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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">medsovet</journal-id><journal-title-group><journal-title xml:lang="ru">Медицинский Совет</journal-title><trans-title-group xml:lang="en"><trans-title>Meditsinskiy sovet = Medical Council</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2079-701X</issn><issn pub-type="epub">2658-5790</issn><publisher><publisher-name>REMEDIUM GROUP Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21518/2079-701X-2020-6-108-113</article-id><article-id custom-type="elpub" pub-id-type="custom">medsovet-5643</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ХИРУРГИЧЕСКАЯ ОТОРИНОЛАРИНГОЛОГИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>SURGICAL OTORHINOLARYNGOLOGY</subject></subj-group></article-categories><title-group><article-title>Особенности применения СО2-лазера при хирургическом лечении хронических рубцовых стенозов гортани</article-title><trans-title-group xml:lang="en"><trans-title>Features of CO2-laser application in surgical treatment of chronic cicatrical stenoses of the larynx</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1743-9023</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Вавин</surname><given-names>В. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Vavin</surname><given-names>V. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Вавин Вячеслав Валерьевич, кандидат медицинских наук, старший научный сотрудник научно-клинического отдела заболеваний верхних дыхательных путей</p><p>123182, Москва, Волоколамское шоссе, д. 30, корп. 2</p></bio><bio xml:lang="en"><p>Vyacheslav V. Vavin, Cand. of Sci. (Med.), Senior Researcher of the Scientific and Clinical Department of Upper Respiratory Diseases</p><p>30, Bldg. 2, Volokolamskoe shosse, Moscow, 123182</p></bio><email xlink:type="simple">lor42@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4302-5203</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Нажмудинов</surname><given-names>И. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Nazhmudinov</surname><given-names>I. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Нажмудинов Ибрагим Исмаилович, доктор медицинских наук, руководитель научно-клинического отдела заболеваний верхних дыхательных путей, Федеральное государственное бюджетное учреждение «Научно-клинический центр оториноларингологии» Федерального медико-биологического агентства России; Федеральное государственное бюджетное образовательное учреждение высшего образования «Российский национальный исследовательский медицинский университет имени Н.И. Пирогова» Министерства здравоохранения Российской Федерации</p><p>123182, Россия, Москва, Волоколамское шоссе, д. 30, корп. 2; 117997, Россия, Москва, ул. Островитянова, д. 1</p></bio><bio xml:lang="en"><p>Ibragim I. Nazhmudinov, Dr. of Sci. (Med.), Head of the Scientific and Clinical Department of Upper Respiratory Diseases, Federal State Budgetary Institution “Scientific and Clinical Center of Otorhinolaryngology” of the Federal Medico-Biological Agency of Russia; Federal State Autonomous Educational Institution of Higher Education “N.I. Pirogov Russian National Research Medical University” of the Ministry of Health of the Russian Federation</p><p>30, Bldg. 2 Volokolamskoe shosse, Moscow, 123182;</p><p>1, Ostrovityanova St., Moscow, 117997</p></bio><email xlink:type="simple">ibragimlor@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2887-0652</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Давудов</surname><given-names>Х. Ш.</given-names></name><name name-style="western" xml:lang="en"><surname>Davudov</surname><given-names>Kh. Sh.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Давудов Хасан Шаманович, доктор медицинских наук, профессор, заместитель директора</p><p>123182, Москва, Волоколамское шоссе, д. 30, корп. 2</p></bio><bio xml:lang="en"><p>Khasan Sh. Davudov, Dr. of Sci. (Med.), professor, Deputy Director</p><p>30, Bldg. 2, Volokolamskoe shosse, Moscow, 123182</p></bio><email xlink:type="simple">prof.davudov-otolar@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5024-6135</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гаращенко</surname><given-names>Т. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Garashchenko</surname><given-names>T. