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2.
Clin Sports Med ; 38(4): 563-575, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31472767

RESUMO

Respiratory symptoms and infections are common among athletes. Viral upper respiratory infection symptoms may precede dyspneic symptoms seen in asthmatics or worsen symptoms of exercise-induced bronchoconstriction Knowing how to instruct an athlete on use of inhalers and having an asthma action plan are critical in management of these athletes. Other life-threatening conditions that may be seen are pneumothorax and laryngeal/pharyngeal perforation. Prompt recognition and treatment are crucial if an athlete is suspected to have pulmonary compromise. Laryngeal/pharyngeal perforations are a rare cause of issues within the training room but require a high degree of suspicion to be diagnosed and managed properly.


Assuntos
Asma/tratamento farmacológico , Broncoconstrição , Exercício/fisiologia , Pneumotórax , Infecções Respiratórias , Volta ao Esporte , Asma/diagnóstico , Humanos , Laringe/lesões , Substâncias para Melhoria do Desempenho , Faringe/lesões , Pneumotórax/diagnóstico , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/terapia , Disfunção da Prega Vocal/diagnóstico , Ferimentos e Lesões/diagnóstico
4.
Afr Health Sci ; 19(1): 1705-1715, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31149001

RESUMO

Background: Laryngeal mask airways (LMAs) are widely used in anaesthesia and are considered to be generally safe. Postoperative sore throat (POST) is a frequent complication following LMA use and can be very distressing to patients. The use of an LMA cuff pressure of between 30 and 32cm of H2O in alleviating post-operative sore throat has not been investigated. Objective: To compare the occurrence of POST between the intervention group in which LMA cuff pressures were adjusted to 30-32cm of H2O and the control group in which only monitoring of LMA cuff pressures was done, to compare the severity of POST between the two study groups and to compare the LMA cuff pressures between the two study groups. Methods: Eighty consenting adult patients scheduled to receive general anaesthesia with use of an LMA were randomized into two groups of 40 patients each. Intervention group: LMA airway cuff pressures were adjusted to 30 to 32cm of H2O. Control group: Only had LMA cuff pressures monitored throughout the surgery. All patients were interviewed postoperatively at two, six and twelve hours. Data of their baseline characteristics, occurrence and severity of POST was collected. If POST was present; a Numerical Rating Scale (NRS) was used to assess the severity. Cuff pressures between the two study groups were also determined. Results: The baseline demographic characteristics of the participants were similar. The use of manometry to limit LMA AMBU® AuraOnce™ intracuff pressure to 30-32cm H2O reduced POST in surgical patient's by 62% at 2 hours and 6 hours (Risk Ratio 0.38 95%CI 0.21-0.69)in the intervention group. The median POST pain score in the intervention group was significantly lower than the control group with scores of 0 at 2, 6 and 12 hours post operatively. Routine practice of LMA cuff inflation by anesthesiologists is variable, and the intracuff pressures in the control group were higher than in the intervention group. (P<0.001). Conclusion: Among this population, reduction of LMA AMBU® AuraOnce™ intracuff pressure to 30-32cm H2O reduces the occurrence and severity of POST. The LMA cuff pressures should be measured routinely using manometry and reducing the intracuff pressures to 30-32 cm of H2O recommended as best practice.


Assuntos
Intubação Intratraqueal/efeitos adversos , Máscaras Laríngeas/estatística & dados numéricos , Laringe/lesões , Manometria/métodos , Dor Pós-Operatória/epidemiologia , Faringite/epidemiologia , Faringe/lesões , Complicações Pós-Operatórias/epidemiologia , Adolescente , Adulto , Idoso , Feminino , Hospitais de Ensino , Hospitais Universitários , Humanos , Intubação Intratraqueal/métodos , Quênia/epidemiologia , Máscaras Laríngeas/efeitos adversos , Masculino , Pessoa de Meia-Idade , Dor Pós-Operatória/etiologia , Faringite/etiologia , Complicações Pós-Operatórias/etiologia , Período Pós-Operatório , Estudos Prospectivos , Adulto Jovem
5.
Radiología (Madr., Ed. impr.) ; 61(3): 259-261, mayo-jun. 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-185298

