RESUMO
A retrospective analysis of treatment was made in 127 adult patients with acute and chronic otitis media complicated by suppurative-inflammatory pathology of the brain. Purulent meningitis was revealed in 52 (40.9%) of hospitalized patients. Meningoencephalitis was often diagnosed in the cases of acute otitis media (15.4%) and in cases of chronic otitis (22.7%). The otogenic brain abscess was detected in 13.5% of otitis media cases and it was noted to be twice frequent (33.3%) in cases of purulent otitis media. The patients 124 (97.6%) have been operated. An extended mastoidotomy and antromastoidotomy were performed in the acute purulent otitis media. An extended radical operation on the ear was applied in case of chronic otitis media. Performance of craniotomy and complete removal of the abscess using modern systems of neuronavigation showed a higher clinical efficacy as compared with transtemporal approach during sanitizing intervention on the ear including the opening and abscess drainage in surgery of otogenic abscesses of the brain.
Assuntos
Antibacterianos/uso terapêutico , Abscesso Encefálico/cirurgia , Craniotomia , Meningoencefalite/cirurgia , Otite Média Supurativa , Procedimentos Cirúrgicos Otológicos , Adulto , Abscesso Encefálico/diagnóstico , Abscesso Encefálico/epidemiologia , Abscesso Encefálico/etiologia , Doença Crônica , Terapia Combinada , Craniotomia/efeitos adversos , Craniotomia/métodos , Feminino , Necessidades e Demandas de Serviços de Saúde , Humanos , Masculino , Meningoencefalite/diagnóstico , Meningoencefalite/epidemiologia , Meningoencefalite/etiologia , Testes de Sensibilidade Microbiana , Neuronavegação/métodos , Otite Média Supurativa/complicações , Otite Média Supurativa/diagnóstico , Otite Média Supurativa/epidemiologia , Otite Média Supurativa/microbiologia , Otite Média Supurativa/cirurgia , Procedimentos Cirúrgicos Otológicos/efeitos adversos , Procedimentos Cirúrgicos Otológicos/métodos , Federação Russa/epidemiologia , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
The objective of the present work was to assess the efficacy of the treatment of chronic rhinosinusitis (CR) in the patients treated with sinuforte using the contact microendoscpic technique. This randomized open clinical and instrumental study included 30 patients presenting with chronic rhinosinusitis. All of them were treated with sinuforte as monotherapy at a dose of 1.3 mg per procedure given once daily during 7 consecutive days. The efficacy of the treatment was evaluated by means of endoscopic and microendoscopic examination supplemented by functional tests on days 1, 2, 4, 6, and 8 after the beginning of therapy. In addition, a questionnaire study was carried out. It was demonstrated that the use of sinuforte for the treatment of the patients with chronic rhinjsinusitis is safe and efficacious as confirmed by the morphological picture revealed by contact microendoscopy.