M.A. RYABOVA, N.А. SHUMILOVA, L.V. PESTAKOVA, Е.К. TIKHOMIROVA

Pavlov First Saint Petersburg State Medical University, 6-8 Leo Tolstoy Str., Saint Petersburg, Russian Federation, 197022

 Ryabova M.A. — Doc. Med. Sc., Professor of the Otorhinolaryngology Department, tel. (812) 338-71-76, e-mail: marinaryabova@mail.ru

Shumilova N.A. — Cand. Med. Sc., Assistant Lecturer of the Otorhinolaryngology Department, Researcher at the Center of Laser Medicine, tel. (812) 338-71-76, e-mail: schumilov211@yandex.ru

Pestakova L.V. — otorhinolaryngologist of the Department of Early Diagnosis of allergic diseases in women of childbearing age, tel. (812) 338-71-76, e-mail: lubov_pestakova@mail.ru

Tikhomirova E.K. — resident of the Otorhinolaryngology Department, tel. (812) 338-71-76, e-mail: kt-92@mail.ru

 The causes of synechia in 17 patients treated in the Otorhinolaryngology Department of Pavlov First Saint Petersburg State Medical University were analyzed. In 53% of cases, synechiae were formed without previous surgical ENT interventions, on the background of long-term inflammatory changes in the mucosa and as a result of nasal packing, nasogastric tubing and nasotracheal intubation. All patients underwent laser dissection of nasal synechiae under optimal conditions of exposure to lasers with a wavelength of 810, 980, 1470 nm. The presence of extended synechiae, the localization of synechiae in narrow anatomical spaces, the atrophic changes in the mucous membrane of the nasal cavity required the use of gentler modes of laser exposure in order to minimize thermal damage to surrounding tissues. One-stage dissection of the synechiae coupled with laser coagulation of the inferior conchas, vaporization of the thorn or crest of the nasal septum eliminated the factors contributing to the recurrence of the synechiae. In the postoperative period, the formation of fibrin plaques in the field of laser action was noted, which were removed without assistance within a period of 1 to 4 weeks. In the postoperative period, all patients were prescribed the combined ointment for the entire period of wound surface healing. No intraoperative bleeding or a recurrence of the adhesions was noted. Depending on the size of the laser wound and the regenerative capacity of tissues, the period of complete healing was 2 to 4 weeks. Thus, laser radiation with various wavelengths is an effective and safe method of dissecting the nasal synechiae; it does not require the use of anti-relapse measures, nasal packing or splints in the nasal cavity, and does not cause recurrence of the disease.

Key words: nasal synechia, laser surgery, postoperative complications.

(For citation: Ryabova M.A., Shumilova N.A., Pestakova L.V., Tikhomirova E.K. Nasal synechia: causes and laser surgery. Practical Medicine. 2018)

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