On question of choosing treatment tactics for patients with modern combat trauma of ear, nose, and throat organs and the presence of foreign bodies

INTRODUCTION. The question of indications for removal of foreign bodies (primary and secondary wounding projectiles) of this localization is still debatable. The decision to remove a foreign body is made taking into account many factors (size, material, proximity to large vessels and nerves, impact on organ function, development of complications, etc.). This article presents two clinical cases of patients with foreign bodies, for each of which the treatment tactics for deciding on their removal are considered.

The purpose of the study: to characterize the choice of treatment tactics for patients with modern combat trauma of ENT organs and the presence of foreign bodies.

MATERIAL AND METHODS. From 2022 to 2024, more than 500 wounded with foreign bodies (FB) of ENT organs were treated in the clinics of the Military Medical Academy.

RESULTS AND DISCUSSION. At present, when deciding on the removal of FB, the scheme proposed by V.I. Voyachek does not lose its relevance. It provides that FBs that cause disorders and are easily removed are subject to removal; the extraction of difficult to remove and non-disordering FBs may be postponed; the removal of hard-to-reach and disordering FBs should be determined by comparing the danger of the operation with the danger of disorders.

CONCLUSION. The results of the study showed that at present, only free-lying superficial and easily accessible FBs are extracted at the advanced stages of evacuation. In the vast majority of cases, FBs are extracted according to indications in a specialized hospital after performing CT and clarifying the location of the fragment. The use of endoscopic and microsurgical techniques in combination with modern navigation systems allows the removal of most foreign bodies in the ENT organs. Recommendations for wounded patients with remaining FBs are given in each case individually depending on the location and prognostic risk of dysfunction and the development of possible toxic effects. In most cases, it is advisable to conduct a control ENT examination after 3-6 months with visualization (CT or radiography).