WAY TO DIFFERENTIATE DETERMINING THE INDICATIONS FOR TREATMENT OF CHILDREN WITH PATHOLOGY OF LACHRYMAL PASSAGE Russian patent published in 2016 - IPC A61B6/03 A61K49/06 A61F9/00 

FIELD: medicine.

SUBSTANCE: invention can be used to determine the indications for treatment of children with disorders of lachrymal passage. Spend multislice computed tomography (CT). As a water soluble contrast agent is selected drug, e.g. Ultravist. In three-dimensional reconstruction data CT scans determine the presence of contrast medium in all parts of the SOP and the nasal cavity, determine the state of the lacrimal sac - its shape, thickness and CT density of its walls, evaluate the width and shape of the nasolacrimal duct, the width of the distal part of the nasolacrimal duct (NSP) patency of the NRS. In the presence of the contrast agent in the nasal cavity and assess the condition of the topography of the soft tissues and bone structures adjacent to the SOP, including CT density. In identifying focal lesions in addition to its CT density estimate its contour. If the contrast agent is present in CNP, nasal cavity, then, regardless of its detection in the lacrimal sac, a timing intubation SOP lacrimal implant. If the contrast agent is absent in the NSP in the nasal cavity, then, regardless of its detection in the lacrimal sac, shown endonasal dacryocystorhinostomy (DCRS) with time intubation dakriostomy lacrimal implant. If there is a diverticulum of the lacrimal sac, which is manifested by the protrusion of its walls, and the contrast agent is present in the NSP, the nasal cavity, the excision of the diverticulum is shown in conjunction with simultaneous time intubation SOP lacrimal implant. If you change the shape and the thickened wall of the lacrimal sac, combined with the value of the CT density of the SOP and the surrounding soft tissues <50 HU, the contrast agent is present in the NSP, the nasal cavity, it is a time intubation SOP lacrimal implant with provisional anti-inflammatory therapy. If the contrast agent is not in the NSP, the nasal cavity, it shows the endonasal DCRS with intubation time dakriostomy lacrimal implant with provisional anti-inflammatory therapy. If the narrowing of the NRS, the contrast agent is present in the nasal cavity is shown with his probing NSP intubation time lacrimal implant. If tapered distal portion of the NRS, the contrast agent is present in the NSP, the nasal cavity and nasal cavity revealed a pathology, it is a surgical correction of intranasal structures in conjunction with simultaneous time intubation SOP lacrimal implant. If the CT density of the lacrimal sac and surrounding tissue is ≥50 HU in combination with the deformation of the bones of the nose and upper jaw, a contrast agent is present in the NSP, the nasal cavity, it is a time to intubation SOP-stage surgical correction Pathology of the facial bones and / or soft tissue. If the contrast agent is not in the NSP, the nasal cavity, it shows the endonasal DCRS with intubation time dakriostomy lacrimal implant and simultaneous surgical correction Pathology of the facial bones and / or soft tissue. If the contrast agent is present in the NSP, the nasal cavity and revealed focal pathology of soft tissues, bordering the area of the lacrimal sac, but not connected with it, then the focal lesions with indistinct outlines, relatively homogeneous structure with CT density of 40-45 HU, is shown conservative treatment of antibacterial and anti-inflammatory therapy. When focal lesions with clear margins and heterogeneous structure, which is a new formation, a CT density of 30-80 HU shown its removal.

EFFECT: method allows you to restore the physiological outflow tract tears, to reduce trauma, to reduce the number of repeat operations and length of stay in hospital by CT of children and use as a contrast agent a water-soluble drug, as well as the evaluation of a set of indicators.

1 cl, 11 ex