Subject of the inquiry: 298 patients with finn deformations of the larynx and trachea
Aim of the inquiry: early rehabilitation of patients with firm deformations of the larynx and trachea path optimization and creating clinical and pathogenic methods of complex treatment.
Methods of the inquiry: clinical examination, special examination: LOR-examination, endoscopy of air ways, X-ray, CT, MRI of larynx, trachea and bronchus, bacterial examination of larynx and trachea wounds; morphological examination, biochemical methods of examination: lipid peroxidation, antioxidant enzymes, activity of hepatic monooxygenase system (MOS); biophysical methods of examination: исследование electric damage of erythrocytes’ membrane (EDEM), blood viscosity (BV) and blood shift velocity (BSV); cytological examination.
The results achieved and their novelty: In patients with firm deformations of the larynx and trachea, firstly basing on complex investigation clinical and structural-functional parameters revealed pathomorphological changes in neck tissues as chronic inflammation with productive component. Despite, revealed disrupt balance of process lipid peroxidation and antioxidant system, hydroxylic function of liver, decrease of electoral penetrability of erythrocytes’ membrane and aggravate of hemorheology. With this, level of expression of changes depends on clinic form and load disease, correlate with stage of wound healing and after restore of functions of the larynx and trachea gradually becoming normal. Presented classification of the firm deformations of the larynx and trachea, permitting complexly counting etiologic factor and morphological variant of the damage of laryngotracheal tract. In scheme of the pathogenic complex conservative therapy before and after reconstructive operations included medicine, influencing on Hemodynamic, with ability membranotrope action, systemic enzymotherapy, immunostimulators, and correction of the tissue metabolism by laser. Created private and modified methods of reconstructive laryngotracheoplasty in case of cicatricle stenosis of glottic and subglottic parts, bilateral paralyses of the larynx, cicatricle deformations of pharyngolarynx, combination deformations and defects of the larynx and trachea, permitting single stage restore laryngotracheal ways.
Practical value: The investigation of pathogenic mechanism of developing of the firm deformations of the larynx and trachea on data of changes of main functional and metabolic processes will permit not only activating and improving of pathogenic therapy, and forecasting variant of development and course of postoperative period after reconstructive operations.
Use of proposed methods of complex conservative and surgical treatment of the firm deformations of the larynx and trachea allowed to provide whole volume of restoring means in more short time and with less quantity of stage operations, preoperative preparing till 3 days, hospital stay till 14-20 days, surgical operations in 1.9 time.
Degree of embed and economical effectivity: The results of investigation intruded in treatment practice of the First and Second Tashkent Medical Institutes, LOR-clinics of Samarqand territorial children hospital, territorial hospital of Karshi. Materials of the investigation using in study process of LOR - cathedra First Tashkent Medical Institutes during lectures and practice tutorials with students, magistracies, and clinic ordinators. Determined main economic effect in use of proposed complex therapy in connection with reduce of term of treatment and hospital stay (on an average 10 days) and taking off or decreased disability on 67% patients.
Sphere of usage: otorhinolaryngology, surgery, reanimation
По современным рекомендациям разных международных онкологических обществ тактика лечения, т.е. выбор метода лечения на первом этапе рака гортани (РГ) существенно изменилась.
Заболевания гортани, приводящие к нарушению голосовой функции, у детей, занимают по частоте второе место (20,3%) в структуре хронической патологии ЛОР - органов. Актуальность данной проблемы объясняется распространенностью, возрастанием частоты и переходом функциональных дисфоний в органическую дисфонию. При дальнейшем развитии ребенка, стойкое расстройство голосовой функции может приводить к ухудшению качества жизни, ограничению межличностных отношений, затруднению процесса социальной адаптации, что негативно отражается на общем развитии, нервно психическом состоянии и формировании личности ребенка. Тревожные, депрессивные расстройства могут способствовать развитию функциональной дисфоний. Значительную роль в возникновении функциональных дисфоний играют гормональные расстройства - чаще заболевания щитовидной железы. Другие причины - неврологические заболевания, такие, как болезнь Паркинсона и миастения, черепно-мозговая травма, нарушение мозгового кровообращения и др. Функциональные изменения обратимы, но в ряде случаев могут приводить к органическим изменениям гортани. Большинство исследователей связывают их с перенапряжением голоса.