Adhesion of the middle turbinate to the lateral wall of the nasal cavity and synechia of the middle meatus are one of the common reasons for the failure of surgical interventions for chronic sinusitis. The use of specially shaped intranasal splints can solve the problem of preventing synechiae in the postoperative period. Many different devices and approaches have been proposed to prevent the development of this category of complications. This study proposes an anatomical version of the splint for the middle turbinate, developed using 3D computer modeling technologies followed by printing from a biocompatible elastic material on a Formlabs 3BL 3D printer. The shape and size of the splint were developed based on the analysis of computed tomography data of 50 adult patients. The safety of the developed device was studied in a group of 20 volunteers in whom the developed splint was installed on one side of the nasal cavity for 2 weeks after bilateral surgery. According to endoscopic examination and patient questionnaires, the developed splint did not cause local or systemic allergic reactions and did not create additional discomfort for the patient in the postoperative period. Installing a splint helped prevent the formation of synechiae. However, to determine clinical effectiveness, a study with a larger sample of patients is required.
Адгезия средней носовой раковины к латеральной стенке полости носа, синехии среднего носового хода являются одной из частых причин неэффективности хирургических вмешательств по поводу хронического синусита. Использование внутриносовых сплинтов специальной формы может решить проблему профилактики синехий в послеоперационном периоде. Предложено множество различных устройств и подходов для профилактики развития данной категории осложнений.
UNASSIGNED: Разработать анатомический внутриносовой сплинт для средней носовой раковины (СНР) с использованием аддитивных технологий и изучить его безопасность в клинических условиях.
UNASSIGNED: Предложен анатомический вариант сплинта для СНР, разработанный с использованием технологий компьютерного 3D-моделирования с последующей печатью из биосовместимого эластического материала на 3D-принтере Formlabs 3BL. Разработка формы и размеров сплинта проведена на основе анализа данных компьютерной томографии 50 взрослых пациентов. Безопасность разработанного устройства исследована в группе из 20 добровольцев, которым сплинт установлен с одной стороны полости носа на 2 нед после двустороннего хирургического вмешательства.
UNASSIGNED: По данным эндоскопического исследования и анкетирования пациентов, сплинт не вызывал местных или системных аллергических реакций, не создавал пациенту дополнительного дискомфорта в послеоперационном периоде.
UNASSIGNED: Установка сплинта способствовала профилактике образования синехий. Однако для определения клинической эффективности требуется проведение исследования с большей выборкой пациентов.

UNASSIGNED: Congenital maxillomandibular fusion is a rare disorder. Maxillomandibular fusion is usually discovered immediately after birth because the newborn is unable to open mouth or feed normally. The fusion defects can present with a wide range of severity, ranging from mucosal band (synechiae) to complete bony fusion (syngnathia).
UNASSIGNED: We report a case of congenital alveolar synechiae with posterior cleft palate in a 3-day-old male neonate. The newborn was managed with the help of a multi-disciplinary approach.
UNASSIGNED: Fusion of the gums is a very rare congenital anomaly. Early division of fibrous bands not only allows effective feeding but also prevents the development of facial deformities. However, anesthesia for this procedure can be challenging.

Diseases of the nasal cavity and paranasal sinuses lead to the development of clinical symptoms, among which difficulty in nasal breathing is among the most common complaints of patients in the practice of otorhinolaryngologists. To prevent the development of synechiae of the nasal cavity in surgery, the following principles are defined: 1) to reduce tissue injury, which is achieved by using modern equipment (endoscopic, laser, radio frequency, etc.); 2) to create a barrier between nearby areas of the nasal mucosa by introducing various intranasal splints; 3) to improve the process of tissue regeneration with the help of medicines (regenerants, reparants, etc.). Currently, there is no single approach to the surgical treatment of synechiae of the nasal cavity. The high frequency of postoperative relapses indicates the need to develop effective methods for the prevention of synechiae of the nasal cavity. The choice of surgical tactics is usually carried out taking into account the localization and extent of synechiae of the nasal cavity. All known methods of surgical treatment, depending on the instruments used for excision of synechiae of the nasal cavity, can be conditionally divided into cold and hot. The Sverzhevsky Research Clinical Institute of Otorhinolaryngology has developed a method of complex treatment and prevention of synechiae of the nasal cavity using laser technologies, silicone splints and a hydrogel material based on sodium alginate with derinate.
Заболевания полости носа и околоносовых пазух приводят к развитию клинических симптомов, среди которых затруднение носового дыхания входит в число наиболее распространенных жалоб пациентов в практике врачей-оториноларингологов. Для профилактики развития синехий в полости носа (СПН) в хирургии определены принципы: 1) уменьшить травматизацию тканей, что достигается путем использования современного оборудования (эндоскопического, лазерного, радиочастотного и др.); 2) создать барьер между близкорасположенными участками слизистой оболочки полости носа путем введения различных интраназальных сплинтов; 3) улучшить процесс регенерации тканей с помощью лекарственных средств (регенерантов, репарантов и др.). В настоящее время нет единого подхода к хирургическому лечению СПН. Высокая частота послеоперационных рецидивов свидетельствует о необходимости разработки эффективных методов профилактики СПН. Выбор хирургической тактики обычно проводится с учетом локализации и протяженности СПН. Все известные методы хирургического лечения в зависимости от используемых для иссечения СПН инструментов можно условно разделить на «холодные» и «горячие». В ГБУЗ «НИКИО им. Л.И. Свержевского» ДЗМ разработана методика комплексного лечения и профилактики СПН с использованием лазерных технологий, силиконовых сплинтов и гидрогелевого материала на основе натрия алгината с деринатом.