RESUMO

Se trata de un paciente varón, de 57 años, que acude al servicio de urgencias tras traumatismo facial y craneoencefálico al caerse por las escaleras. El paciente refiere cefalea intensa, motivo por el cual se le solicita una tomografía computarizada craneal donde se objetivan burbujas aéreas en espacio retrofaríngeo. Dado este hallazgo, se decide ampliar el estudio a región cervical y valorar así la posibilidad de perforación faríngea. Las perforaciones faríngeas en el contexto traumático son poco frecuentes, pero más aún lo son las causadas por la calcificación del ligamento longitudinal anterior como en nuestro caso


We report the case of a 57-year-old man who presented at the emergency department with injuries to his face and head after falling down the stairs. A head computed tomography examination done because he complained of an intense headache revealed air bubbles in the retropharyngeal space. Given this finding, a computed tomography of the neck was done to evaluate the possibility of pharyngeal perforation. Traumatic pharyngeal perforations are uncommon, but those caused by the calcification of the anterior longitudinal ligament, as in our case, are even more uncommon


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Faringe/lesões , Traumatismos Faciais/complicações , Traumatismos Craniocerebrais/complicações , Ossificação do Ligamento Longitudinal Posterior/complicações , Diagnóstico por Imagem/métodos , Fatores de Risco
6.
J Vet Intern Med ; 33(4): 1833-1839, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31058361

RESUMO

BACKGROUND: Characterization of the clinical signs, response to treatment and prognosis can be useful information for decision-making when evaluating cattle with pharyngeal trauma. OBJECTIVE: To describe the signalment, history, clinicopathologic, endoscopic, ultrasonographic, radiographic, and postmortem findings as well as treatments and outcomes of cattle diagnosed with pharyngeal perforation/trauma. ANIMALS: Review of medical records of cattle >1 month of age admitted to a Veterinary Teaching Hospital from 1995 to 2017. METHODS: Retrospective study. Review of medical records of cattle with pharyngeal perforation/trauma identified by oral or endoscopic examination in hospital setting. RESULTS: Twenty-seven out of 7550 (0.36%) cases met the inclusion criteria. Pharyngeal perforation/trauma was associated with the administration of a bolus in 24 (89%) cows and a magnet in 3 (11%) cases. The boluses contained monensin (n = 12), calcium salts (n = 5), iodine (n = 1), aspirin (n = 1), vitamins (n = 1), and an unknown product (n = 4). The primary clinical signs were dysphagia, swelling of the throatlatch, subcutaneous emphysema, swelling, and pain on palpation of the throatlatch. Seventeen (63%) cows were discharged whereas 10 (37%) were euthanized. Median time between the suspected traumatic event and hospital admission was 1 day (range: 0.5-3 days) and 2 days (range: 0.5-15) for surviving and nonsurviving cattle, respectively. All 5 cows that suffered pharyngeal trauma associated with administration of calcium salt bolus were euthanized. CONCLUSIONS AND CLINICAL IMPORTANCE: Pharyngeal trauma is a rare condition in cattle. Case fatality rate increases if not diagnosed and treated promptly. The nature of the penetrating foreign body influences the outcome.


Assuntos
Administração Oral , Bovinos/lesões , Corpos Estranhos/veterinária , Doenças Faríngeas/veterinária , Faringe/lesões , Animais , Compostos de Cálcio/administração & dosagem , Feminino , Corpos Estranhos/diagnóstico , Imãs/efeitos adversos , Monensin/administração & dosagem , Doenças Faríngeas/diagnóstico , Doenças Faríngeas/terapia , Prognóstico , Estudos Retrospectivos
9.
Radiologia ; 61(3): 259-261, 2019.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30501997

RESUMO

We report the case of a 57-year-old man who presented at the emergency department with injuries to his face and head after falling down the stairs. A head computed tomography examination done because he complained of an intense headache revealed air bubbles in the retropharyngeal space. Given this finding, a computed tomography of the neck was done to evaluate the possibility of pharyngeal perforation. Traumatic pharyngeal perforations are uncommon, but those caused by the calcification of the anterior longitudinal ligament, as in our case, are even more uncommon.


