[Prospects for the use of autofluorescence endoscopy in rhinosurgery]. / Perspektivy primeneniya autofluorestsentnoi endoskopii v rinokhirurgii.

The condition of blood supply and microcirculation in the mucous membrane is considered to be the main factor determining the consistency of local flaps of the nasal mucous membrane. OBJECTIVE: To assess the possibility of using autofluorescence endoscopy to control the condition of flaps of the nasal mucous membrane after surgical interventions. MATERIAL AND METHODS: The assessment of the processes of biological destruction of 15 fragments of the mucous membrane of the inferior nasal concha, obtained during intranasal interventions with endoscopic technique in autofluorescence mode, followed by histological examination at different periods of observation, has been conducted. The results of the proposed method were tested in 84 patients with chronic and intraoperative defects of the nasal septum after the surgical intervention. RESULTS: It has been shown that autofluorescence endoscopy can be used to assess the viability of flaps of the nasal cavity's mucous membrane. A change of the autofluorescence signal to a whitish and orange shades indicates the presence of ischemia and necrosis. Method sensitivity was 92.3%, specificity was 95.8% and total accuracy was 95.4%. CONCLUSION: This method is promising for predicting the long-term outcomes of surgical treatment of the nasal septum's perforation in relation to the risk of reperforation forming, as well as for assessment of the functional viability of local flaps in plastic reconstruction of defects of the anterior skull base.

[The efficacy of medical care following modified rhinosurgical interventions].

The objective of the present study was to evaluate the efficacy of medical aid after modified rhinosurgical interventions with the use of the methods for the objective assessment of the normalization of the nasal function and the patients' quality of life during the treatment. A total of 38 patients presenting with deviation of the nasal septum and persistent disturbances of the nasal breathing were examined and treated to estimate the quality of the medical aid following modified rhinosurgical interventions. The study has demonstrated the high quality of medical care for the patients undergoing modified rhinosurgical interventions which is the leading criterion for the treatment of the subjects suffering diseases of the nasal cavity.

[Local ocular immunity parameters in chronic rhino- or odontogenic infection].

Thirty-four patients with foci of chronic rhino- or odontogenic infection were examined. All the patients underwent physical examination, biochemical blood analysis, immunological test for immunoglobulins A, G, and M, circulating immune complexes, leukocyte migration inhibition test with phytohemagglutinin, Con A, with antigens of the retina, vitreous body, iris, and lens, scrapes from the dentogingival pocket, conjunctival and nasal cavities for Chlamydia, followed by direct immunofluorescence, polymerase chain reaction, and culture. Chronic rhino- or odontogenic infection foci impair local ocular immunity in ophthalmologically healthy patients. The foci of chronic rhinogenic infection cause more pronounced changes in systemic and local ocular immunity than those of chronic odontogenic infection. In half the patients with chronic rhino- or odontogenic infection foci, Chlamydia are detectable in the oral, nasal, and ocular mucosae, which suggests that there is generalized infection and there is a need for complex sanitation of the body. Isolated local treatment for Chlamydia infection is not promising.