[Issues of problematic education at clinical departments of a "narrow" specialization].
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Biomedical subjects
Publications and source records attributed to Iu P Tolstov.
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The study included 62 patients who had undergone radical surgery (RS) on the middle ear. The patients were later operated to improve hearing according to the original reconstructive technique. Before the reconstructive surgery and 1-2, 3-6, 12 and 36 months after it combined vestibulometric examination, otomicroscopy, audiometry assessed the treatment efficiency. Perception of live speech was also investigated. Vestibular dysfunction occurred in 87.1% of the examinees with the history of RS. One of the main causes of the dysfunction was micropathological foci in the trepanation cavity located primarily on the medial wall. Surgical reconstruction creates a closed ventilated neotympanic cavity lined with mucosa. This promotes correction of vestibular dysfunction. Vestibular dysfunction late after radical surgery on the middle ear should be, along with hypoacusis, an indication for reconstructive hearing-improving surgery because the latter relieves or eradicates subjective and objective manifestations of the vestibular dysfunction in many previously operated patients.
303 ears were examined otomicroscopically in 267 patients who had undergone radical operation on the middle ear (RO). Local and general symptoms in patients after RO were defined as "the operated ear disease". Otomicroscopic picture of pathomorphological changes in the trepanation cavity is provided. It is necessary to account for these changes in planning reconstructive surgery.
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Incidence rate of otitis media in children under 7 years of age by the number of outpatient consultations in Orenburg, implications of some social factors in this rate and in growing number of cases of chronic otitis media are analysed.
Patients with otitis media chronica with central tympanic perforation underwent glue myringoplasty or radical operation. In 52.2 and 33.3% of them an original technique developed by the authors, has discovered defect of barofunction of the auditory tube named inflation effect of the auditory tube. High intratympanic pressure observed in this effect should be taken into consideration in tympanoplasty as it underlies rupture or dislocation of the transplant in myringoplasty or dislocation of the neotympanic membrane in reconstructive surgery on the middle ear.
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Clinical data about cancer metastases of the vestibule of larynx to neck regional lymph nodes are presented. Indications for Crile's operation and fascial excision of neck mucosa and lymph nodes during combined therapy are described. A modification of the excision based on a temporary section of m. sternocleidomastoideus at the sternum is proposed. Remote results of therapy of cancer metastases of the vestibule of larynx to neck regional lymph nodes are discussed.
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