Gusakova A. Clinical efficiency of bone marrow autotransplantation in plastic surgery of postoperative cavities of temporal bone of patients with chronic pyogenic oti-tis media.

The thesis is concerned with problem of raising the efficiency of surgical treatment of pyogenic attic disease by means of using of plastic surgery of post operative defect by bone marrow autotransplant. There were 58 patients with chronic otopyosis media, under the medical supervision. Wall-down mastoidectomy was done according to general methods with subsequent plastic surgery of trepanation defect with bone marrow autotransplant. Comparison groups consisted of patients with chronic otopyosis media, who were operated on by means of wall-down mastoidectomy on the ear without plastic surgery of postoperative cavity (22), and with plastic surgery of postoperative cavity of muscular periosteus flap (10).Patients of the main and control groups were subjected to audyological research, audiometric registration of brain response, vestybulometrical research, X ray method according to Shuller, and computer tomography. Volume of postoperative cavity is determined by volumetrical method There was proposed the complex of methods in mastoidal plastic surgery with the use of bone marrow autotransplant: placing of autotransplant for the rear wall of otopharyngeal passage from the sponge autobone with inclination to front part, isolation of attic from the mastoidal cavity and plastic surgery of fistula of semicircuit channel. Patients who had fistula or erosion of wall of channel, and who had plastic surgery of defect by sponge bone and bone marrow, at distant postoperative period did not have complaints of vestibular character. Total relative quantity of improvements of bone conductivity, (decreasing of thesholds of perception by 10 dB and more) in the patients of main group made 28,3%, worsening - 3,7%.