This article describes 1-year outcomes of a new intra-ocular implant, \"Glauco-Claw,\" in refractory chronic angle-closure glaucoma (ACG). Glauco-Claw is a novice polymethylmethacrylate implant with a central ring and five claws placed circumferentially. It was placed in the anterior chamber and the peripheral iris was tucked into the claws, thus causing goniosynechialysis and preventing the reformation of goniosynechiae. It was implanted in five eyes of five patients, and they were followed up for 1 year. Target intra-ocular pressure was achieved and maintained in all the patients till the last follow-up. Two patients did not require any anti-glaucoma medication. No significant complications were observed in any patient. Glauco-Claw could be another armamentarium in the management of refractory chronic ACG.

OBJECTIVE: To describe the histological events that occur after maxillary sinus floor elevation when the elevated and undetached sinus mucosa are in close proximity or in contact with each other.
METHODS: From 76 rabbits, 152 elevated maxillary sinuses were analyzed histologically. Sites without adhesions were classified as \"No proximity,\" whereas the adhesion stages were divided into \"Proximity,\" \"Fusion,\" and \"Synechia stages.\" The width of the pseudostratified columnar epithelium and the distance between the two layers of the elevated and undetached sinus mucosae were measured at various standardized positions.
RESULTS: Thirty-one sites presenting with adhesions were found. Twelve sites were in the proximity stage,\" presenting cilia of the two epithelial layers that were shortened and interlinked within the mucous context. Hyperactivity of the goblet cells was also observed. In the other cases, the hyperplastic epithelium showed attempts to reach the contralateral mucosa. The 15 \"fusion stage\" sites presented regions with epithelial cells of the two mucosal layers that penetrated each other. Four sites presented \"synechiae stages,\" represented by bridges of connective tissue connecting the two lamina propria.
CONCLUSIONS: Close proximity or tight contact between the elevated and undetached mucosa adhering to the bone walls might occur after maxillary sinus floor elevation. This induced hyperplasia of the epithelial cells and adhesion of the two layers until synechiae formation.

The shape and position of middle turbinate play an important role in ventilation and drainage of the osteomeatal complex. The preservation of middle turbinate is one of the major goals of functional endoscopic sinus surgery (FESS). Middle turbinate intervention is essential to prevent obliteration of osteomeatal complex. The aim of this prospective study is to postulate which middle turbinate intervention is most effective and compare the results with conventional technique. In this randomized controlled study, 60 patients were included of the age group of 15-60 years who presented to the Otorhinolaryngology OPD of our institute between November 2017 to June 2019 with symptoms of chronic sinusitis with clinical and radiological evidence and who underwent FESS. The patients were divided into three group, Group A-Bolgerization (n = 20), Group B-Vicryl-conchopexy (n = 20) and Group C-No intervention, Control group (n = 20). The patency of middle meatus and the status of middle turbinate (medialized or lateralized or neither of the two) was ascertained postoperatively. Improvement in symptoms was also evaluated. The middle turbinate was medialized in 90% of Group A and 95% of Group B cases. The middle turbinate was neither medialized nor lateralized in 70% of patients in Group C. 70% of the patients in Group A and 80% of patients in Group B had complete improvement in symptoms with no recurrence of sinusitis compared to Group C in which only 50% of the patients had improvement in symptoms due to development of synechiae. Medialization of the middle turbinate should be considered as one of the essential steps of FESS as it helps in improving the surgical outcome.

