ДОКТОРУ
Научные статьи
Kozlov V. S., Shilenkova W., Derzhavina L. L., Shilenkov A. A. Yaroslavl Medical Academy, Center of Microendoscopic ORL, Yaroslavl, Russia
Consequently, when treating sinusitis a doctor has two major goals: to restore the function of sinus ostia and to suppress the infection. The principle of YAMIK method is based on managing of pressure in nasal cavities and PNS. Management of pressure, meaning controlled change of it from negative to positive, allows to evacuate the pathological secretion from PNS and to introduce medicinal substances to PNS through their natural ostia. Evacuation of secretion and introduction of medicinal substances is executed via ostiomeatal complex, contributing to fast restoration of the function of the ostia and to suppression of bacterial infection.
Indications: At acute sinusitis using of YAMIK method is expedient in case of ineffectiveness of general antibiotic therapy. At chronic sinusitis YAMIK method is indicated in case of exacerbation of purulent process as a stage of preparation to surgical intervention or in cases when patient's refuse to be operated. YAMIK method is the ideal method of treatment at recurrence of purulent as well, as of polypous process after FESS. Treatment of «empty nose» syndrome can be performed with using YAMIK catheter and special suction machine. The choice of medicinal substance introduced to the sinuses is very important. However, the greatest importance belongs to the proper performance of the procedure by the doctor. If made proficiently YAMIK-method allows increasing the effectiveness of treating patients with acute and chronic sinusitis rapidly.
Treatment of sinusitis in children with YAMIK sinus-catheter
Shilenkova V
Department of Otorhinolaryngology, Yaroslavl Medical Academy, Yaroslavl, Russia
Incidence of sinusitis in children is still a common pediatric problem. In the most of cases, inflammatory process affects rather ethmoidal cells and maxillary sinus than other «large» sinuses. When treating children's sinusitis we have to use the methods that are non-traumatic, easy, safe, painless as well as effective and reliable.
We have used YAMIK method for 6-years-old children and older. We usually use the third model of YAMIK. The principles of the YAMIK- procedure in children do not differ a lot from those in adults. However, there are some peculiarities. To block the nasopharynx in adults it is required to introduce 14 to 16 ml of air into the YAMIK «back» balloon of sinus-catheter; whereas in children younger than 8 years, 6 ml of air will be sufficient, in 8 to 10-years-olds 8 to 10 ml, in 11 to 14-years-olds 12 ml. Before the procedure the doctor explains to the child that manipulation is necessary and it is painless, demonstrates sinus-catheter and inflates its balloons with syringe.
The method was applied to 64 children with non-complicated acute purulent sinusitis. 11 patients were treated in the hospital (group I) and 53 patients were out (group II). In the group I the YAMIK procedures were administrated daily or every other day. In the group II the YAMIK procedures were administrated twice a week. Outpatients were provided with irrigation of the nasal cavity twice a day between the YAMIK procedures. This combination of the above techniques provided the continuity of treatment and reduced the total number of the YAMIK procedures to 3 or 2. The YAMIK sinus catheter has shown its high efficiency in children. CT scans, the endoscopy of the nasal cavity, rhinomanometry and acoustic rhinometry demonstrated its.