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"etiology": "<p><span id=\"docs-internal-guid-badaf9d9-7fff-9248-f3ae-96bf3e1613dd\"><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">В основе заболевания лежат врожденные аномалии развития угла передней камеры и дренажной системы глаза, создающие препятствие оттоку внутриглазной жидкости или в значительной степени затрудняющие его, что приводит к повышению внутриглазного давления. Причины этой аномалии — различные патологические состояния женщины, особенно в первые месяцы беременности. Обусловливаются они самыми разнообразными причинами: инфекциями (коревая краснуха, грипп и т. д.), отравлениями, алкоголизмом, ионизирующей радиацией и пр.</span></span></p>",
"pathogenesis": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Передняя камера глаза заполнена прозрачной жидкостью, которая омывает глазные структуры и сохраняет его оптические свойства: водянистая влага, которая для поддержания стабильного внутриглазного давления постоянно поступает и выводится из этой части глаза.</span></p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Врожденная глаукома выражается в дефекте, связанном с формой угла, образуемого при соединении роговицы с радужной оболочкой, и через который происходит дренаж водянистой влаги. Этот дефект приводит к повышению внутриглазного давления и последующему повреждению зрительного нерва.</span></p>",
"diagnostics": "<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Выявление врожденной глаукомы производится врачом-офтальмологом на основании данных осмотра, офтальмологических исследований (тонометрии, гониоскопии, кератометрии, биомикроскопии, офтальмоскопии, УЗ-биометрии). Также немаловажную роль в диагностике этого состояния играют генетические исследования, изучение наследственного анамнеза и течения беременности. </span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">При осмотре обнаруживаются увеличенные (при ранней форме) или нормальные размеры глаз, может также наблюдаться отек окружающих глазное яблоко тканей. Горизонтальный диаметр роговицы увеличен, на ней возможны микроразрывы и помутнение, склера истончена и имеет голубоватый оттенок, поражается при врожденной глаукоме и радужная оболочка – в ней возникают атрофические процессы, зрачок вяло реагирует на световые раздражители. Передняя камера глаза углублена (в 1,5-2 раза больше возрастной нормы).</span></p>",
"treatment": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">При врожденной глаукоме чаще всего проводится оперативное вмешательство, при этом выбор метода операции остается за хирургом. Это зависит от стадии, вовлеченности глазных структур. Только хирургическими методами возможно создать условия для нормального оттока внутриглазной жидкости.</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Дренирование угла передней камеры. Это уникальная техника, которая позволяет в большинстве случаев привести к стабилизации глаукоматозного процесса и нормализации внутриглазного давления.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Трабекулотомия. Применяют при сильном помутнении роговицы — через разрез склеры рассекается трабекула – участок угла передней камеры для улучшения оттока внутриглазной жидкости.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Трабекулэктомия. Через разрез в склере удаляется часть трабекулы, что создает путь оттока жидкости под конъюнктиву, из-за этого идет снижение внутриглазного давления</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Гониотомия. Проводят на ранних стадиях глаукомы. Рассекается участок угла передней камеры через роговицу, эффективность операции в этом случае составляет 85%.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Комбинированная методика (трабекулотомия + трабекулэктомия)</span></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Все оперативные вмешательства у детей требуют применения наркоза.</span></p>",
"prevention": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Избежать развития наследственной глаукомы практически нельзя. Но предотвратить порок, который возникает по негативным факторам, несложно. Будущей маме нужно забыть о вредных привычках, сбалансировать пищу, избегать травмы живота.</span></p>",
"clinical_picture": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Врожденная глаукома характеризуется своеобразными клиническими проявлениями, обусловленными возрастными особенностями глаз у детей.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Если ребенка глаукома, симптомы могут быть следующими:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">повышение внутриглазного давления;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">светобоязнь, слезотечение;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">увеличение размера глазного яблока (ребенок рождается с большими, «выразительными глазами»), причем увеличение быстро прогрессирует;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">увеличение диаметра роговицы (на поздних стадиях диаметр роговицы может достигать 20 мм и более), ширины лимба;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">отек роговицы (она выглядит мутной);</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">замедление зрачковых реакций;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">изменения диска зрительного нерва.</span></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Врожденная глаукома нередко сочетается с одновременным развитием дефектов в других системах и органах (микроцефалия, пороки сердца, глухота, факоматозы и т. д.), так и в глазу (микрокорнеа, аниридия, катаракта и пр.).</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Врожденная глаукома в 75% наблюдений развивается в обоих глазах. По наблюдениям специалистов, врожденная и детская глаукома у большинства детей не сопровождаются жалобами, исключая те, которые вызваны роговичным синдромом. </span></p>",
