CC BY
12УДК 616.216.1-002-036.11
DOI: 10.24411/2181-0443/2020-10143
ТЕХНИЧЕСКИЕ ВОЗМОЖНОСТИ УЛЬТРАЗВУКОВОЙ ДИАГНОСТИКИОКОЛОНОСОВЫХ ПАЗУХ
Тоджихужаев Шоядбек Шукурилло угли
Андижанский государственный медицинский институт
Инструментальная диагностика заболеваний околоносовых пазух пазух остается актуальной проблемой в практической оториноларингологии. Используемый для идентификации синусита метод должен быть простым в исполнении, быстрым, безопасным и приемлемым для скрининговой диагностики.
Ключевые слова: диагностика, ультразвуковый метод, околоносвый пазух.
БУРУН ЁНДОШ БУШЛИЦЛАРИНИНГ УЛЬТРАТОВУШ ТЕКШИРУВИНИНГ
ТЕХНИК ИМКОНИЯТЛАРИ
Параназал синус касалликларини инструментал диагностика цилиш амалий оториноларин гологияда долзарб муаммо булиб цолмоцда. Синуситни аницлаш учун ишлатиладиган усул содда, тезкор, хавфсизва скрининг диагностикаси учун мацбул булиши керак.
Калит сузлар: диагностика, ултратовуш усули, параназал синус.
TECHNICAL CAPABILITIES OF ULTRASONIC DIAGNOSTICS
Instrumental diagnosis of diseases of the paranasal sinuses remains an urgent problem in practical otorhinolaryngology. The method used to identify sinusitis should be simple to perform, fast, safe and acceptable for screening diagnostics.
Key words: diagnostics, ultrasound method, paranasal sinus.
Relevance. Currently, the most common method for diagnosing sinusitis is plain radiography. However, the use of the X-ray method has strict limitations due to high radiation exposure, which is especially important in childhood and during dynamic observation of the patient in order to control the quality of treatment [2,5].
It should also be noted that the interpretation of the results of plain radiography depends on the quality of the radiographs and the qualifications of the radiologist [7]. The interpretation of the X-ray picture in diseases of the paranasal sinuses is often ambiguous. The main term "darkening" can reflect the picture of edema of the mucous membrane, polyps, cysts, tumors or pathological
contents [1,3]. Plain radiographs can confirm the diagnosis of exudative sinusitis or frontal sinusitis only if the fluid level in the sinus cavity can be clearly identified.
To assess the state of the ethmoid sinus, which is of paramount importance in the pathogenesis of most cases of chronic sinusitis, conventional radiography is also not very informative [6]. At the same time, computed tomography, which is one of the most informative X-ray techniques, cannot be used in the daily practice of an otorhinolaryngologist to identify acute sinusitis due to the high cost of research.
It should also be noted that in pediatric practice, inflammation of the maxillary sinus occurs more often than is
recognized by native radiography [3,7]. Such difficulties are associated with the anatomical features of the structure of the paranasal sinuses and the specificity of the responses of the child's body to local foci of infection, as a result of which the clinical manifestations of sinusitis in children differ significantly from those in adults. In most children, diseases of the paranasal sinuses are latent or with little symptoms. Even during periods of exacerbation of the pathological process, patients relatively rarely complain of headache, which is the leading symptom of sinusitis in adults [2,6]. Therefore, it is especially important to early detection of sinusitis in a polyclinic for the purpose of timely treatment and prevention of possible complications.
Thus, the diagnosis of diseases of the paranasal sinuses remains an urgent problem. The method used to identify sinusitis should be simple to perform, fast, safe and acceptable for screening diagnostics. These methods include ultrasound (ultrasound). The advantages of ultrasound are known and do not require proof. However, in otorhinolaryngological practice,
ultrasound of the sinuses is rarely used. Apparently, this is due to the fact that the practicing physician often encounters difficulties in choosing the optimal research method. In addition, the indications for ultrasound in the diagnosis of pathology of the paranasal sinuses have not been studied.
To study the paranasal sinuses, two ultrasound methods can be used: the A-method (or one-dimensional ultrasound) and the B-method (or two-dimensional ultrasound). In ENT practice, the A-method of ultrasound is most often used [5]. However, this technique has a number of disadvantages: it is not very informative in detecting cysts and polyps. Scanning ethmoidal cells and wedge-shaped sinus by the A-method of ultrasound is almost impossible [3].
Two-dimensional ultrasound makes it possible to obtain more
information about the nature of the pathological process due to the simultaneous emission of several ultrasonic signals by the ultrasonic sensor. However, in the diagnosis of diseases of the paranasal sinuses, this method is practically not used, because little studied and insufficiently detailed in the literature.
Purpose of the study: To study methods of two-dimensional ultrasound diagnostics of diseases of the paranasal sinuses
Materials and research methods: General clinical characteristics of the examined persons. The work is based on the analysis of a comprehensive clinical examination of 115 patients with various pathologies of the paranasal sinuses hospitalized in the AGMI clinics in Andijan for the period from 2019 to 2020.The age of patients was from 11 to 77 years.The average age was 41.8 years.
Adults were 79 people 42 men and 37 women There were 36 children, among them 15 boys, 21 girls The largest number of patients were people aged 19 to 59 years (57.4%)
Research results. The division of patients into the above clinical groups allowed us not only to study in practice the echographic signs of sinusitis developed during the examination of patients, but also to objectively assess the role of two-dimensional ultrasound scanning in the formation of a clinical diagnosis.
Theresultsofthestudyofthesubgrou pwereusedfor a
comparativeanalysisofthediagnosticcapab ilitiesofplainradiographyandtwo-dimensionalultrasoundoftheparanasalsin usesSubgroup B included 29 peoplewhounderwentultrasoundofthesin usesofthenasalcavityusingtwoscanningme thods, one-dimensionalandtwo-
dimensional.
Clinical group II included 25 patients who, in addition to plain radiography and two-dimensional ultrasound, underwent computed
tomography of the paranasal sinuses in two projections (axial and coronary) according to the standard method.The aim of the examination of this group was to establish the diagnostic information content of two-dimensional scanning of the paranasal sinuses in comparison with other radiation methods. : plain radiography and computed tomography
chronic form of the disease Catarrhal sinusitis was diagnosed in 15 patients (13.6%) Cysts of the maxillary sinuses were detected in 9 cases (8.2% ), polyposis sinusitis - in 11 patients (10%)/
dimensional ultrasound scanning is significantly superior to the one-dimensional ultrasound method in diagnosing various pathological conditions of the paranasal sinuses, including cysts and polyps.So, the average accuracy of two-dimensional ultrasound was 76.4% (p <0.05), the sensitivity was 71.2% ( p<0.05) and specificity 63.6% (p <0.05) The average accuracy of one-dimensional ultrasound scanning does not exceed 54%, sensitivity - 53.1%, specificity - 35%.
Conclusion:
Two-
According to the duration and nature of the course of the disease, 62 patients (53.9%) had acute exudative sinusitis, 48 (41.7%) were diagnosed with a chronic form of the disease.In acute and chronic sinusitis, inflammation in the paranasal sinuses was most often purulent Purulent sinusitis took place in 49 patients (44.5%) with an acute course of the disease and in 26 (23.6%) with a
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