Assuntos
Ossificação Heterotópica/diagnóstico por imagem , Faringe/lesões , Acidentes por Quedas , Tratamento Conservador , Meios de Contraste/administração & dosagem , Enfisema/diagnóstico por imagem , Humanos , Hipofaringe/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Ossificação Heterotópica/complicações , Faringe/diagnóstico por imagem , Ruptura/diagnóstico por imagem , Ruptura/etiologia , Tomografia Computadorizada por Raios X
10.
Emerg Med Clin North Am ; 37(1): 131-136, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30454776

RESUMO

This article reviews the presentation, diagnosis, and management of common traumatic injuries of the ear, nose, and throat, including laryngeal trauma, auricular and septal hematomas, and tympanic membrane rupture.


Assuntos
Orelha/lesões , Nariz/lesões , Faringe/lesões , Otopatias/diagnóstico , Otopatias/terapia , Emergências , Hematoma/diagnóstico , Hematoma/terapia , Humanos , Septo Nasal/lesões , Perfuração da Membrana Timpânica/diagnóstico , Perfuração da Membrana Timpânica/terapia
11.
BMJ Case Rep ; 11(1)2018 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-30567215

RESUMO

We present a case of Zenker's diverticulum in a 45-year-old woman, occurred as complication after anterior cervical discectomy and fusion for a cervical spine injury. The oesophageal complication occurred 12 months after vertebral cervical surgery and presenting symptoms were fever, dysphagia and neck pain with evidence of retropharyngeal infection. We performed a posterior cervical stabilisation C3-D1 by screws and rods and a second anterior left cervical approach with anterior plate removing and oesophageal wall break repairing with a sternohyoid muscle patch. Despite pharyngo-oesophageal diverticulum may be a complication of anterior cervical surgery (traction diverticulum), in case of an already present true Zenker's diverticulum, delayed complication may occur without cervical hardware pull-out.


Assuntos
Vértebras Cervicais/cirurgia , Discotomia/métodos , Faringe/lesões , Complicações Pós-Operatórias/cirurgia , Fusão Vertebral/efeitos adversos , Traumatismos da Coluna Vertebral/cirurgia , Divertículo de Zenker/patologia , Placas Ósseas/efeitos adversos , Transtornos de Deglutição , Esofagoscopia , Feminino , Humanos , Pessoa de Meia-Idade , Complicações Pós-Operatórias/patologia , Resultado do Tratamento , Divertículo de Zenker/etiologia , Divertículo de Zenker/cirurgia
12.
PLoS One ; 13(10): e0204846, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30286145

RESUMO

BACKGROUND: Sore throat is common after tracheal intubation. Water can be used to lubricate tracheal tubes, but its benefit has not been validated. We thus did a randomised non-inferiority trial to test the hypothesis that a tube lubricated with water does not reduce sore throat after tracheal intubation. METHODS: We randomized female or male patients (n = 296) undergoing surgery in the ears or eyes to receive either a tube lubricated with water or a tube without lubrication for intubation. We assessed sore throat at 0, 2, 4, and 24 h after surgery; pharyngeal injury at 2 and 24 h after surgery; and respiratory infections within 7 days after surgery. For the incidence of sore throat within 24 h after surgery (primary outcome), the two-sided 90% confidence interval of the risk difference was compared with the prespecified non-inferiority margin of 15%. Other outcomes were analyzed with two-sided superiority tests. RESULTS: The incidence of sore throat within 24 h after surgery was 80/147 (54.4%) in the non-lubricated tube group and 83/149 (55.7%) in the water-lubricated tube group (risk difference -1.3%, 90% confidence interval -10.9% to 8.3%). Because the confidence interval was below the non-inferiority margin, the incidence of sore throat was not higher in the non-lubricated tube group than in the water-lubricated tube group. There was no significant association between groups in the sore throat, pharyngeal injury, and respiratory infection at each assessment time. CONCLUSIONS: The tube lubricated with water did not reduce sore throat and pharyngeal injury after tracheal intubation compared to the tube without lubrication.


