FIELD: medicine.
SUBSTANCE: invention relates to medicine, namely to otorhinolaryngology. Acoustic rhinometry (AR) is carried out for three times in the right and left nasal passage separately. The minimum cross-sectional area (MCSA1) is measured at a distance of 0-22.0 mm from the entrance to the vestibule of the nasal cavity to the closure of the perforation, after the closure of the perforation, while sealing the right common nasal passage from the left, and after the use of vasoconstrictors. The average values of the indicators obtained are calculated. After that, a conclusion is made about the degree of influence of perforation of the nasal septum on intranasal aerodynamics. In this case, the value of MCSA1, equal to 0.5-0.7 cm2 for each half of the nose, is considered physiological. MCSA1 value less than 0.5 cm2 is taken as pathological narrowing of the nasal flow. Before the acoustic rhinometry (AR), endoscopic examination of the nasal cavity is carried out, determining the localization and size of the defect. Then computed tomography of the paranasal sinuses is performed. A computer model of the structure of the nasal cavity is built. The thickness of the nasal septum in front of the perforation zone of the nasal septum, the length of the major semiaxis and the length of the minor septum of the nasal septum defect are determined. Then, the area of the perforation image is calculated using the formula for calculating the area of the ellipse: S=πab × 10000, where π is pi (3.1415), a is the length of the major semiaxis of the nasal septum in meters (m), b is the length of the minor semiaxis perforation of the nasal septum in meters (m), S is the image area of the perforation of the nasal septum in cm2. Then a sponge is cut out of a nasal tampon marked "STIP" of an elliptical shape with an area S. The thickness of the sponge is calculated by the formula: P=(d/2) × 100, where d is the thickness of the nasal septum in front of the perforation zone of the nasal septum in meters (m); P is the thickness of the sponge piece in cm. Anterior active rhinomanometry (AARM), rhinoresistometry (RR) are performed. The objective degree of nasal obstruction is established. The presence or absence of disturbances in nasal breathing is determined for the right and left halves of the nose separately. Graphs of the dependence of the nasal flow on pressure are plotted, characterizing each half of the nasal cavity separately and their total indicators. Moreover, AARM and RR are carried out for three times before closing the perforation, after closing the perforation with a sponge and after applying 200 mcg of naphthyzine in the form of drops. Then, namely at the stage of performing the acoustic rhinometry (AR), the volume of the nasal flow is additionally calculated in the interval of 0-22.0 mm. The minimum cross-sectional area of the nasal cavity (MCSA2) is measured in the interval of 22.0-54.0 mm and the volume of the nasal flow is also calculated. In this case, an increase in the MCSA2 indicator in relation to the MCSA1 is considered the norm. The obtained degrees of disturbance of nasal breathing are first compared with the degrees of obstruction, established first before closing the perforation, again after closing the perforation of the nasal septum with a sponge, then after applying naphthyzine.
EFFECT: method makes it possible to increase reliability of the assessment of the patient's nasal breathing function by expanding the diagnostic information content of the study carried out taking into account the influence of the presence or absence of a nasal septum defect.
3 cl, 10 dwg, 1 ex
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Authors
Dates
2021-06-11—Published
2020-09-09—Filed