Affiliation:
1. Saint Petersburg Research Institute of Ear, Throat, Nose and Speech
Abstract
In modern otomicrosurgery, there are significant successes of surgical treatment in the volume of tympanoplasty, but despite this, the problems of surgical treatment of chronic purulent otitis media are still relevant. One of the unsolved problems is the effective restoration of perforations of the tympanic membranemyringoplasty. The termination of infection of the tympanic cavity and the effect on the functional result of surgical treatment in chronic inflammatory diseases of the middle ear depends on the performance of this stage of tympanoplasty. The application of the layering method, the use of fascial-cartilage grafts, the formation of the neotimpanal membrane at the natural level is certainly the key to success in eliminating even total perforations of the tympanic membrane. However, it was noted that in the early postoperative period, the issue of effective flap vascularization and prevention of septic complications is of primary importance. Prolonged tamponade of the external auditory canal, the use of local and systemic antibacterial therapy reduces the risk of complications, but significantly increases the period of hospitalization, and hence the period of disability. It is observed that in large otorhinolaryngological surgical centers, mostly nonresident patients are in bed for several weeks. These patients are waiting for tamponade removal and evaluation of the effectiveness of surgical treatment, which, no doubt, is perceived positively from the point of view of the treatment process, but goes against the criteria for the effectiveness of specialized high-tech medical care. Therefore, many experimental and clinical studies have been conducted at present, which are aimed at finding an effective plastic material that contributes to the correct formation of the neotimpanal membrane, prevention of inflammation in the surgical wound area and shortening the period of engraftment of meattimpanal flaps. Considering the above, based on the latest data from domestic and foreign otorhinolaryngologists, in this article we offer our solution to the problem of effective performance of myringoplasty. It is noted that there is a need to study various materials for faster and more effective engraftment of the tissues of the tympanic membrane. The percentage of unsatisfactory morphological and functional outcomes, according to domestic and foreign authors, mainly in the plastic of suband total defects, remains high. The problem of surgical treatment of patients with chronic purulent otitis is of urgent importance for otosurgeons. The aim of the work was to study the use of biodegradable hydrogel in the healing of postoperative wounds in the surgery of chronic purulent otitis media. Description of a clinical case in a patient with chronic purulent otitis media using a biodegradable gel.