Assuntos
Intubação Intratraqueal/efeitos adversos , Lubrificantes/administração & dosagem , Faringite/epidemiologia , Água/administração & dosagem , Adulto , Idoso , Feminino , Humanos , Incidência , Lubrificantes/farmacologia , Masculino , Pessoa de Meia-Idade , Faringite/etiologia , Faringite/prevenção & controle , Faringe/efeitos dos fármacos , Faringe/lesões , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/etiologia , Resultado do Tratamento , Água/farmacologia
13.
Ann Otol Rhinol Laryngol ; 127(10): 698-702, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30032647

RESUMO

OBJECTIVES: The authors report a small case series of an unusual ingested foreign body, wire brush bristles, whose small size can present a challenge for endoscopic removal. The authors describe transnasal endoscopic removal and provide a literature review. METHODS: From 2011 to 2017, 8 patients presented to an academic tertiary medical center with ingestion of wire brush bristles. The patients' medical records were reviewed and are described in this report, along with a literature review. RESULTS: In 4 patients, the bristles were in the lingual tonsils. In 1 patient, a bristle was within the pharyngoepiglottic fold and lingual tonsils. Three patients underwent office removal with a fiber-optic laryngoscope under local anesthesia. Two patients underwent direct laryngoscopy with bristle removal. In 1 patient the wire bristle transected the esophagus, requiring an open procedure. One patient presented with a complicated deep-space neck infection. CONCLUSIONS: Wire brush bristles easily become displaced and subsequently become lodged in the upper aerodigestive tract. Localization of a bristle can be difficult on examination and laryngoscopy. Radiography can be performed, but computed tomographic examination with contrast is superior for precise localization for preparation for an operative approach. Depending on the precise location of the bristle, endoscopic removal using a fiber-optic channeled scope may be a safe and effective solution. LEVEL OF EVIDENCE: Case Series, IV.


Assuntos
Corpos Estranhos/diagnóstico , Laringoscopia/métodos , Faringe/lesões , Adulto , Idoso , Diagnóstico Diferencial , Ingestão de Alimentos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Faringe/diagnóstico por imagem , Tomografia Computadorizada por Raios X
14.
Pediatr Radiol ; 48(12): 1806-1813, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30054666

RESUMO

Iatrogenic injuries to the upper gastrointestinal tract in neonates are rare but may lead to significant morbidity and mortality if undiagnosed. The clinical presentation of such injuries is usually nonspecific and symptoms may be overlooked, particularly in sick preterm neonates. Therefore, it is important to recognize the findings on plain chest radiographs obtained regularly in neonatal intensive care units (NICUs) on intubated patients. The purpose of this pictorial essay is to describe the imaging findings of various iatrogenic injuries to the pharynx and esophagus in the neonatal period in a cohort of seven cases.


Assuntos
Traumatismos do Nascimento/diagnóstico por imagem , Esôfago/lesões , Doença Iatrogênica , Intubação Gastrointestinal/efeitos adversos , Intubação Intratraqueal/efeitos adversos , Faringe/lesões , Feminino , Humanos , Recém-Nascido , Masculino
15.
J Trauma Acute Care Surg ; 85(3): 541-548, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29787546

RESUMO

BACKGROUND: This article describes our experience with penetrating pharyngoesophageal injuries (PEI) in the light of a selective conservative approach, and has the objective to define criteria for nonoperative management (NOM). METHODS: This retrospective single-center review of patients with penetrating neck injury treated for confirmed PEI over a 6-year period aimed to test our proposed hypothesis that NOM is safe for hemodynamically stable patients with PEI, who have no competing indications for exploration, have no established sepsis, and who have a water-soluble contrast swallow either showing no- or a contained extravasation. RESULTS: Eighty-six (9%) patients with PEI (oropharynx, 17; hypopharynx, 40; esophagus, 29) of 948 patients with penetrating neck injury were included. Of the cohort 38 (44%) underwent NOM (oropharynx, 15 [88%]; hypopharynx, 18 [45%]; esophagus, 5 [17%]), and 48 (56%) were managed operatively. The median length of stay was 12 days (interquartile range, 19-8). Fifteen (17%) had a persistent leak and six (7%) mediastinitis. Five (6%) patients died but only one (1%) had isolated PEI. Retrospectively, 27 patients fulfilled our proposed criteria for NOM of which 23 had been treated actively by NOM (oropharynx, 8; hypopharynx, 12; esophagus, 3). For these patients, the length of stay was 10.0 days (interquartile range, 13-6), and none developed deep wound sepsis, mediastinitis, persistent leaks, or died. Of the remaining patients treated by NOM without fulfilling the proposed criteria, two were palliated (esophagus) and 13 were managed actively (oropharynx, 7; hypopharynx, 6). Only four of these patients (oropharynx, 1; hypopharynx, 3) were assessed with water-soluble contrast swallow, which showed noncontained extravasation, and three complicated with persistent leaks. CONCLUSION: Nonoperative management of PEI is safe for a carefully selected subgroup of patients. However, most injuries to the caudal part of the cervical digestive tract mandate urgent exploration. LEVEL OF EVIDENCE: Clinical Management Study, Level V evidence.


