Algorithm of adenoiditis treatment in adults, depending on the pharyngeal tonsil hypertrophy stage.

OBJECTIVE: Introduction: Implementation of the endoscopic technologies while the upper airways diseases gave opportunity to diagnose the adenoid vegetation in adults. The aim: Тo offer effective algorithm of curing adults for adenoiditis, depending on the degree of pharyngeal tonsil hypertrophy. PATIENTS AND METHODS: Materials and methods: 43 patients aged 18 - 55 with hypertrophy of pharyngeal tonsil were examined. Depending on the degree of hypertrophy three clinical groups of patients was created: the first one receiving only conservative treatment, the second one receiving conservative therapy and radiowaveradiation coagulation with the apparatus "SURGITRON" and the third one receiving the endoscopic shave adenotomy. Statistical processing of the received data was made in the programs «Exсel¼ and «STATISTICA 6.0¼. Data rows were checked for the normality with the help of Shapiro-Wilk statistical criteria (small sample) and Kolmohorov-Smirnov (large sample). Checking of the dispersion uniformity was done by Leneva criteria. During the comparison of the rows criteria of Student and Wilkokson for the non-paired, Kolmogorov-Smirnov were used. RESULTS: Results: During the re-examination of patients who received only conservative therapy treatment in a month endoscopic signs adenoiditis were distinguished and a year later percentage of relapse was higher than in patients with complex treatment. After shave adenotomy adenoiditis recurrence was not observed. CONCLUSION: Conclusions: While treatment of the patients with the pharyngeal tonsil hypertrophy of the 1 and 2 degree conservative therapy is possible. Addition into the scheme of conservative treatment RWCAV actually reduces quantity of adenoiditis recurrence and allows fast recovery. Treatment of patients with the pharyngeal tonsil hypertrophy of 3 degree, in context of contraindication absence requires surgical treatment (adenotomy) in 100% of cases.

[Radio-wave surgery in the treatment of dacryocystitis]. / Radiovolnovaia khirurgiia v lechenii dakriotsistita.

By improving the existing surgical technologies for dacryocystitis, one enhances the effectiveness of patient rehabilitation. AIM: To evaluate the effectiveness of radio-wave surgery in the treatment of dacryocystitis and lacrimal sac abscesses. MATERIAL AND METHODS: The clinical group consisted of 207 patients ranging in age from 7 to 89 years (the mean age of 41±7.3 years). For 39% of patients this was a repeated treatment, while 9.3% had undergone 4-5 surgical interventions. The following types of surgical interventions were performed: dacryocystorhinostomy with external approach and lacrimal stent placement - 128, dacryocystectomy for stenosing dacryocystitis with lacrimal stent placement - 21, dacryocystectomy without lacrimal stent placement in somatically complicated patients after repeated dissection of the abscess who developed fistula and granulation - 23, and lacrimal sac abscess drainage - 35. In all patients, the treatment involved high-frequency radio-wave surgery (3.8 to 4 MHz). The article contains a detailed description of the four types of interventions and provides an explanation of the choice of electrode, mode and power level. RESULTS: Positive changes were observed in all cases of chronic dacryocystitis and lacrimal sac abscess. The patency of the lacrimal system, including canalicular and nasolacrimal tests, was assessed 6 months after dacryocystorhinostomy. The results were judged positive in all cases despite slowed dye evacuation in 11 cases. The severity of epiphora (Munk scores) decreased from 3.45±0.7 at baseline to 1.0±0.7 (p<0.05). In 5 dacryocystorhinostomy patients the stoma occluded. CONCLUSION: Positive characteristics of radio-wave surgery help increase the effectiveness of surgical treatment of dacryocystitis, improve surgical performance, reduce duration of the procedure and postoperative care, reduce the number of complications, and achieve a better cosmetic effect.

Outcomes of Treatment of Eyelids and Third Eyelid Tumours in Dogs Using High-Frequency Radiowave Surgery.

In human ophthalmology, the benefits of using high-frequency radiowave (HFR) electrocautery for surgical procedures were demonstrated and include effective haemostasis, shorter surgery times, and rapid recovery. In canine eyelid surgery, intraoperative bleeding is a common feature that may obscure the surgical field view and lead to the increased swelling of adjacent tissues, bruising, and pain. To evaluate the efficacy and benefits of HFR electrocautery in canine eyelid and third eyelid surgery, the medical records of 48 surgical excisions of eyelid tumours (involving up to one-third of the eyelid length) and 4 third eyelid excisions were reviewed. The information was collected including the breed, age, clinical signs, HFR power setting and mode of the surgical unit, electrode used for the surgery, intraoperative complications, histopathological diagnosis, and postoperative outcomes. Surgical techniques were performed using the Surgitron Dual 3.8 MHz Frequency RF device (Ellman International, Oceanside, NY, USA). Intraoperative bleeding was recorded as absent or very mild, and the surgical procedures were very fast. No complications occurred during the procedures. Healing within 10 days was observed in all the dogs. No tumour recurrences were recorded at the 12-month follow-up. HFR electrosurgery proved to be a safe, effective, and easy-to-perform technique for the removal of eyelid and third eyelid tumours in dogs.