Sapronova O. Endonasal modified microsurgery in rehabilitation of the sick with pathology in sphenoid sinus

In the thesis the results of surgery of the sick with pathology in sphenoid sinus are under consideration. The state of sphenoid sinus anastomosis is under estimation, as well as functional state of mucous membrane and nasal cavity before and after variants of curing which have been proposed, clinical condition of the sick was also examined. We researched the results of methods of surgery, improved by us, with transseptal (group 1) and transnasal (group 2) access of 145 sick people with isolated sphenoid sinuses affection. The patients of each group had been splitted into two groups: the main one (A) who were cured according to the developed methods of surgery in clinic; the group of comparison (B) consisting of those who were operated according to the standard procedure. In group 1 there were 64 patients with chronic inflammatory process in sphenoid sinuses. In subgroup 1A there were 31 people; while transnasal surgery on sphenoid sinus we operated anastomosis according to the improved methods. In subgroup 2 there were 33 people and the same operation was done according to the standard methods. Group 2 consisted of 81 patients and these people underwent transseptal access to sphenoid sinuses, as the stage of neuro-surgery of sellar localization tumour . Main subgroup 2А included 31patient, to whom improved sparing method was applied.All patients of this group suffered from tumour which ingrew in sinus cavity. The subgroup of comparison 2B consisted of 50 people, who underwent a standard surgery. The analyses of effectiveness of the developed curing methods during early and late afterwards stages was carried out. Surgery of patients with isolated sphenoid was improved by means of modified nasal sphenotomia, which gave us a possibility to get 96.8% of patients with positive results, which were confirmed by endoscopic research, and it helped to reduce scarring of newly-created anastomosis in late afterwards period in 4.8 times. Normal functioning of nasal cavity of 93.6% patients after transseptal access to sphenoid sinus by means of modified transseptal access to sphenoid sinuses was scientifically grounded, 5.6 times reduce in quantity of nasal septum perforation in late after-surgery period was brought out.