Many diseases of the paranasal sinuses remain unidentified because of their asymptomatic course. The objective of the present study was to estimate the incidence of clinically manifested and asymptomatic fungal balls in the patients who had undergone the surgical intervention for the treatment of paranasal sinus diseases. The retrospective analysis of the case histories of 737 patients subjected to the surgical treatment of the inflammatory diseases of the paranasal sinuses was carried out. All the patients were examined prior to surgery with the use of spiral computed tomography (SCT) of the paranasal sinuses for determining their pathological contents, and the fragments of the mucous membrane that were investigated by means of microscopic, microbiological, and histopathological methods. The fungal balls were found in 57 patients who accounted for 7.7% of their total number. 49 patients of this group presented with the clinical symptoms of sinus disease; in 8 patients, the fungal balls were an accidental finding documented during skull SCT carried out for other indications.
It is currently known that chronic dacryocystitis is from 2 to 7,5% among patients who have consulted an ophthalmologist about lacrimation disorders. Patients with this pathology are subject to surgical treatment – dacryocystorhinthymia. But the number of relapses after dacryocystorhinostomy is 2–16%, this is due to the tendency of the dacryostomy to heal and scar, which ultimately leads to reoperations. The purpose of this work: To highlight the method of preventing recurrence of chronic dacryocystitis, with endoscopic endonasal dacryocystorhinostomy. Methods. A technique for preventing dacryostomy scarring with the use of a stent for draining dacryostomy in endoscopic endonasal dacryocystorhinostomy has been developed and tested in clinical practice (RF Patent RU No. 201235). The essence of the technique is as follows: the surgeon performs surgical treatment in the volume of endonasal endoscopic dacryocystorhinostomy, with the formation of dacryostomy. Then, through the formed dacryostomy, endonasally, under the control of the endoscope, a „T“-shaped stent made intraoperatively is installed into the cavity of the lacrimal sac. Results. Using the proposed technique, surgical treatment of 24 patients with chronic dacryocystitis was performed. Complications and relapses of the disease were not observed in all 24 cases. Conclusion. The presented technique helps to avoid complications in the early and late postoperative periods (granulations, fusion of dacryostomy, synechia, etc.), which prevents the recurrence of the disease and, as a result, further reoperations.
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