Eardrum Bypass Surgery In Tver Children's Hospital No. 1: Who And Why Is The Operation Indicated

Health 2023
Eardrum Bypass Surgery In Tver Children's Hospital No. 1: Who And Why Is The Operation Indicated
Eardrum Bypass Surgery In Tver Children's Hospital No. 1: Who And Why Is The Operation Indicated

Video: Eardrum Bypass Surgery In Tver Children's Hospital No. 1: Who And Why Is The Operation Indicated

Отличия серверных жестких дисков от десктопных
Video: SYNCHRONY PIN Cochlear Implant Surgical Guidelines 2023, February
Anonim

In October 2019, tympanic membrane bypass surgeries began to be performed at the Tver City Children's Hospital 1. The operation itself is not new, but earlier the young residents of the Tver region were sent to Moscow for such a bypass. Now they are operating in Tver. Eardrum bypass surgery is a microsurgical operation performed when fluid accumulates in the middle ear. Such a complication after colds such as sinusitis or adenoid hypertrophy most often occurs in preschool children. If left untreated, the child develops hearing loss, which can remain with him for life. We talked about the new operation, immunity in modern children and the constant training of doctors with the head of the ENT department of the Children's City Hospital 1 Natalia Nevskaya and the operating otorhinolaryngologist Sergey Kosarev. The Otolaryngology Department of Children's City Hospital 1 is located on the banks of the Volga, in a separate two-story building. This is the only specialized department of this kind in our region. The department is warm, clean and quiet. Children sit in wards. Doors with large windows, medical staff and doctors can make sure everything is in order while passing by without entering the room. The head of the department, Natalya Nevskaya, has been working in this hospital for over 11 years. She came here as a resident and stayed. She became the manager in 2018. - I was a sickly child in childhood, one might say, was close to medicine, but as a patient. This is probably why I decided to become a doctor - so that the children were less sick. The very work with children is a joy, and when you were able to help them it brings great moral satisfaction,”she says. Sergei Kosarev perceives medicine as a battle between a doctor and a disease. He has been in the hospital for five years. Now he continues to study in graduate school at the Department of Pediatrics. - The profession of a doctor has always been interesting to me. You face an illness, try to overcome it, try to help a patient, especially a child. Why this particular operation Every year, the department introduces new methods of treatment, so in 2019 they mastered the bypass of the tympanic membrane. - Modern children are often sick. There are many reasons for this, ranging from ecology to antibiotic resistance, - says Natalya Nevskaya. - After diseases of the nose, nasopharynx, for example, hypertrophy of the adenoids, ventilation of the middle ear worsens, as a result of which fluid accumulates in it and the child loses hearing. The need for such operations has increased. The children turn to us, but we could not help them before, they were sent to federal hospitals in Moscow and St. Petersburg. And this is often an additional problem and a financial burden for the family: you have to go to Moscow, live somewhere and be observed later. - Persistent hearing loss develops without surgery. Hearing may not return, due to the fact that adhesions are formed in the middle ear, - continues Sergey Kosarev. How the operation is carried out - This is an abdominal microsurgical operation, it is carried out in the middle ear cavity, therefore it takes place in a sterile operating room and under general anesthesia, says the head of the department. - Sergey Sergeevich will tell you more. He performed the first two operations in October. They were successful. - Yes, and this is very pleasing, - Sergey Kosarev picks up. - As a rule, a complication such as conductive hearing loss (accumulation of fluid in the middle ear, leading to hearing loss), develops in both ears at once. We carry out the operation using a microscope with microsurgical instruments.A puncture is made in the eardrum and a shunt is inserted there, its size is about 2 mm. The entire operation takes less than an hour, and the child can be discharged in two days. If there are indications, adenoids, which are often the root cause of hearing loss, are removed at the same time as the shunt is inserted. What Happens After the Surgery Hearing improvement, according to doctors, occurs almost immediately. Thanks to the micro-hole, the atmospheric pressure in the middle ear is equalized, thereby creating favorable conditions for the outflow of fluid, improving the ventilation of the middle ear and returning hearing. The patient needs to be seen by a doctor once a month for a specialist to assess his condition. - Recovery can take from three months to a year, - comments Sergey Kosarev. - After that, we remove the shunt in the same way, and the eardrum is completely restored on its own within 2-3 weeks. The boy who was operated on in October has already twice visited the doctors at the first city hospital for an examination. He feels well and his hearing is fully restored. - We introduced a new operation, and it was successful - I am very happy about that. But this is the result of the work of not only one doctor, but the entire department: both the anesthesiologist and the operating room nurse - all took part in the patient's treatment. The hearing loss was palpable, - explains the doctor. Who is the operation indicated for and how to sign up for it - The operation is indicated for children with persistent hearing loss who have not been helped by conservative treatment. Parents need to pay attention to this: if the child stops responding to quiet sounds, listens loudly to the TV, - you need to go to the ENT. In the event that the doctor diagnoses conductive hearing loss, he will first prescribe conservative treatment - drugs and physiotherapy. If this does not help within two or three months, he will write the child a referral to our operation, - explains the otorhinolaryngologist. He adds that the pathology may be poorly diagnosed. Parents may not pay attention to the fact that the child began to frequently ask again. And, since this happens most often with young children, they themselves cannot explain that they have begun to hear worse. - It's never too late to contact us. The adhesion process, that is, irreversible hearing loss, develops for several years. How much does the operation cost - This operation is free for the patient, it is carried out at the expense of the compulsory medical insurance funds. The hospital purchased titanium shunts. We cannot yet say how many operations will be required per year, because children could be sent to Moscow for surgery from polyclinics without our participation. But by the end of this year, we have already planned two more operations. Presumably, there will be 2 of them per month. And there, we will look and decide on requests, - Natalya Nevskaya shows a package with one shunt. In a sealed tight bag, a plastic box of a complex design, and in it a tiny metal tube. “Physically, we can do two such operations a day,” adds Sergey Kosarev. The training of doctors in the ENT department in the first children's city hospital in Tver, according to its head, is almost complete, although two doctors are now on maternity leave. Several new doctors have recently come to the department. All doctors are constantly learning something new. - It was the shunting of the eardrum that I studied in Moscow and Kazan - explains Sergey Kosarev. - In addition, I went on an internship in otolaryngology in Austria. It was my decision to learn this operation. In total, the training in the two cities took about 3 weeks. You need to understand that a doctor's studies goes on throughout his life. You can't unlearn it once and that's it. Science is developing, we also need to do this.

Image
Image

Popular by topic