducing a probability of the inflammatory process in the prostate, ensuring a differentiated therapeutic approach by detecting the group of patients whom the antibacterial therapy is indicated to.
3 cl, 3 ex
SUBSTANCE: pathogenetic treatment of chronic tonsillitis and/or hypertrophy of palatine tonsils in preschool children suffering from lymphoproliferative syndrome is ensured by the palatine tonsils debridement. An interleukin-1β(IL-1β) level is measured in the palatine tonsils washing. If the measured value is less than 5.8 pg/ml, recombinant interleukin-1β (IL-1β) is to be administered orally by phonophoresis with the use of the Tonsillor MM apparatus. Two courses of 10 procedures every 14 days are performed. The clinical effectiveness is assessed if observing a positive dynamics of IL-1β measured in the palatine tonsils washing 17 and 41 days after the beginning of the immunomodulatory therapy.
EFFECT: higher clinical effectiveness ensured by the differentiated selection of children for carrying out the immunomodulatory therapy, reducing a rate of infectious involvements of the palatine tonsils in the declared group of patients by the pathogenetically reasoned application of recombinant IL-1β.
3 cl, 2 tbl, 1 ex
SUBSTANCE: method involves the combined exposure to ultrasound and electric current on a projection of the bladder. The ultrasonic exposure is carried out at the intensity of 0.2-0.4 W/cm2, frequency of 1 to 3 MHz. The electric pulse exposure involves amplitude modulated current in the frequency range of 100-250 Hz, at a basic frequency of 5-8 kHz for 10 minutes. The therapeutic course involves 8-12 procedures.
EFFECT: method prevents such complications of the bladder dysfunctions, as vesicoureteral reflux, chronic inflammatory renal and urinary diseases.
SUBSTANCE: palatal tonsils are daily sanitated with antibacterial preparations selected in accordance with the bacteriological examination of oral smears for pathogenic microflora and antibiotic sensitivity with the tonsil lacunae washed for 10 days. Pre-anaesthesia is followed by the tonsil lacunae exposure to an ultrasonic disintegrator at a depth of a probe working area at an amplitude of 23-26 mc every second day for 5 days. That is followed by paratonsil administration of polyoxidonium in an adult dose of 6 mg every second day for 5 days; the therapeutic course is performed once a year.
EFFECT: method enables higher clinical effectiveness in chronic tonsillitis.
2 tbl, 2 ex
SUBSTANCE: placenta hydrolyzate 1 ml mixed with lanolin 30 g before the procedure is applied on an anterior abdominal wall of a patient lying on his/her back in the projection of adhesions. That is followed by phonophoresis generated by UZT-1.07F ultrasonic therapeutic apparatus and sounded by an emitter of the diameter of 4 cm of the intensity of 0.4-0.6 W/cm2. The exposure mode is continuous; an emitter velocity is 1-1.5 cm/sec. The length of procedure is 5-7 minutes. The therapeutic course is 10 procedures.
EFFECT: reduced progression of abdominal adhesions and their manifestations by evident anti-inflammatory effect, reduced pain syndrome, higher adaptive body reserves.
3 tbl, 2 ex
SUBSTANCE: before the implantation, a demineralised bone graft (DBG) is kept for 2 hours in 0.9% chloride solution at room temperature. Thereafter, the DBG is exposed for 10 minutes to ultrasound at frequency 44±4.4 kHz and vibrational amplitude 30 to 50 mcm in 0.9% sodium chloride solution heated to 36°C.
EFFECT: method enables accelerating the repair processes in grafting a fragment of the demineralised bone graft of the pre-set shape in experimental animals and increasing substantially post-grafting osteogenesis rate in a segment of a skull flat bone.
SUBSTANCE: invention refers to medicine, namely to prevention of purulent-septic inflammatory complications in obstetric patients of a high infectious risk group. A device comprises an ultrasonic generator with a monitor control, a piezoceramic radiator with a terminal wave guide and an intravenous medication system with a control valve, a pivotally connected system of equally spaced support nuts, supplementary ultrasonic generators with monitor controls and piezoceramic radiators built into the nuts; with a quantity of the piezoceramic radiators matching a quantity of the nuts laid on a spacer, a programmed microcontroller and an indication panel. The piezoceramic radiators are fixed on the support nuts of the pivotally connected systems, flow through spacer holes and are connected to outputs of the respective ultrasonic generators the monitor controls of which are connected to matched outputs of the programmed microcontroller which are simultaneously connected to matched inputs of the indication pane and the control valve of the intravenous medication system.
EFFECT: providing individual spatial characteristic of the effect and higher reliability.
