RESUMEN
OBJECTIVE: To study the anatomical features of the lower nasal passage in children in the age aspect by analyzing the results of endoscopic examination of the nasal cavity. MATERIAL AND METHODS: The study included 377 children who did not have otorhinolaryngological and ophthalmological pathologies, as well as congenital anomalies in the architectonics of the nose. The distribution into 4 groups, depending on age, was carried out according to the main provisions of the classification of childhood periods by N.P. Gundobin: the first group - children under 1 year old - 80 (21.2%), the second group - from 1 year to 3 years inclusive - 97 (25.7%), the third group - from 4 to 6 years inclusive - 96 (25.5%), the fourth group (control) - from 7 years and older - 104 (27.6%). All patients underwent endoscopic examination of the nasal cavity using rigid endoscopes with a viewing angle of 0 and 30 degrees, 2.7 mm in diameter, and a fibroscope with an inspection angle of 0 degrees, 2.5 mm in diameter. RESULTS: The data on the features of the development of the lower nasal passage in children were obtained. Changes in such anatomical parameters as the diameter of the lower nasal passage, the location of the distal opening of the nasolacrimal canal and the lower turbinate itself in the nasal cavity are presented. Highlighted the peak age periods of the development of the lower nasal passage in children: the first 6 months, 3-4 years and 7-8 years of a child's life. It was revealed that in children under 6 months of age, the middle turbinates are closely adjacent to the lower ones, which, as a rule, are large, tightly pressed to the bottom of the nasal cavity, and therefore the lower nasal passages are extremely weakly expressed. With growing up, their diameter grows from less than 2.0 mm to an average value of 2.90±0.03 mm, while after 7 years, fully formed volumetric lower nasal passages are already noted. In newborns and children of the first year of life, the mouth of the nasolacrimal duct is as close as possible to the bottom of the nasal cavity, and during growing up it gradually shifts upward (finally settling in the area of the fornix of the lower nasal passage or in the area of transition of the fornix to the lateral wall of the lower nasal passage) and posterior to the anterior the end of the inferior turbinate (up to 4 years old is at a distance of less than 1.0 cm, from 4 to 6 years old - 1.0 cm, from 7 years old - 1.14±0.01 cm). CONCLUSIONS: The data obtained as a result of the study are necessary for an otorhinolaryngologist and an ophthalmologist for a full understanding of the processes of development and course, as well as methods of treating various combined rhinological and dacryological pathologies in children.
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Cavidad Nasal , Conducto Nasolagrimal , Niño , Preescolar , Endoscopios , Endoscopía , Humanos , Lactante , Recién Nacido , Cavidad Nasal/diagnóstico por imagen , Cornetes NasalesRESUMEN
Hairy polyp is a rare congenital anomaly, pharynx mass, that causes respiratory and swallowing disorders, and sometimes threatens child's life. A 6 mounths old girl with this pathology was examined and surgically treated at the Department of Otorhinolaryngology, Pediatric Faculty, N.I. Pirogov Russian National Research Medical University. Epipharingoscopy and computed tomography (CT scan) were used during diagnosis. The surgery was performed under endotracheal anesthesia using ERBE VIO electrosurgical complex.
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Trastornos de Deglución , Otolaringología , Pólipos , Niño , Femenino , Humanos , Lactante , Federación de Rusia , Tomografía Computarizada por Rayos XRESUMEN
Aesthetically acceptable cosmetic results of surgical correction of external genital organ defects are important for treatment evaluation along with well-known criteria of good functional outcomes.The purpose of this study was to improve the results of treating children with hypospadias by improving the assessment of results and introducing multi-step correction modalities. MATERIALS AND METHODS: From 2013 to 2015, 476 patients with various forms of hypospadias were treated at the Department of Uroandrology of RCCH. The patients age ranged from 1 year to 17 years (mean age 3 years). All patients were divided into 3 groups depending on the form of hypospadias and type of treatment. They included patients with distal forms of hypospadias (group1, n=270), proximal forms (group 2, n=112) and patients with stem and penoscrotal hypospadias who underwent 3-6 operations before admission (group 3, n=94). RESULTS: The study evaluated both functional and cosmetic results. Cosmetic appearance was assessed using the HOPE scoring system [2]. Despite the difference in surgical methods used for all types of hypospadias, good cosmetic results have been achieved in the majority of patients (65%). Functional outcomes differed depending on the form of hypospadias. In primary patients with distal and proximal forms of hypospadias, good results were achieved in 96% and 77% of patients, respectively. At the same time, 72% of patients who underwent repeat interventions had good results, which is comparable to the group of primary patients with proximal forms. CONCLUSION: The results of treating patients after repeat/failed surgery confirm the high effectiveness of our surgical methods (the Bracka two-stage graft repair, buccal mucosa hypospadias repair, reconstruction with scrotal skin flaps, correction of scrotal transposition). Using the HOPE scoring system to assess cosmetic results helps motivate surgeons to achieve the best treatment results.
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Hipospadias/terapia , Procedimientos de Cirugía Plástica/métodos , Adolescente , Niño , Preescolar , Humanos , Hipospadias/patología , Lactante , Masculino , Estudios RetrospectivosRESUMEN
Autotransplantation of the left kidney into the iliac zone was fulfilled. A direct pelvic-vesical anastomosis was made for total tuberculosis of the ureter, which resulted in perfect clinical recovery. The patient was reexamined 6 months later and found to be practically healthy. On the basis of the absence of the vesical-pelvic reflux in the autotransplanted kidney the authors propose to refuse of the intestinal plasty of the ureter in favour of the vesical-pelvic (pelvic-vesical) anastomosis.
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Trasplante de Riñón , Tuberculosis Renal/cirugía , Tuberculosis Urogenital/cirugía , Enfermedades Ureterales/cirugía , Estudios de Seguimiento , Humanos , Pelvis Renal/cirugía , Masculino , Persona de Mediana Edad , Vejiga Urinaria/cirugía , Derivación Urinaria/métodosRESUMEN
Within the first 6 weeks after kidney transplantation the diagnostic and prognostic importance of some characteristics of partial renal function was studied in 48 patients with postoperative acute renal failure (ARF), precrisis, acute rejection of the transplant, and a crisis-free course of the postoperative period. It was established that the numerical data and the diagnostic importance of the characteristics under study are determined by the degree of the preceding ischemic lesion of the kidney. Some functional criteria of the crisis irreversibility and the effect on its temporary parameters of postoperative ARF were defined.
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Trasplante de Riñón , Lesión Renal Aguda/diagnóstico , Adolescente , Adulto , Cadáver , Femenino , Rechazo de Injerto , Humanos , Pruebas de Función Renal , Masculino , Persona de Mediana Edad , PronósticoRESUMEN
The authors report 5 patients who developed acute peptic ulcers following transplantation of a cadaveric kidney and 4 patients who developed erosive gastritis or gastroduodenitis. The diagnosis and treatment of these complications are described.