Assuntos
Esôfago/lesões , Trato Gastrointestinal/lesões , Lesões do Pescoço/complicações , Faringe/lesões , Ferimentos Penetrantes/complicações , Adulto , Tratamento Conservador/métodos , Deglutição/fisiologia , Esôfago/patologia , Feminino , Trato Gastrointestinal/patologia , Humanos , Escala de Gravidade do Ferimento , Tempo de Internação , Masculino , Lesões do Pescoço/epidemiologia , Lesões do Pescoço/terapia , Faringe/patologia , Estudos Retrospectivos
16.
Am J Emerg Med ; 36(7): 1321.e5-1321.e6, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29602671

RESUMO

Negative pressure pulmonary edema (NPPE) is a clinical syndrome well described in the literature and easy to recognize in cases of suspicion, but probably underdiagnosed. It can be a cause of morbidity and admission to the intensive care unit of healthy young individuals. It is present in approximately one in every thousand anesthetics and in 10% of the episodes of upper airway obstruction that are observed in routine clinical practice. It is a non-cardiogenic form of pulmonary oedema thought to be caused by the highly negative intra-thoracic pressure generated when trying to breathe against an acute obstruction. We report a case of NPPE after an airway obstruction in a young male patient.


Assuntos
Obstrução das Vias Respiratórias/complicações , Corpos Estranhos/complicações , Faringe/lesões , Edema Pulmonar/etiologia , Adulto , Obstrução das Vias Respiratórias/diagnóstico , Animais , Peixes , Corpos Estranhos/diagnóstico , Humanos , Masculino , Edema Pulmonar/diagnóstico , Radiografia Torácica
17.
Scand J Surg ; 107(4): 336-344, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29628012

RESUMO

BACKGROUND:: Blunt pharyngoesophageal injuries pose a management challenge to the trauma surgeon. The purpose of this study was to explore whether these injuries can be managed expectantly without neck exploration. METHODS:: The National Trauma Databank datasets 2007-2011 were reviewed for blunt trauma patients who sustained a pharyngeal injury, including an injury to the cervical esophagus. Patients who survived over 24 h and were not transferred from other institutions were divided into two groups based on whether a neck exploration was performed. Outcomes included mortality and hospital stay. RESULTS:: A total of 545 (0.02%) patients were identified. The median age was 18 years and 69% were male. Facial fractures were found in 16%, while 13% had an associated traumatic brain injury. Of the 284 patients who survived over 24 h and were not transferred from another institution, 65 (23%) underwent a neck exploration. The injury burden was significantly higher in this group as indicated by the higher median Injury Severity Score (17 vs 10, p < 0.01) and need for intensive care unit admission (75% vs 31%, p < 0.01). The overall mortality was 2%: 3.1% for neck explorations versus 1.6% for conservative management (adjusted p = 0.54). Neck exploration patients were more likely to remain longer in the hospital (median 13 vs 10 days, adjusted p = 0.03). CONCLUSION:: Pharyngoesophageal injuries are rare following blunt trauma. Only a quarter require a neck exploration and this decision appears to be dictated by the injury burden. Selective non-operative management based on clinical status seems to be feasible and is not associated with increased mortality.


