Наш способ микроэндоскопического исследования слуховой трубы

Abstract

help of fine optical systems. The authors suggested various techniques of micro-endoscopic examination of the auditory tube (Chays A., Magnan J.; Kimura et al.; Edelstein et al.; Klug C. et al.; Christopher J. Linstrom, etc.) However, it should be noted that all the previously presented techniques had a number of technical drawbacks, such as: low resolution of optical instruments; imperfection of the method of optical fibers feed the into the auditory tube; contamination of the distal endoscope part with mucous discharge; the absence of easy but reliable methods of controlling the optical fiber position in the middle ear. The article presents our method of micro-endoscopic examination of the auditory tube. Working at this task, we used a flexible unguided micro-endoscope Omex, model OME 400. The device has the following specifications: diameter: 0.78 mm, minimal bending radius: 25 mm, resolution: 15,000 pixels. The insertion of the instrument into the auditory tube was performed by means of a special device for examination and management of the auditory tube diseases and a special elastic catheter. The article provides various options of the auditory tube examination both from the pharyngeal orifice and from the tympanic orifice side during tympanoplasty. The group of authors conducted endoscopic examination of the auditory tube in 90 children aged 3 to 12 years during cold-plasma adenotomy and shunting of the tympanic cavities under general anesthesia. Besides, the examination of the auditory tube in adult patients during tympanoplasty was performed. The total number of examinations was 20 people, males and females, aged 29-61 years. We revealed a number of pathomorphological changes of the auditory tube mucous membrane in chronic secretory otitis media, chronic purulent otitis media. We observed edema, folding of the mucous membrane of the auditory tube in the membranous cartilaginous part; polypus-changed mucous membrane in the area of the auditory tube tympanic orifice; fibrin strands in the area of auditory ossicles and the absence of changes in the auditory tube in the middle ear pathology.