OBJECTIVE: To collect information on the application and behavior of a novel degradable polymeric film (DPF) developed to prevent intra-uterine adhesions (IUAs) after hysteroscopic surgery.
METHODS: A prospective observational study conducted in a university hospital in Naples, Italy. Women undergoing hysteroscopic myomectomy, metroplasty or adhesiolysis, were eligible for the study. Women had their uterine cavity assessed by transvaginal ultrasound scan before their hysteroscopic surgery, which was followed by the DPF insertion. Ultrasonographic and hysteroscopic assessments were undertaken immediately after insertion then at 2 h, 2-5 days, and 6 weeks postoperative. The main outcome of interest was to assess the behavior of the DPF, from insertion to degradation, by ultrasound and hysteroscopy. Other outcomes included ease of DPF insertion, any patient reported adverse events and the presence of IUAs at 6 weeks.
RESULTS: A total of 15 patients were enrolled into the study. The DPF insertion was reported to be very easy in almost all the cases and was visualized immediately and 2 h after insertion in all patients. At the 2-5 day follow-up 5 and 2 of the 15 participants still had the entire or partially hydrolyzed film respectively. By 6 weeks there was no evidence of the DPF in all women. No adverse events were reported at the time of insertion or follow-up. None of the study participants had IUAs at the 6-week assessment.
CONCLUSIONS: According to this pilot study, the solid degradable polymer film, Womed Leaf, is a promising, easy to apply and well tolerated novel option for the prevention of intrauterine adhesion formation after hysteroscopic surgery.

BACKGROUND: There is a lack of consensus regarding the need for nasal packing after a septoplasty. The use of nasal packing has been proposed to reduce bleeding, synechiae and haematomas. Despite these advantages evidence is scant to support postoperative packing. Furthermore, packing is not an innocuous procedure and can cause complications.
OBJECTIVE: The purpose of this study was to investigate the efficacy of quilting sutures compared with sponge nasal packing on haemostasis, haematomas and wound healing following septoplasty.
METHODS: Seventy-six patients with nasal septum deviation requiring septoplasty and turbinoplasy with radiofrequency were included. Following surgery, fifty patients were selected randomly for septoplasty with one quilting suture. And twenty-six patients had sponge nasal packing. Haemostatic properties, formation of haematomas, formation of synechiae, the patients\' pain and bleeding on removal of the packing were evaluated.
RESULTS: Both techniques were equally effective in the control of postoperative bleeding, haematoma and synechiae formation following septoplasty. Sponge packing was associated with significant pain and bleeding on removal.
CONCLUSIONS: The use of quilting sutures like sponge packing is efficient in controlling bleeding, synechiae and haematomas after septoplasty and turbinoplasty.

We report a full-term male neonate found to have undiagnosed syngnathia requiring extensive resuscitation at birth followed by urgent tracheostomy. We conducted a systematic literature review to study the presentation, resuscitation methods, and outcomes of neonates with congenital syngnathia. Of the 174 cases reported to date, 91 had initial resuscitation data available. Extensive resuscitation was required in 16 of these 91 infants (18%). This ranged from nasal intubation to emergent tracheostomy. These neonates are potentially higher risk deliveries for which methods in addition to those recommended by the American Heart Association neonatal resuscitation guidelines may be needed.

Synechiae are intrauterine adhesions that affect the fertility of women. They are most often of post-traumatic origin. The management of pregnancy abortions in the first trimester and post-delivery retention are the main contributing factors. Synechiae is responsible for cycle disorders and repeated pregnancy loss. Hysteroscopy is the reference method for its diagnosis and treatment. The surgical objective is the restoration of a normal sized cavity and a functional endometrium to allow fertilization and implantation. The use of small diameter (5mm) hysteroscopes and no energy or bipolar energy instruments are recommended. Echo guidance facilitates the treatment of severe synechiae and limits the risk of intraoperative perforation. The main risk of treatment is recurrence, particularly in severe cases where multiple operating times are sometimes necessary. An office hysteroscopy at 6 weeks is recommended to identify and treat these recurrences. Different physical, molecular or cellular methods are studied as primary and secondary prevention of postoperative synechiae. The objective of this review is to provide an update on the treatment of synechiae in the context of infertility.