MIL-therapy / Method of treatment / 7.15. Otolaryngological (ENT) pathology.
7.15. Otolaryngological (ENT) pathology.
Rehabilitation after rhinosurgical interventions
Rhinosurgeries are quite frequently complicated with long lasting edema of the nasal mucous and dystrophic rhinitis with the formation of crusts, dryness in the nose.
MIL-therapy is performed intranasally via attachnments No.4 or No.5 (Fig. A Annex 1) daily (5-7 procedures). A lightguide is inserted into the nasal passage 2-5 mm deep; irradiation is stable, impulse frequency is 50 Hz, LED radiation power is 90 mWt, exposure into every nostril is 2 min.
In the majority of patients after the 3rd procedure there is a reduction of nasal cavity mucous edema, pain syndrome; nasal respiratory function and olfaction are restored. Complete epithelization of the injured tissues develops by the 5-7 day; mucous membrane have normal humidity and colour. Duration of treatment is reduced by 2-3 days on the average comparing to traditional treatment.
Maxillary sinusitis (sinusitis)
MIL-therapy is performed only if there is a passage for secretion discharge from the cavity (natural or postoperative). To form a natural discharge vasoconstrictive drops, anemization with 0,1% adrenaline hydrochloride solution and others are prescribed. In 95% of cases the developed acute process may be controlled without puncturing the maxillary sinus.
The terminal is applied (Fig. 39) on the mastoid processes (zones 2) with 2 min. exposure, on the projection of Highmore cavity (zones 8) - 1-2 min, on the barbate process of the 3rd neck vertebrae (zone 5)- 1 min, on the thymus projection (zone 11) - 1 min. Impulse frequency is 50 Hz, LED radiation power is 80 mWt. 7-8 daily procedures for the course; the course may be repeated in 2 weeks (7-8 procedures but every other day).
Duration of treatment is reduced by almost one third in comparison to the conventional therapy.
Tonsillitis, laryngotracheitis, pharyngotracheitis
MIL-therapy is added to basic curative manipulations (lavement, mucous ointment ). The terminal is applied (Fig. 38) on the submandibular zones (4) under the angles of lower jaw (exposure 1-2 min on each zone), on the area of fossa jugularis (zone 10) with exposure of 1 min, on the vocal chords projection (zone 6) (1 min), on the thymus projection (zone 11) ( exposure for 1 min), on the barbate process of the third neck vertebrae (zone 5) - 1 min, bilaterally on the barbate process of the seventh neck vertebrae (zone 7) for 1 min on one zone.
Fig. 39. Zones for MIL-irradiation in treating otolarhynlaryngological (ENT) disorders
Impulse frequency is changed every day in the following order: 50 Hz, 150 Hz, 600 Hz, 150Hz, during the last two procedures - 80 Hz. MIL-therapy course consists of 7-8 daily procedures. Duration of treatment is reduced by 20-30%. In six months a new MIL-therapy course is recommended to prevent recurrences.
Rhinitis (catarrhal, purulent, vasomotor, exacerbation of chronic atrophic rhinitis)
The terminal is put (Fig. 39) on the bridge of the nose (zone 13) ( exposure 1 min.), on the submandibular zones (zones 4) below the lower jaw angle ( exposure for 1-2 min on one zone), on the thymus projection (zone 11) ( exposure 1 min.), on the barbate process of the third neck vertebrae (zone 5), (exposure 1 min.), bilaterally on the points of barbate process at the seventh neck vertebrae (zone 7)(exposure 1 min.). Impulse frequency is 50 Hz during the first three procedures, later - 80 Hz; LED radiation power is 70 mWt. MIL-therapy course consists of 8-10 daily procedures. Drugs are not applied in many cases.
Attachments No.4,5,6 are used for the direct irradiation of nasal mucous (Fig. A, Annex 1) .
Symptoms of acute rhinitis are controlled after the 3th-4th procedure. In 20% of patients their local status remains unchanged during MIL-treatment, but subjectively all patients note a marked improvement. Thus, therapeutical effectiveness of this method goes up to 80%.
Adenoid vegetations, stages II-III
MIL-therapy is performed daily ( the course consists of 7-8 procedures). Irradiation is done intranasally (for 1 min on each half of the nose), endoorally close to the front teeth, without the attachement (for 1 min), under the lower jaw anteriorly to the jaw angle (Fig. 39, zone 4) - bilaterally for 1 min each side and on the thymus projection (zone 11) during 0,5 min. Frequency is 80 Hz, LED radiation power is 40 mWt.
The second MIL-therapy course is repeated in 2-3 months, the 3rd course is performed in 6 months. Adenoid vegetations become reduced up to the dimensions of the first stage; nasal respiration is restored practically in all patients. In the majority of cases no recurrences are observed.
Chronic purulent middle otitis
The terminal is applied (Fig. 39) on the area of external acoustic canal (zone 1), on the mastoid process (zone 2), under the angle of lower jaw (zone 4) located at the same side with the diseased ear, exposure 1-2 min on each zone. After that the area of barbate process of the third neck vertebrae (zone 5) is irradiated during 1 min. Impulse frequency is 50 Hz, LED radiation power is 70 mWt. To deliver IR radiation from the terminal directly to the lesion one can use the reflexotherapeutical attachment (No.6) inserted (very carefully) into to the ear through the auricle.
The course of treatment consists of 7-8 daily procedures. After 2-4 procedures pain and itching disappear, otorrhea significantly decreases, a persistent remission develops. In 3 weeks a repeated course of MIL-therapy is recommended (7-8 procedures every other day under the same scheme).
Menier disorder, neurosensor hearing disorder
In the majority of patients the activation of POL processes and depression of antioxidant blood system activity because of the presence of accompanying pathologies in the heart, lungs, kidneys and other organs are revealed.
MIL-irradiation is performed (Fig. 39) on the left subclavicular vascular bundle (zone 12) with exposure 2 min., frequency 5000 Hz, LED radiation power 60 mWt; then both inguinal vascular bundles (Fig.37, zone 6) are irradiated with frequency 1500 Hz and LED radiation power 90 mWt for 2 min on every bundle. 7-8 procedures for the course. MIL-therapy may be repeated in 6 months, if indicated.
In cochleoneuritis (Fig. 39) the terminal is applied contactly on the mastoid process (zone 2). After that the area of external acoustic canal (zone 1) is irradiated for 2 min on each ear. Impulse frequency is changed every day ( the course consists of 10 daily procedures) in the following order: 5, 10, 50, 150, 600, 1500, 5000, 600, 150 Hz; LED radiation power is constant during the whole course - 50-55 mWt. In 3 weeks the course is repeated under the same scheme. After 6 -month break MIL-therapy may be repeated, if indicated by the audiogram data.
While treating otorhynolaryngological (ENT) diseases the magnetic field and laser light interact with numerous types of tissues which have different density (bones, fascias, muscles, mucous, etc.) and consequently, highly different optophysical features. That is why biophotometrical control in treating ENT pathology is very important for correcting MIL-therapy approach and dosage (see Article 8).