| Popis: |
The urgency of improving the effectiveness of dacryocystitis treatment is determined by: their stable proportion among eye diseases, a high percentage of post−traumatic, iatrogenic and chronic forms, ability to be a source of dangerous complications and social significance. Existing anatomical and physiological relations and values of rhinogenic factors determine the involvement of otolaryngologists in dacryocystitis treatment. In order to determine the characteristics of the contingent of patients with dacryocystitis, structure of rhinogenic factors, methods of examination, surgical treatment and principles of postoperative management of patients, a study was conducted with 107 patients with chronic disease. The clinical effectiveness in diagnosis and planning of surgical intervention of the combination of endonasal optical rhinoscopy, probing and contrast of the nasolacrimal pathway with triombrast with subsequent radiological and (or) CT examination was determined. It is shown that the correction of endonasal structures should be performed simultaneously with dacryocystorhinostomy. The efficiency of the classical West−Bokstein surgery has been determined, the necessity of an individual approach to its planning has been shown. The main tasks of each stage of the surgery, which significantly affect its outcome, are established. When performed correctly, the effectiveness of "plastic" and "simple" rhinostomy, management of patients with and without stenting is almost the same. It has been proven that the use of radio wave and shaver techniques can greatly simplify the stages of the surgery and improve healing. Based on the obtained results, a conclusion was made about the expediency of involving an otolaryngologist in the consultation of patients with chronic dacryocystitis in each case. The criterion for choosing treatment tactics in favor of endonasal endoscopic dacryocystorhinostomy is the presence of rhinogenic factors of dacryocystitis. Key words: dacryocystitis, endonasal endoscopic dacryocystorhinostomy, rhinogenic factors, stenting, surgical treatment, epiphora, lacrimation. |
