BELARUSIAN EDICAL POSTRGRADUETED AKADEMY WELCOM TO BELARUS Professor
BELARUSIAN МEDICAL POSTRGRADUETED AKADEMY WELCOM TO BELARUS Professor, Ph. D. , Dr. Sc. Elena Merkulava Dr. Aleksandre Kobakhidze Minsk, Republic of Belarus
MINSK – THE CAPITAL OF BELARUS
PATHOLOGY OF UPPER RESPIRATORY WAYS IS A TOPICAL PROBLEM
PEOPLE LIVING ON MARSH – LAND
CLIMATIC PECULARITIES – HIGH HUMIDITY
BELARUSIAN МEDICAL POSTRGRADUETED AKADEMY Minimal Invasive Laser Surgery of the Nasal Septum Professor Ph. D. , Dr. Sc. Elena Merkulava Dr. Aleksandre Kobakhidze
Laser surgery
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Nasal swell body(NSB) anatomical characteristics o Thickest and widest region of the nasal septum o Located at the level of the internal nasal valve o Anteriosuperior portion of the nasal septum o Overlying the cartilage and bone Nasal Septal Swell Body* (NSB) sagital CT image
Histological evaluation of the NSB o venous sinusoids, vascular structures o glandular and vaso erectile tissues o connective tissue Copyright © 2010 American Medical Association. All rights reserved. Hematoxylin-eosin–stained photomicrographs of the nasal septal swell body (NSB). The SB shows connective tissue (ct), glands (g), and thin-walled venous sinusoids (s) (original magnification × 40). (Arch Otolaryngol Head Neck Surg. 2010; 136(11): 11071110. doi: 10. 1001/archoto. 2010. 201)
Nasal swell body(NSB) = Septal turbinate
Nasal swell body(NSB) functions o. Regulation of nasal airflow o. Secretory function
q. Can produce a significant effect on nasal resistance. Nasal Septal Swell Body* (NSB) coronal CT image q. Nasal obstruction Nasal Septal Swell Body* (NSB) axial CT image
Treatment of nasal swell body q. Medicinal treatment q. Surgical correction (inadequacy of medicinal treatment)
surgical correction q. Classical surgical treatment septal swell body q. Radio. Frequency Ablation of Septal Swell Body
laser surgery of the nasal septal swell body
The aim of our experiment q. To work out length and frequency of laser wave q. Suggest minimally invasive laser surgery of swell body. q. Minimize risk of damage cartilage and mucosa
Experiment q. Rabbits (N=4) q. Thulium laser (with different emitter parameters) q. Different types of laser attachment q. Histological research.
Acute experiment wavelength 1560 nm 970 nm Power 3 w, Power 7 w, Power 10 w,
Results Hematoxylin-eosin–stained photomicrographs of the rabbits nasal septal swell body (SB) After the laser impact 970 nm, power 3 W. The SB shows connective tissue (ct), glands (g), and thin-walled venous sinusoids (s) (original magnification × 150).
Results Hematoxylin-eosin–stained photomicrographs of the rabbits nasal septal swell body after the vaporisation. After the laser impact 1560 nm, power (I)7 W. (II)9 W The SB shows connective tissue (hemorrhage) (ct). Laser vaporization zone (lv), cartilage (c) Flat epithelium (fa) (original magnification 100).
according to experiment laser vaporisation of NSB with emitter parameters: wavelength-1560 nm and power-7 W is a safe and effective treatment option for the correction of nasal obstruction, caused by nasal swell body.
ü If we do an operation with 7 wats, there is high risk postoperative nasal septal perforation ü The mucus membrane is much more resistant to laser radiation than connective tissue ü An ideal parameter for swell body surgical treatment (laser vaporization) is 6 -7 wat
- Slides: 30