The objective of this review is to summarize and systematize the data concerning the modern laser and laser-based systems, their characteristics, and possible applications in various spheres of medicine including otorhinolaryngology. The application of laser technologies in medical practice gains ever increasing popularity. Lasers have been successfully used during a long period for the diagnostic and therapeutic purposes. At present, they are just as actively applied in different fields of the surgical practice. Otorhinolaryngology makes the most extensive use of neodymium, CO2, and holmium lasers. The latter has the most universal characteristics and is operated in a relatively short wavelength range (λ=2.01 mcm); moreover, its radiation penetrates as deep as 0.4 mm into the biological tissues. In other words, the holmium laser not only combines the advantages of the CO2 and neodymium lasers but is also devoid of their shortcomings. The holmium laser is considered to be the most promising source of laser radiation for the application in otorhinolaryngological surgery with a potential encompassing the most wide spectrum of surgical manipulations needed to treat pathological changes in the ears, nose, and throat. The application of this instrument in medical practice opens up new prospects for the development of otorhinolaryngology.
The objective of the present work was to study syntopy of the large neck vessels in relation to the capsule of palatine tonsils with the use of the MRI technology. A total of 109 patients (218 palatine tonsils) presenting with chronic tonsillitis were available for the examination including 64 women and 45 men at the age varying from 15 to 54 years. All of them underwent MRI-guided vascular visualization in the paratonsillar region together with the measurements of the vessels extending to the capsule of the palatine tonsils at the level of the upper and lower poles, and also close to the mid-third of each palatine tonsil. The distance from the external carotid artery to the upper and lower poles of the palatine tonsils was found to be 17.1±1.01 mm and 10.3±0.18 mm respectively and in the mid-third the palatine tonsil 10.7±0.12 mm; the distance from the internal carotid artery to the upper and low poles of the palatine tonsil amounted to 14.5±0.84 mm and 16.8±0.77 mm respectively while that to the mid-third of the palatine tonsil was 15.3±0.07 mm. The branches of the external carotid artery feeding the palatine tonsils are the most frequent sources of bleedings; the following measurements were obtained: the maxillary artery 16.4±0.43 mm (17.4%) - the upper pole 9.6±0.02 mm (46.2%), the mid-third of the palatine tonsil 18.5±0.74 mm (29.5%) - the lower pole; the lingual artery 4.7±0.02 mm (6.8%) - the mid-third of the palatine tonsil, 6.2±0.82 mm (56.8%) - the lower pole; facial artery: 4.2±0.01 mm (0.76%) - the mid-third of the palatine tonsil; the occipital artery 25.6±0.12 mm (19%) - the upper pole; 14.8±0.11 mm (18.9%) - the mid-third of the palatine tonsil 9.56±0.12 mm (3.8%) - the lower pole; the tonsillar artery 1.88±0.01 mm (9.8%) - the upper pole; 2.51±0.01 mm (23%) - the mid-third of the palatine tonsil; 2.12±0.01 mm (11%) - the lower pole. The distance from the internal jugular vein to the capsule of the palatine tonsils in the region of the upper pole of the palatine tonsil was 28.3±1.01 mm, in the lower pole region 26.6±1.54 mm, and in the region of the mid-third of the palatine tonsil 22.7±1.24 mm. It is concluded that the results of the present study may be useful for the planning of the surgical strategy for the treatment of the patients presenting with chronic tonsillitis and for the prevention of hemorrhagic complications of tonsillectomy.
The objective of the present study was to evaluate the effectiveness of the administration of a medication into the middle ear structures during catheterization of the acoustic tube (AT) in the course of the contrast-enhanced X-ray salpingographic investigation. The study included 18 patients (18 ears) presenting with chronic otitis media and the perforated tympanic membrane without the disturbances of the ventilation function of the auditory tube. All the patients were allocated to two groups depending on the type of the Eustachian catheters being used. Group 1 was comprised of 9 patients treated with the use of traditional Giyot's catheter, group 2 was composed of another nine patients who were treated with the use of the Eustachian catheters having an original shape with a specific configuration of its distal part. The X-ray studies were carried out before and after catheterization of the acoustic tube with the administration of 1 ml of the hypaque contrast medium. The study has demonstrated that the X-ray contrast agent did not penetrate into the inner structures of the middle ear of the patients comprising group 1 whereas in the patients of the second group the contrast medium reached as far as the bony portion of the acoustic tube.
The authors carried out a detailed analysis of various methods of physical exposure to tissues during surgical treatment of patients with chronic tonsillitis. Removal of palatal tonsils in their chronic inflammation has been carried out since ancient times. Today modern medical technologies allow performing this intervention using various technologies, whether – classic „cold“ tools or one of the variants of „hot“ methods of tonsillectomy. In the article, the authors analyzed the advantages and disadvantages of semi-surgical treatments for chronic tonsillitis, when most of the palatal tonsil remains intact, and also compared the effectiveness of possible surgical methods of radical tonsillectomy: using an electrocoagulator, harmonic or ultrasonic scalpel, surgical laser or cold plasma; frequency of intra- and postoperative hemorrhagic complications is estimated.
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