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Гаращенко Татьяна Ильинична, доктор медицинских наук, профессор, ученый секретарь, Федеральное государственное бюджетное учреждение «Научноклинический центр оториноларингологии» Федерального медико-биологического агентства России; Федеральное государственное бюджетное образовательное учреждение высшего образования «Российский национальный исследовательский медицинский университет имени Н.И. Пирогова» Министерства здравоохранения Российской Федерации</p><p>123182, Россия, Москва, Волоколамское шоссе, д. 30, корп. 2; 117997, Россия, Москва, ул. Островитянова, д. 1</p></bio><bio xml:lang="en"><p>Tat’yana I. Garashchenko, Dr. of Sci. (Med.), professor, academic secretary, Federal State Budgetary Institution “Scientific and Clinical Center of Otorhinolaryngology” of the Federal Medico-Biological Agency of Russia; Professor of the Department of Otorhinolaryngology, Faculty of Continuing Professional Education, Federal State Autonomous Educational Institution of Higher Education “N.I. Pirogov Russian National Research Medical University” of the Ministry of Health of the Russian Federation</p><p>30, Bldg. 2 Volokolamskoe shosse, Moscow, 123182;</p><p>1, Ostrovityanova St., Moscow, 117997</p></bio><email xlink:type="simple">9040100@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0622-8749</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Давудова</surname><given-names>Б. Х.</given-names></name><name name-style="western" xml:lang="en"><surname>Davudova</surname><given-names>B. Kh.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Давудова Башарат Хасановна, кандидат медицинских наук, старший научный сотрудник, врач-оториноларинголог</p><p>123182, Москва, Волоколамское шоссе, д. 30, корп. 2</p></bio><bio xml:lang="en"><p>Basharat Kh. Davudova, Cand. of Sci. (Med.), senior researcher, otorhinolaryngologist</p><p>30, Bldg. 2, Volokolamskoe shosse, Moscow, 123182</p></bio><email xlink:type="simple">basharat@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2381-7817</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Магомедова</surname><given-names>К. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Magomedova</surname><given-names>K. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Магомедова Камила Магомедовна, кандидат медицинских наук, врач-оториноларинголог </p><p>123182, Москва, Волоколамское шоссе, д. 30, корп. 2</p></bio><bio xml:lang="en"><p>Kamila M. Magomedova, Cand. of Sci. (Med.), otorhinolaryngologist</p><p>30, Bldg. 2, Volokolamskoe shosse, Moscow, 123182</p></bio><email xlink:type="simple">kamila-m@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4549-9074</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Хоранова</surname><given-names>М. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Khoranova</surname><given-names>M. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Хоранова Марина Юрьевна, младший научный сотрудник, врач-оториноларинголог</p><p>123182, Москва, Волоколамское шоссе, д. 30, корп. 2</p></bio><bio xml:lang="en"><p>Marina Yu. Khoranova, junior researcher, otorhinolaryngologist</p><p>30, Bldg. 2, Volokolamskoe shosse, Moscow, 123182</p></bio><email xlink:type="simple">marina17.03@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Научно-клинический центр оториноларингологии</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Scientific and Clinical Center of Otorhinolaryngology</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Научно-клинический центр оториноларингологии; &#13;
Российский национальный исследовательский медицинский университет им. Н.И. Пирогова</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Scientific and Clinical Center of Otorhinolaryngology; &#13;
N.I. Pirogov Russian National Research Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2020</year></pub-date><pub-date pub-type="epub"><day>25</day><month>05</month><year>2020</year></pub-date><volume>0</volume><issue>6</issue><fpage>108</fpage><lpage>113</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Вавин В.В., Нажмудинов И.И., Давудов Х.Ш., Гаращенко Т.И., Давудова Б.Х., Магомедова К.М., Хоранова М.Ю., 2020</copyright-statement><copyright-year>2020</copyright-year><copyright-holder xml:lang="ru">Вавин В.В., Нажмудинов И.И., Давудов Х.Ш., Гаращенко Т.И., Давудова Б.Х., Магомедова К.М., Хоранова М.Ю.</copyright-holder><copyright-holder xml:lang="en">Vavin V.V., Nazhmudinov I.I., Davudov K.S., Garashchenko T.I., Davudova B.K., Magomedova K.M., Khoranova M.Y.