METHOD FOR SURGICAL MANAGEMENT OF GUNSHOT WOUND OF MAXILLARY SINUS ACCOMPANIED BY EPISTAXIS Russian patent published in 2024 - IPC A61B17/12 A61B17/24 A61M25/10 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to emergency otorhinolaryngology. Primary surgical preparation of a wound canal of tissues of the buccal region, inspection of a maxillary sinus for the presence of foreign bodies and their removal. Artificial junction of a maxillary sinus is created with a nasal cavity under an inferior nasal concha. Continuing bleeding from the wound cavity is stopped. Mucosal wound and an opening in the anterior wall of the maxillary sinus are dilated on the vestibule of the mouth. Balloon in an unfilled state is placed through the opening into the cavity of the maxillary sinus. Balloon consists of a glove rubber, inside of which there is a part of the infusion system tube one and a half centimetres with an adapter inserted into its end for the additional injections of the infusion system. Placed part of the infusion system tube is fixed to the glove rubber by tying two surgical knots with a capron suture on the distal end of the glove rubber. First of them is located in the projection of the connection of the adapter for the unit of additional injections of the infusion system with the tube of the infusion system, and the second one is in five millimetres distal from the above connection. Then, after placing the balloon in the cavity of the maxillary sinus, the free end of the tube for the infusion system is brought out by clamping from the maxillary sinus through the created artificial fistula in the lower nasal passage into the nasal cavity, and then outside it. Thereafter, a syringe with a volume of at least 20 ml filled with normal saline is connected to the brought-out end of the infusion system tube. That is followed by filling the balloon until a portion of its surface extends beyond the opening on the anterior wall of the maxillary sinus in the vestibule of the mouth. Thereafter, a free portion of the infusion system tube is clamped. Then the syringe is disconnected and the free end of the infusion system tube is tied with a simple knot. Further, the clamp is disconnected; at the point of exit of the tube of the infusion system from the vestibule of the nose, it is fixed to the crease of the wing of the nose by means of an attachment to the latter. Thereafter, the wound of the mouth vestibule mucosa is closed. On the next day, part of the physiological solution is evacuated from the balloon. If epistaxis occurs, the same amount of normal saline is introduced into the balloon that was previously evacuated. In the absence of epistaxis, the unfilled balloon is removed from the maxillary sinus cavity through the created artificial fistula.

EFFECT: method enables the surgical treatment of the gunshot wound of the maxillary sinus, accompanied by epistaxis, eliminating the anterior tamponade of the nasal cavity with early recurrent epistaxis in the postoperative period, preserve nasal breathing, exclude the block of the nasolacrimal canal outlet and the eustachian tube outlet into the nasal cavity.

1 cl, 13 dwg, 1 ex