[Esophageal injuries caused by foreign bodies or instruments].
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Biomedical subjects
Publications and source records attributed to V M Bobrov.
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A total of 2,690 patients with paratonsillitis (PT) including 83 (3.08%) ones with PT complicated by parapharyngitis were treated from 1984-2002. At admission, all the patients were punctured, the paratonsillar abscess was opened. Abscess tonsillectomy was made in 82 patients. Four patients developed flegmon of the neck. Besides abscess tonsillectomy, opening and drainage of cervical flegmon were conducted in these patients. Two patients died of mediastinitis. Thus, success of treatment of acute parapharyngitis depends on early diagnosis, especially at prehospital stage, detailed examination in ENT department, early and adequate surgical intervention and combined conservative treatment. It is recommended to measure the content of middle mass molecules during the treatment of pyoinflammatory, septic conditions in otorhinolaryngological practice.
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The analysis of urgent treatment of frontal sinus inflammation from 1985 to 1999 and 6 months of 2000 made in ENT clinic of Izhevsk shows advantages of conservative therapy (trepanation puncture and frontal sinus probing) in diagnosis and treatment of frontal sinus inflammation. Literature data on safety of such manipulations is confirmed.
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Of 40 patients admitted to the ENT clinic in 1984-1998 (age 18-77 years) with cicatrical esophagostenosis, 34 entered with acid or alkaline burn resulting in esophagostenosis of degree III or IV. Bouginage was a prevalent treatment. Bouginage of the lower third of the stenotic esophagus along 8-12 cm was made according to an original technique of orthograde double bouginage by two different bougies. The bouginage was successful in 8 patients with life-threatening cicatrical esophagostenosis in the lower third, with tubular stricture along two-three segments and obstruction of the degree III and IV.
Middle-mass molecules (MMM) were measured in ENT patients hospitalized urgently for purulent sinusitis with orbital complications, mastoiditis, parapharyngitis, paratonsillar abscesses, complicated furuncles of the nose and upper lip, abscessing epiglottitis, etc. MMM amount, as an indicator of endogenic intoxication, were studied in 150 ENT patients aged 15 to 63 years. With the number of MMM it was found feasible to follow up and compare endogenic intoxication and thus control and correct of the treatment efficacy.
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A total of 63 cases of exudative frontitis were treated using probing and draining in an ENT department of a hospital from 1986 to 1998. 40 patients were males, 23 were females. The age ranged from 15 to 79 years. 43 patients had acute frontitis, 20 patients suffered of chronic frontitis. Probing and draining of the sinus was made with application of standard cannulas. Probing was unsuccessful in 8 patients. Later, they have undergone radical surgery on the frontal sinuses or trephine puncture (2 and 6 patients, respectively). 23 patients who discharged pus and mucus after the initial probing of the frontal sinus were drained for some time with polyethelene catheter having the fixing device. Probing and draining of the frontal sinuses with subsequent introduction of medicines should be applied in all cases of purulent otitis. Only if no effect is reached, surgical intervention is justified.
16 cases of rhinoliths were registered in the ENT clinic for 12 years. The patients were aged 12 to 63 years (4 males and 12 females). Solitary rhinoliths occurred in 14, multiple ones in 2 patients. Four groups of rhinoliths are distinguished basing on the time of the rhinolith occurrence in the nose after occasional introduction of the foreign body, rhinolith weight, size, negative effects on the adjacent tissues and organs.
21 cases of congenital parotid fistula are reported. The patients' age ranged from 7 to 50 years. Dissection of the fistula under local anesthesia was made in 9 patients. A 7-year-old patient was operated under intravenous calipsol anesthesia. Four kinds of the fistula depending on its shape and size are described. Two of them cause no trouble, the other two manifest from early childhood with inflammation, recurrences with abscesses. In such cases the fistula should be radically removed.
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The authors report 6 cases of life threatening hemorrhage which occurred in 1985-1995. The cases were characterized by massive recurrent bleeding resistant to standard conservative methods of stopping. In a posttonsillectomy patient bleeding from the tonsillar niche and in two patients nasal bleeding because of trauma or tumor were stopped only after ligation of the external carotid artery. Arrosive bleeding from the internal jugular vein in a patient after opening of a deep tonsillogenic neck flegmon was stopped by ligation of the jugular vein along the length of the wound. Bleeding after opening of a paratonsillar abscess was stopped after abscess tonsillectomy. Bleeding from tracheostoma was stopped only after suturing of the vessel in the wound. All the 6 patients were discharged in a satisfactory condition.