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.med-sovet.pro/jour/article/view/5643">https://www.med-sovet.pro/jour/article/view/5643</self-uri><abstract><p>Цель обзора – определить современные возможности применения углекислого лазера в микрохирургическом лечении хронических рубцовых стенозов гортани. В настоящее время лазерные эндоларингеальные операции являются одним из основных стандартов в хирургическом лечении пациентов с данной патологией гортани, в том числе и при оказании высокотехнологичной помощи. Применяются разнообразные типы лазеров и методы хирургического воздействия на гортань. Выбор данных методик обусловлен, в первую очередь, мнением оперирующего хирурга. В обзоре освещены принципы лазерной хирургии в общем, и при использовании углекислого лазера в частности. Использование микроманипуляторов позволяет совмещать работу углекислого лазера с операционным микроскопом, бесконтактно воздействуя на ткани-мишени с максимальной точностью. Данная технология способствует расширению спектра хирургических манипуляций при эндоларингеальных вмешательствах. Рассмотрены основные рабочие режимы углекислого лазера, применимые для различных клинических ситуаций, такие как мощность, импульсность, плотность лазерной мощности (PD). Помимо этого, совмещение микроманипулятора с операционным микроскопом позволяет применять дополнительные приемы, направленные на профилактику рестенозирования, такие как использование микролоскутов, подслизистая вапоризация рубцовой ткани гортани. Представлены возможности рецидива рубцового стеноза различными вариантами стентирования. Риск осложнений этой методики не выше, чем при других типах лазерных операций на гортани, и при соблюдении должных мер профилактики может быть сведен к минимуму. В обзоре подробно разобраны возможные осложнения, как ранние, таки и поздние, меры их профилактики, а также способы устранения их последствий.</p></abstract><trans-abstract xml:lang="en"><p>The aim of the review is to identify current possibilities of carbon dioxide laser application in microsurgical treatment of chronic laryngeal cicatricial stenoses. Currently, laser endolaryngeal surgeries are one of the main standards in surgical treatment of patients with this laryngeal pathology, including when providing high-tech assistance. Various types of lasers and methods of surgical treatment of the larynx are used. The choice of these methods is primarily determined by the opinion of the operating surgeon. The review highlights the principles of laser surgery in general, and when using carbon dioxide laser in particular. The use of micromanipulators makes it possible to combine the work of carbon dioxide laser with the operating microscope, affecting target tissues noninvasively with maximum precision. This technology makes it possible to expand the range of surgical manipulations in endolaryngeal surgeries. The main operating modes of the carbon dioxide laser, applicable for different clinical situations, such as power, impulse, laser power density (PD) are considered. In addition, the combination of a micromanipulator with an operating microscope allows the use of additional techniques aimed at preventing restenosis, such as the use of microflaps, submucosal laryngeal cicatricial tissue vaporization. The possibilities of the recurrence of cicatricial stenosis by different variants of stenting are presented. The risk of complications of this technique is not higher than in other types of larynx laser surgeries, and with proper preventive measures can be minimized. In the review, possible complications, both early and late, measures of their prophylaxis, as well as ways to eliminate their consequences are analyzed in detail.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>углекислый (СО2) лазер</kwd><kwd>микрохирургия гортани</kwd><kwd>осложнения</kwd><kwd>хронический рубцовый стеноз гортани</kwd></kwd-group><kwd-group xml:lang="en"><kwd>carbon dioxide (CO2) laser</kwd><kwd>microsurgery of the larynx</kwd><kwd>complications</kwd><kwd>laryngeal stenosis</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Steiner W., Fagan J. Transoral laser microsurgery (TLM) of cancer &amp; other pathology of the upper aerodigestive tract. In: Fagan J. et al. The Open Access Atlas of Otolaryngology, Head &amp; Neck Operative Surgery. 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