3 cl, 2 dwg
SUBSTANCE: invention refers to medical equipment, namely to ultrasound therapeutic apparatuses. An ultrasonic transducer contains at least one ultrasonic radiating element with ultrasonic wave front sets radiated by the element representing spherical surfaces of the same radius, while the ultrasonic radiating element performs a function of ultrasound reflection and forms a spherical resonant cavity. If using more than one ultrasonic radiating element, they are configured to form a combined spherical resonant cavity. An internal space of the spherical resonant cavity is shaped as a full spherical envelope or a truncated spherical envelope with a sphere centre inside, while the ultrasonic waves generated by at least one ultrasonic radiating element are focused in the area which comprises the sphere centre of the spherical resonant cavity.
EFFECT: using the invention provides an ultrasonic focus energy gain, as well as eliminated working frequency influence of an ultrasonic source.
15 cl, 11 dwg
SUBSTANCE: vivification of the tympanic membrane perforation and an inspected tympanoplasty are performed. Where it might be necessary, the tympanic cavities are sanitated, and an ossiculoplasty is performed. That is followed by myringoplasty using the autologous conchal cartilage. A rounded segment of the autologous cartilage 10-11 mm in diameter is cut out with preserving the perichondrium covering it from both sides. From one side the perichondrium is removed and left from the other side. The autologous cartilage kept attached to the perichondrium is put into a horseshoe shape 1.5-2 mm wide. A superoinferior size of the formed cartilage portion is greater than that of the bone ring. The mucous membrane of the inner surface of the rest tympanic membrane and walls of the anterior bone ring is separated, displaced from the fibrous ring. A bed is formed for the transplant. The formed transplant is placed into the bed with its perichondrium to the outside, and a convex side of the cartilage horseshoe to the anterior bone ring. The perichondral portion from its inside is placed on the handle of the hammer and on a posterior wall of the external acoustic meatus and covered with the meatotympanic flap which is coated with latex strips. The external acoustic meatus is packed.
EFFECT: method provides the reliable fixation of the transplant within the anterior portions by the size and shape of the cartilage component that prevents lateralisation of the neotympanic membrane, transplant retraction in the anterior tympanic ring.
2 dwg, 2 ex
SUBSTANCE: trephine cavity is inspected, an implant FMT-coil is installed on the round window membrane, and a connecting cable is fixed. Two bone slots are formed. The first slot is formed at a posterior border of the mastoid segment of the trephine cavity, and the second slot - above the intersection of the facial nerve canal. The connecting cable is fixed to the bone walls of the slots by filling the latter with glass-ionomer cement. Open areas of the connecting cable are covered with autocartilage plates.
EFFECT: improving the clinical-morphological effect in the patients suffered the ear ablation by installing the implant coil in the tightest contact to the round window membrane, preventing the implant FMT-coil migration and reliable fixation of the connecting cable.
6 dwg, 2 ex
SUBSTANCE: invention refers to medicine. A device comprises an elongated cannula having the first end and the second end, and an elongated element made of a foam material and having a distal end and a proximal end. A portion of the elongated element made of the foam material is compressed inside the cannula. The distal end is not compressed and freely projects beyond the first end. The proximal end is not compressed and freely projects beyond the second end. The distal end projects beyond the elongated cannula at a lesser length as compared to the proximal end that ensures the absorption process towards the distal end. When a fluid flow is absorbed from the distal end into the proximal end, the proximal end expands.
EFFECT: providing the silent exudate removal from the middle ear.
12 cl, 9 dwg
SUBSTANCE: invention refers to medicine, namely to otorhinolaryngology, otosurgery. A mastoid segment of a trephine cavity is inspected and de-epidermised, and bone walls are polished. A back wall of an external acoustic meatus is repaired with Alloplant costal cartilage placed into formed spur grooves. A mastoid process cavity is filled rectangular fragments of Alloplant costal cartilage. That is combined with the tympanoplasty.
EFFECT: method enables eliminating the trephine cavity completely, repairing the natural architectonics of the external acoustic meatus, its resonant characteristics, restoring the eardrum integrity, recreating the air eardrum limited from the ambient medium, as well as eliminating the additional surgical injury accompanying an autograft sampling.
8 dwg, 1 ex
SUBSTANCE: invention refers to medicine, namely otorhinolaryngology. The tympanic cavity deepening in the patients underwent radical middle ear surgery is ensured by intrameatal separation of the ear tract and the mastoidal skin, and the residual tympanic membrane. One or two cartilage plates are laid under the created meatotympanic flap from the patient's ear concha onto the bone wall of a horizontal plate of an intersection-supported facial canal.
EFFECT: developed method for lying one or two autocartilage plates provides the neotympanic cavity volume by increasing its height and preventing cicatrisation between the neotympanic membrane and the medial wall of the tympanic cavity that has an effect on the functional effect of reconstructive surgeries.
