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    Article
    World of Medicine and Biology / №3(61), 2017 / EXPERIENCE OF THE COMPUTER CONFIGURATION PLANNING OF SURGICAL INTERFERENCE IN PATIENTS WITH CHRONIC FRONTAL SINUSITIS
    Loburets A.V., Besshapochny S.B., Avrunin V.G.

    EXPERIENCE OF THE COMPUTER CONFIGURATION PLANNING OF SURGICAL INTERFERENCE IN PATIENTS WITH CHRONIC FRONTAL SINUSITIS

    About the author: Loburets A.V., Besshapochny S.B., Avrunin V.G.
    Heading CLINICAL MEDICINE
    Type of article Scentific article
    Annotation Modern forecasting methods are based on mathematical analysis of data and are implemented using electronic computing equipment. Computer configuration planning surgery in functional rhinology designed for prediction of functional results according to the operation of virtual modeling changes architectonics nasal cavity. The article represents the results of the computer configuration planning of the value of surgical interference of 56 patients who underwent inpatient treatment of chronic frontal sinusitis. The analysis of rhinomanometry indicators according to active posterior rhinomanometry (APR; M±m; kPa · s / l = Pa · s / m 3·106 ) and the research of aerodynamics of air resistance of nasal breathing were performed according to a spiral computer tomography (SCT; M±m; Pa · s / m 6·109) before and after surgery within the patients of the main group (n = 27) who underwent endonasal frontotomy correction intranasal structures (INS) and controls (n = 29) – by which was made the endonasal frontotomy. Extensive results of the study of two patients are presented separately. Statistically significant differences in the indicators of rhinomanometry before АAPR = 2,15±0,11 and after 4 weeks after surgery АAPR = 1,43±0,09 were observed in the patients of the main group who performed endonasal frontotomy with INS correction (p<0.001). In the control group: before surgery АAPR = 1,41±0,07, after surgery АAPR = 1,29±0,05. Thus, rhinomanometry indicators in the control group of patients who underwent frontotomy without correction INS, did not have a statistically significant difference (p = 0.168). In the analysis of SCT data, the value of the aerodynamic nasal resistance is determined by the formula ASCT=Δp/Q2. Patients in the main group have an indicator ASCT = 2,82±0,21, patients in the control group - ASCT = 1,06±0,06. Patients in the control group the data correspond to the average values of the norm for this study. Patients of the main group indices showed the existence of violations of the INS, which consisted of violating the forward aerodynamic resistance. Thus, the correction of INS changes the aerodynamic nasal resistance in a larger area, and in a wide range of values; without correction INS - only at the site that immediately adjacent to the anastomosis site, and also due to a general decrease in the edema of the mucous membrane of the nasal cavity. Using this method makes it possible during surgical planning to conduct a quantitative assessment of postoperative improvement of functional results of surgery, and, most importantly, considering postoperative changes in local aerodynamic resistance, observed in more than 80% in functional septoplasty. Computer planning makes it possible to increase the effectiveness of functional rhinological interference by an average 32%. But its implementation needs highly accurate diagnostic methods and cumbersome procedures of the virtual simulation of surgical interference.
    Tags chronic frontal sinusitis, computer configuration planning, rhinomanometry, frontal sinus surgery
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    Publication of the article «World of Medicine and Biology» №3(61), 2017 year, 027-032 pages, index UDK 616.216.2-002
    DOI 10.26724/2079-8334-2017-3-61-27-32