НОВЫЕ МЕТОДЫ ЛАРИНГОПЛАСТИКИ У БОЛЬНЫХ С ХРОНИЧЕСКИМ ПАРАЛИТИЧЕСКИМ СТЕНОЗОМ ГОРТАНИ

Аннотация

қисқа вақт ичида тикланиши эрга даволаш- фонопе- The aim of the study was to evaluate the effectiveness дик реабилитацияга имкон беради. Буларнинг бар- of various types of surgical treatment of patients with часи лазерли шиллиқ ости хордаретиноидотомияни bilateral paralytic stenosis of the larynx. The study амалиёт кенг қўллашга йўл очиб беради. involved 22 patients aged 2 to 60 years, suffering from Калит сўзлар: уиқилдоқнинг паралитик торайи­ paralytic stenosis of the larynx, who was treated in the ши, лазерли ларингопластика, хордаритеноидото- period from 2015 to 2020. The results of treatment with мия, овоз бурмалари, жарроулик аралашуви. the use of laser resection of the vocal fold, Closing the surgical wound with matching the edges of the mucous A method of surgical treatment of chronic paralyt­ membrane and suturing provides fast healing by primary ic stenosis of the larynx - laser endoscopic submucosal intention, which allows you to start early therapeutic chordaritenoidotomy, based on the studies, has shown and phonopedic rehabilitation. All this allows us to its clinical effectiveness. Antibacterial inhalation therapy recommend laser submucosal chordaritenoidotomy for occupies an important place in the complex of medical use in clinical practice. rehabilitation of patients, it is an effective method of pre­ Key words: paralytic stenosis of the larynx, laser venting complications, a method of local anti-inflamma­ laryngoplasty, chordaritenoidotomy; vocal folds, surgical tory treatment, which promotes rapid rehabilitation in the intervention. postoperative period. Chronic stenosis of the larynx (CSL) is a group of dis­ РЕЗЮМЕ eases that differ in etiological factor, the main symptom Целью исследования явилось оценка эффективно­ of which is persistent narrowing of the larynx lumen, dis­ сти различных видов хирургического лечения боль­ rupting the flow of air into the respiratory tract, leading ных с двусторонними паралитическими стенозами to the development of obstructive respiratory failure, as гортани. В исследовании приняли участие 22 па­ well as pronounced impairment of the voice Sanction. The циентов в возрасте от 20 до 60 лет, страдающий course of CSL is characterized by a slowly progressive паралитическим стенозом гортани, находившийся development. Decompensation of stenosis is a life-threat­ на лечении в период с 2015 по 2020 год. Результаты ening condition for the patient that in some cases requires лечения с применением лазерную резекцию голосовой immediate surgical intervention. The presence of a tra­ складки. Закрытие операционной раны с сопостав­ cheostomy leads to social maladjustment and persistent лением краев слизистой оболочки и наложением disability in a significant number of patients of working швов обеспечивает быстрое заживление первичным age [1,5, 6,9, 10, 13]. натяжением, что позволяет начать раннюю лечеб- One of the types of stenosis is paralytic stenosis of the но-фонопедическую реабилитацию. Все это позво­ larynx (PSL), in which the narrowing of the larynx lu­ ляет рекомендовать лазерную подслизистую хор- men is associated with a disorder of motor function in the даритеноидотомию к использованию в клинической form of a decrease in the strength / amplitude of volun­ практике. Ключевые слова: паралитический стеноз tary movements (paresis) or their complete absence (pa­ гортани, лазерная ларингопластика, хордаритенои- ralysis) due to a violation of the innervation of the corre­ дотомия, голосовые складки, хирургическое вмеша­ sponding muscles of the larynx. Neurogenic disorders of тельство. the motor function of the larynx account for up to 30% of all diseases of the vocal apparatus. Up to 90% of patients ХУЛОСА with this pathology are persons of working age, of which Тадқиқотнинг мақсади хиқилдоқнинг икки томон- 86% are women [11]. лама паралитик торайиши бўлган беморларни турли Paresis and paralysis of the muscles of the larynx are хил жарроҳлик даволаш самарадорлигини баҳолаш- subdivided into central (cortical, cortico-bulbar, bulbar), дан иборат эди. Тадқиқотга 2015 йилдан 2020 йилгача developing with encephalitis, encephalopathy of various бўлган даврда 20 ёшдан 60 ёшгача бўлган хиқилдоқ origins, congenital cerebral palsy, diffuse atherosclerosis паралитик торайиши билан оғриган 22 нафар бемор of the cerebral vessels, circulatory disorders in the arter­ жалб қилинган. Овоз бойлами лазерли резекцияси ies of the anterior and lower upper, middle, lower lateral натижалари шуни кўрсатдики, юқоридаги жарроҳлик branches), neoplasms of the cerebellum. Peripheral steno­ аралашув усулларидан сўнг бирламчи жароҳатнинг sis occurs at various levels of the laryngeal nerve lesion. WWW.TSDI.UZ 57 ПРОБЛЕМНЫЕ СТАТЬИ ИОБЗОРЫ In case of damage above the origin of the superior laryn­ contact - using flexible light guides (Diodes, KTP, Nd: geal nerve from the trunk of the vagus nerve, both laryn­ YAG). Each of these methods has its own advantages geal nerves are affected, and in case of damage