SUBSTANCE: audiometry is performed; an acoustic frequency-response characteristic is evaluated, and a frequency range of residual perceptive hearing sensitivity is recovered. A base of visual images sounded by respective reference voice signals is formed. A visual image is selected in the data base; its image and its letter symbol are represented and simultaneously sounded. Before supplied to the patient, the respective reference voice signal is transformed by translating its spectrum into the frequency range of the patient's residual perceptive hearing sensitivity and supplied to the acoustic organs. The patient's responses are analysed by comparing the signal from the patient after representing the reference voice signal with the respective reference voice signal; a coincidence rate to be visually presented in the form of a numerical correlation showing the patient's correct pronunciation is assessed. The method is implemented by using a device comprising a microphone, an electronic circuit board and headphones. The electronic circuit board is designed to form the data base to store the tutorial images and audio files, displaying the tutorial images, and provided with a computer input connector.
EFFECT: invention enables reducing the length of audio-verbal rehabilitation that is ensured by forming noise-immune and invariant voice signal identification, objective assessment of the patient's ability to percept speech in the process of rehabilitation.
18 cl, 4 dwg
SUBSTANCE: tympanic shunt consists of a vent pipe with two flanges on opposite ends with the vent pipe and the flanges diameters related as 0.6÷0.7. The shunt is provided with a slot valve on one of the flanges. The valve provides the efflux of liquid in the tympanic cavity and eliminates its penetration from the outside.
EFFECT: device provides more effective surgical management in patients with an acoustic tube dysfunction by reliable fixation of the tympanic shunt in the tympanic cavity; it arranges the efflux of liquid from the tympanic cavity in a combination with preventing its penetration into the tympanic cavity from the outside.
4 cl, 2 dwg
SUBSTANCE: retention element comprises a wall and an interior space, wherein at least two thin plates directed into the interior space are placed on the wall. The above at least two thin plates face oppositely in the interior space, and the above at least two thin plates are configured so that to overlap each other axially.
EFFECT: creating the auricular suppository with the retention element that prevents the further migration of condensation water and potential bleeding of wax, and that provides an air permeability of the retention element even in case of greater amounts of condensation water and wax.
14 cl, 5 dwg
SUBSTANCE: invention refers to medicine, namely to otorhinolaryngology, and can find application in radical middle ear surgery. The method consists in separating an epidermal lining of a tympanic region of the trephine cavity which extends from an intersection, a facial canal, labyrinth windows, while exposing a stapes footplate and a cochlear window. An autograft is placed on a prepared bed whereon an implant bobbin is placed and fixed. Then, the implant bed is prepared. The implant is placed and fixed. The separating procedure covers an additional region from a medial wall to an auditory tube, and also within an anterior bone ring. The epidermis surrounding a tympanic opening of the auditory tube is removed circumferentially by 3-5 mm. The implant ribbon is fixed on a promontory with delimitation of the tympanic opening of the auditory tube from the trephine cavity.
EFFECT: using the given invention enables improving the clinical-morphological effect of the reparative middle ear surgery due to the closure of the tympanic opening of the auditory tube.
1 dwg, 1 ex
SUBSTANCE: invention relates to field of medicine, namely to otolaryngology and neurology and can be applied in treatment of patients with benign paroxysmal positional dizziness with injury of front semicircular duct. Method includes carrying out the following positional manoeuvre: from sitting position patient is laid on back with fast movement, throwing their head 30 degrees back, and holding patient in this position until manifesting vertical rotary nystagmus and dizziness stop. After that, patient's head is bent 60 degrees frontward and, not less than after a minute after appearance of rotary nystagmus, patient is sat back into the initial position.
EFFECT: method makes it possible to increase treatment efficiency, reduce risk of recurrence and reduce treatment terms.
1 cl, 2 ex
FIELD: medicine, otolaryngology.
SUBSTANCE: the present innovation deals with introducing neomycin sulfate antibiotic in granules prepared by the following technique. Tablet of neomycin sulfate 1.0g should be put into a vial with 100 ml distilled water till tablet's decomposition. Then vial's content should be shaken and kept till suspension sedimentation. In a day one should take 1 ml of supernatant liquid to be put into another vial and diluted with distilled water at 1:100 ratio. This procedure should be repeated 4 times more, moreover, during the last procedure one should apply alcohol for dilution. Then one should transfer the drop of alcoholic solution into a vial with granules out of milk sugar to then shaken and kept open for 1 d till granules" drying up. The suggested preparation should be applied per 1 granule under the tongue, moreover, multiplicity and duration of the above-suggested intake should be matched individually by patient's sensitivity and obtaining the clinic effect. The method enables to improve the value of tonic threshold audiometry by about 30-50 dB, decrease perception threshold of vocal range frequencies and widen the range towards high frequencies.
EFFECT: higher efficiency of therapy.