Biomedical subjects
Publications and source records attributed to G Z Piskunov.
In small anastomoses of the paranasal sinuses blocking in inflammation we observe acute pyo-exudative inflammation; in large anastomoses--chronic productive form with development of the cysts and polyps. By the authors' experience, 8-10% of the population have no maxillary anastomosis in the crescentic fissure. It locates in the posterior part of its medial wall.
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Laser coagulation of concha nasalis inferior is essentially atraumatic, bloodless, sterile and causes no edema. The specific effect of a laser beam on microcirculation suggests that laser surgery can be viewed as a pathogenetic method of therapy of vasomotor rhinitis. Laser coagulation of concha nasalis inferior was performed in 74 patients, 42 of which were older than 50 years. The elderly patients suffered from other diseases, e.g. ischemic heart disease or cardiopulmonary pathology, which excluded contact surgery intervention. Laser therapy was well tolerated by all the patients. Good results were recorded in 80% of patients without concomitant sinusitis and in 66.6% of patients with concomitant sinusitis.
The 5-year experience gained in the ENT hospital of the Kursk Medical Institute and the ENT department of the Central Hospital of the USSR Ministry of Health proved effective the use of polymer-based drugs in chemotherapy of acute and chronic maxillary sinusitis. The drugs carried by polymers were introduced into the maxillary sinus by puncture or drainage. As a rule, these are antibiotics or the latter in combination with hormones and enzymes. Drugs with addition of polymers can be produced in any pharmacy.
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The analysis of complications consequent to 200 endoscopic intranasal operations (computed tomography was performed preoperatively in 96 and was not performed in 104 patients) has shown that the incidence of serious complications in both groups was minimal and that of such complications as eyelid hematoma, neuralgia and hemorrhage was similar. Complication-safe operative procedure is described. It is believed that the absence of computed tomograms should not cause the change of functional intranasal surgery for radical surgery by external approach or common polypectomy.
Microdebrider "Hummer" was used for functional endoscopic sinus surgery (FESS) in 66 patients. Extent of the surgery varied from partial resection of middle turbinate to ethmoidectomy and opening of all sinuses. "Hummer" is the best device for accurate removal of polypoid and hypertrophic tissue from the middle turbinate, posterior end of the inferior turbinate and the nasal septum. Use of "Hummer" makes opening of maxillary and sphenoid sinuses and revision of the frontal and sphenoethmoidal recess much easier and safer. No complications occurred in this group of patients. Further studies are needed to answer the question whether or not use of microdebrider can improve distant results of FESS.