The functional state of the nasal mucosa in patients under mechanical ventilation for severe mixed craniofacial injury

Introduction. In recent years, injuries ranked fourth among the main causes of death of the population after diseases of the cardiovascular system, malignant neoplasms and infectious diseases. The clinical course of associated injuries, as a rule, is characterized by a high number of complications, much more than in isolated injuries.Objective. Explore approaches to improving otorynolaryngological tactics from the standpoint of normalizing the functional state of the nasal mucosa, as well as increasing the effectiveness of treatment of patients with severe concomitant trauma on prolonged mechanical ventilation.Materials and methods. In the process of studying the problem of impaired mucociliary clearance of the nasal mucosa, the functional state of the mucous membrane in patients with severe concomitant head trauma undergoing prolonged artificial lung ventilation was analyzed. We studied the state of one of the most important mechanisms of sanitation and local protection of the respiratory tract - mucociliary clearance, which provides the necessary potential for barrier, cleansing and immune functions. A study was made of the thermal effect of the nasal cavity, pH + of the mucous membrane, the study of the frequency of beating of the cilia of the ciliated epithelium and the rate of mucociliary transportResults and discussion. The results of the study showed that the problem of post-traumatic and nosocomial sinusitis in patients with severe concomitant head trauma must be resolved as soon as possible, with the involvement of modern diagnostic and treatment methods, including the proposed method of artificial ventilation of the nose. The severity of the patient's condition, the severity of the injuries received excludes the use of advanced methods of surgical, otorhinolaryngological treatment.Conclusion. 12:30 PMThe use of minimally invasive methods of treatment, precision technical execution, including under endovideo control, polysinusotomy made it possible not to burden the condition of the victims and exclude iatrogenic damage that could entail irreversible changes in the body and condition of the victim.

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Allografts for surgery in the closure of nasal septal intraoperative defects

Aspirantskiy Vestnik Povolzhiya ◽

10.17816/2072-2354.2020.20.1.44-48 ◽

2020 ◽

Vol 20 (1-2) ◽

pp. 37-43

Author(s):

Mariia A. Shelikhovskaia ◽

Fedor A. Syroezhkin ◽

Vasily P. Tipikin ◽

Ksenia V. Vinichenko ◽

Alexandra V. Kulish ◽

...

Keyword(s):

Mucous Membrane ◽

Nasal Mucosa ◽

Functional State ◽

Functional Activity ◽

Nasal Septum ◽

Surgical Correction ◽

Surgical Interventions ◽

Anti Inflammatory ◽

One Year ◽

Inflammatory Effect

Surgical correction of the deviation of nasal septum is the most frequently performed surgical interventions in Otorhinolaryngology departments. Sometimes such operations can be complicated by an intraoperative defect in the nasal septum, which is not always possible to close with autogenous tissue. Thats why it has become important to use new allogenic transplant materials in the treatment of these defects. The purpose of the study was to evaluate the effectiveness of allografts (allogeneic fascia and allogenic cartilage treated by Alloplant technology) in closure of intraoperative defects of the nasal septum. The treatment was performed to 40 patients aged 2455 who developed defect of the mucous membrane of the nasal septum during the operation for nasal spetum deviation. Patients were randomly divided into two groups of 20 people. The 1st group included patients whose allogenic transplantat materials were used in addition to their own tissues during the closure of the defect. The 2nd group consisted of patients whose autogenous tissues were used during the operation. The data of functional state of the nasal mucosa and the anatomical integrity of the nasal septum of all patients before treatment, one month and one year after the treatment were checked and compared. It was revealed that allografts (allogenic fascia and allogenic cartilage treated by Alloplant technology) demonstrated an anti-inflammatory effect, and their use in closing of intraoperative defects of the nasal septum is more effective. This procedure also accelerates improvement of the functional activity of the nasal mucosa in comparison with the use of autogenous tissues solely.

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