Применение холодно-плазменной абляции при эндоскопической эндоназальной дакриоцисториностомии

2019 
The aim is to evaluate efficacy of the method of cold-plasma ablation when performing endonasal of dacryocystorhinostomy. Patients and Methods. With the use of the equipment Coblator II were 31 unilateral dacryocystorhinostomy patients with obstruction of the lacrimal ducts at the level of the lacrimal-nasal duct. After a full examination, including color samples, rinsing and probing of lacrimal ducts, radiographic, and, in some cases, transcanalicular endoscopy, when indicated, was performed endonasal dacryocystorhinostomy with the use of cold-plasma ablation. Using a set of equipment Coblator II performed 31 unilateral cerebral PALSY patients with obstruction of the lacrimal duct at the level of the lacrimal duct. In the postoperative period, antibacterial therapy, lacrimal lavage, full volume washing of the nasal cavity, inhalation of mucolytics and antibiotics with a nebulizer were carried out, lubricants were also used. Results . In the early postoperative period and 1 month after surgery, all patients reported no complaints of lacrimation and purulent discharge. In endorinoscopy, healing was observed by the type of predominant epithelialization, the stoma functioned, when washing the stagnant content in the lacrimal SAC was not. There was a small bleeding intraoperatively and in the early postoperative period. Conclusion . Endoscopic endonasal dacryocystorhinostomy with the use of the method co-ablation is a safe and effective alternative to other methods of holding the endonasal dacryocystorhinostomy. The advantages are the ease of implementation, no need for additional, including power tools (pliers, cutting head of a shaver, rasp, etc.) for removal of soft tissue in the area formed dacryocystectomy, good visualization due to the coagulating effect of the cold-plasma ablation, the possibility of gentle removal of even the hypertrophied wall of the lacrimal SAC. The main drawbacks are the high cost of equipment and consumables.
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