Assuntos
Esôfago/lesões , Faringe/lesões , Ferimentos não Penetrantes/diagnóstico , Ferimentos não Penetrantes/terapia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Bases de Dados Factuais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Índices de Gravidade do Trauma , Estados Unidos , Ferimentos não Penetrantes/etiologia , Adulto Jovem
18.
Rev. esp. anestesiol. reanim ; 65(4): 229-233, abr. 2018. ilus
Artigo em Espanhol | IBECS | ID: ibc-177054

RESUMO

Un hematoma retrofaríngeo es una situación clínica que puede poner en peligro la vida por la potencial obstrucción de la vía aérea superior y que requiere un rápido diagnóstico. Puede presentarse clínicamente de diferentes formas, según el tamaño y la velocidad en su desarrollo. La primera medida a tener en cuenta es la protección y el manejo de la vía aérea que, en la mayoría de las veces, es una situación de vía aérea difícil. En la aparición de un hematoma retrofaríngeo puede existir un antecedente traumático previo, con o sin fractura cervical asociada. El tratamiento del hematoma en la mayoría de los casos es conservador, con una estrecha vigilancia hasta su reabsorción en 3-4 semanas, aunque en ocasiones precisa de evacuación quirúrgica. Presentamos el caso clínico de un paciente que desarrolló un gran hematoma retrofaríngeo tras traumatismo cervical menor y describimos el abordaje de la vía aérea mediante el uso del laringoscopio óptico desechable Airtraq(R)


Retropharyngeal haematoma is a life-threatening clinical situation that can lead to a potential obstruction of the upper airway and requires rapid diagnosis. Clinicaly, it can be presented in different ways, depending on its size and growing speed. The first measure is to protect and manage the airway: in most cases this is a difficult airway situation. A retropharyngeal haematoma can be formed due to a previous traumatic history, with or without associated cervical fracture. Treatment of the haematoma is conservative in most cases, with close monitoring until it is reabsorbed in 3-4 weeks, although they can sometimes require surgical evacuation. We present the case of a patient who developed a large retropharyngeal haematoma after minor cervical trauma and describe an approach of the airway using the Airtraq(R) disposable optical laryngoscope


Assuntos
Humanos , Masculino , Idoso de 80 Anos ou mais , Faringe/lesões , Manuseio das Vias Aéreas/métodos , Lesões do Pescoço/complicações , Hematoma/etiologia , Anestésicos/administração & dosagem , Laringoscopia/métodos , Obstrução das Vias Respiratórias/complicações , Diagnóstico Tardio , Hipofaringe/lesões , Anestesia/métodos , Transtornos de Deglutição/etiologia
20.
Vestn Otorinolaringol ; 83(1): 62-64, 2018.
Artigo em Russo | MEDLINE | ID: mdl-29488501

RESUMO

The objective of the present study was the enhancement of the effectiveness of the treatment of the consequences of the gunshot wounds and mine-blast injuries inflicted to the face, head, and neck encountered in the otolaryngological practice as well as the prevention of the formation of the large demarcation areas in the injured tissues and the preparation of these tissues for the further restorative treatment. Anti-microbial and anti-inflammatory photodynamic therapy (PDT) as well as light-emitting-diode (LED) phototherapy were carried out in 20 patients who suffered gunshot wounds and mine-blast injuries to the face, head, and neck. The photodynamic therapy was performed with the use of an aqueous solution of methylene blue at a concentration of 0.1%, the 'Alod-1' infrared laser ('Granat' modification, Russia), and the 'AFS-Solaris' light-emitting diode-based phototherapeutic apparatus (Russia). The analysis of the results of the study has demonstrated the high efficiency of the proposed approach that made it possible to prevent the development of severe septic complications, reduce the amount of drug therapy, significantly shorten duration of the treatment, and create the conditions for the earlier rehabilitation and further plastic and cosmetic restoration of the tissue structures.


Assuntos
Traumatismos por Explosões/complicações , Traumatismos Craniocerebrais , Orelha/lesões , Laringe/lesões , Lesões do Pescoço , Nariz/lesões , Faringe/lesões , Fotoquimioterapia , Fototerapia , Ferimentos por Arma de Fogo/complicações , Traumatismos Craniocerebrais/etiologia , Traumatismos Craniocerebrais/terapia , Humanos , Raios Infravermelhos/uso terapêutico , Lasers Semicondutores/uso terapêutico , Masculino , Lesões do Pescoço/etiologia , Lesões do Pescoço/terapia , Fotoquimioterapia/instrumentação , Fotoquimioterapia/métodos , Fototerapia/instrumentação , Fototerapia/métodos , Resultado do Tratamento
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