Patent RU-2630352-C1 (RU)
Title: Method for eustachian tube diseases research and treatment
Inventor: VAKHRUSHEV SERGEJ GENNADIEVICH
IPC: A61M25/00
Filed: 2016-08-30
Granted: 2017-09-07
Abstract: FIELD: medicine. 
     SUBSTANCE: mucosa of the nasal cavity is preanematized in patient by administering 0.05% of xylometazoline solution in an amount of 0.6 ml for 4 minutes. Endoscopic examination is carried out in the nasal cavity and nasopharynx and the features of the structure, the presence or absence of deflected nasal septum, the size of the lower and middle nasal conchae and the width of the common nasal passage are determined. Examination of the lateral wall of the nasopharynx is performed by inserting a rigid endoscope to the half of the nose opposite from the examined one and the location and structure of the tubular roller is assessed. A metal guide, an elastic catheter and a flexible endoscope are inserted into the nasal cavity on the side of the examined ear and brought to the pharyngeal mouth of the eustachian tube with its catheterization. The elastic catheter is advanced along the lumen of the eustachian tube by 1.5-2 cm. A microendoscope is inserted to the lumen of the elastic catheter up to the distal end. The elastic catheter and the microendoscope are advancced along the lumen of the eustachian tube by the depth of 2.5 cm. Diaphanoscopy is performed on the side of tympanic membrane of the examined ear and the position of the distal end of the microendoscope is determined by the glow. The elastic catheter and the microendoscope are advanced to the tympanic mouth of the eustachian tube and the examination of the tympanic cavity is performed. In the process of extracting the elastic catheter with the microendoscope installed near the distal end and forming a lumen expansion of the eustachian tube, an endoscopic luminal picture is evaluated. Pathological formations in the form of scars, adhesions, mucous discharge and polyposis changes in the mucous membrane are determiend. The microendoscope and the elastic catheter are reinserted into the tympanic mouth and control diaphanoscopy is performed. The microendoscope is removed from the elastic catheter. The state of the tympanic membrane is determined by the endoscope with a viewing angle of 0° and a diametre of 2.7 mm. The eustachian tube and the tympanic cavity are washed by a 10 cm 3  syringe, connected to the transitional cone of the elastic catheter, with a sterile 0.9% sodium chloride solution in an amount of 15 ml and the treatment is carried out by administering 5 ml of a drug solution consisting of 0.5 ml of 0.1% dexamethasone solution and 4.5 ml of a 0.9% sodium chloride solution, wherein 2.5 ml of the solution is injected into the tympanic mouth area, and by 1.25 ml into the isthmus and pharyngeal mouth of the eustachian tube. The elastic catheter is removed from the lumen of the eustachian tube and the metal device is removed from the nasal cavity. Evaluation of the eustachian tube state is carried out at 24, 48, 72 hours after manipulation. Eustachian tube state is detetrmined by acoustic impedansometry on the 7th, 14th, 28th day. 
     EFFECT: allows to provide a visual assessment of the mucous membrane state of the eustachian tube and the tympanic cavity, perform the washing of the eustachian tube and the tympanic cavity with the precise administration of the drug in the membranous cartilaginous isthmus, the bone sections of the eustachian tube and the tympanic cavity, significantly reduces the risk of damage to the mucosa, eustachian tube walls and the internal carotid artery during the procedure. 
     8 dwg, 2 ex