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"etiology": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Основная причина дизэмбриогенеза структур наружного уха – негативное внешнее влияние на развитие плода во время беременности. Наследственная микротия может являться составляющей одного из генетических синдромов – Нагера, Тричера-Коллинза, Конигсмарка, Гольденхара. К наиболее распространенным тератогенным факторам, обуславливающим развитие патологии, относятся:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">TORCH-инфекции. Это общее название инфекционных заболеваний, при которых имеется риск внутриутробного заражения плода и формирования пороков развития. Включают токсоплазмоз, герпес-вирусы типов 1, 2 и 3, краснуху, сифилис, цитомегаловирус, парвовирус.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Физические факторы. Обычно это ионизирующее излучение при рентгенографии или компьютерной томографии, которые проводятся по жизненным показаниям или при недиагностированной беременности. Также в эту группу входят лучевая терапия при онкопатологиях, лечение радиоактивным йодом, продолжительная гипертермия.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Вредные привычки. Губительное влияние на внутриутробное развитие ребенка оказывает употребление беременной алкогольных напитков, наркотических веществ (чаще всего – кокаина), табачных изделий.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Фармакологические препараты. Некоторые медикаменты способны провоцировать врожденные аномалии у ребенка. Это антибиотики (тетрациклины, пеницилламин), гипотензивные (эналаприл, каптоприл) средства, препараты на основе йода или лития, антикоагулянты (варфарин), гормональные средства (андрогены).</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Эндокринные патологии. К ним относятся сахарный диабет в стадии декомпенсации, фенилкетонурия, недостаточность фолиевой кислоты, эндемический зоб. Отдельно выделяют гормонально активные опухоли, в том числе – андрогенпродуцирующие.</span></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>",
"pathogenesis": "",
"diagnostics": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Постановка диагноза возможна сразу после родов на основании визуального осмотра. В последующем ребенок направляется к детскому отоларингологу для выявления сопутствующих поражений среднего и внутреннего уха, оценки функциональных возможностей звукопроводящей и звуковоспринимающей систем. Структура диагностической программы зависит от возраста пациента на момент обращения к специалисту. Помимо внешнего осмотра деформированной ушной раковины и сбора анамнеза она может включать в себя:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Изучение слухового восприятия. Основывается на разговоре или использовании звучащих игрушек. Этот тест позволяет провести первичную оценку общего звукового восприятия и звукопроводимости каждого уха в отдельности. У младенцев вместо речи используются громкие внезапные звуки.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Тональную пороговую аудиометрию. Дает возможность оценить воздушную проводимость и костное восприятие со стороны поражения. При микротии легкой, средней и тяжелой степени наблюдается кондуктивная тугоухость до 60-70 дБ. При анотии может присутствовать поражение звуковоспринимающего аппарата. Аудиометрия применяется у пациентов в возрасте от 3-4 лет, поскольку исследование требует адекватного восприятия звуковых сигналов и понимания сути теста.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Акустическую импедансометрию. Используется для оценки функционального состояния барабанной перепонки, адекватности реакции цепи слуховых косточек на звук, определения патологий внутреннего уха. На основе полученных результатов устанавливается целесообразность слухопротезирования. При необходимости это методика дополняется ABR-тестом, изучающим реакцию ЦНС на звук.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Компьютерную и магнитно-резонансную томографию. КТ височной кости в аксиальной, фронтальной и коронарной проекциях позволяет послойно визуализировать просвет наружного уха, барабанную полость и слуховые косточки или определить их отсутствие. У детей с рудиментарным проходом наружного уха по результатам исследования принимается решение о характере и объеме будущей операции, исключается наличие холестеатомы. Для диагностики потенциальных аномалий мягких тканей и изучения хода лицевого нерва показана МРТ височной кости.</span></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>",
"treatment": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Цели лечения – устранение косметического дефекта, улучшение слуховой функции, профилактика развития осложнений. Основной метод их достижения – хирургический. Выбор оперативного вмешательства зависит от выраженности микротии, степени развития слухового канала и сопутствующей дисплазии региональных костных структур. Из социальных и психологических соображений лечение рекомендуется проводить в дошкольном периоде – в 5-6 лет. В детской отоларингологии с этой целью используются:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Аурикулопластика. В зависимости от клинической ситуации проводится пластика ушной раковины собственными тканями или (при III-IV ст.) с помощью имплантатов. Во втором случае используется аутотрансплантат, взятый из хряща VI, VII, VIII ребра с противоположной поражению стороны. Самая распространенная методика – многоэтапная реконструкция по Танзеру-Бренту.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Меатотимпанопластика. Заключается в формировании косметически и функционально приемлемого слухового прохода при наличии такой возможности. В настоящее время обычно осуществляется меатотимпанопластика по методике С. Н. Лапченко.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Слухопротезирование. При двухсторонней тяжелой кондуктивной тугоухости применяются слуховые аппараты с костным вибратором. При сохранении слухового прохода показаны классические слуховые проборы или кохлеарные имплантаты.</span></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>",
"prevention": "<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Специфических профилактических мер в отношении микротии не разработано. Неспецифическая профилактика подразумевает рациональное планирование беременности, ограничение или минимизацию влияния тератогенных факторов на плод: прием медикаментозных средств во время вынашивания ребенка строго по предписанию специалистов, отказ от вредных привычек, раннюю диагностику и лечение инфекционных патологий, эндокринных нарушений.</span></p>",
"clinical_picture": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">На основании морфологических характеристик выделяют 4 клинических формы заболевания: истинная микротия, анотия, малая и сложенная ушная раковина. Наиболее распространенная – истинная. Она проявляется наличием вертикального кожно-хрящевого валика с мочкой на конце. Последняя по сравнению с физиологическим расположением смещена кверху и кпереди. Слуховой проход часто заращен или отсутствует. Кости лицевого черепа, как правило, не деформированы. Анотия является самой редкой формой микротии. Внешне она характеризуется полным отсутствием ушной раковины или хрящевым бугорком, не имеющим мочки. Может сохраняться входное отверстие слухового канала. Часто сопровождается аномалиями развития лицевого скелета.</span></p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Сложенная раковина наружного уха представляет собой вариант микротии, при котором наблюдается недостаточное развитие верхней половины органа. Клинически это проявляется сращиванием ножки завитка и козелка. Из-за этого визуально ухо выглядит «свернутым», а его вертикальный размер существенно уменьшается. Противозавиток часто недоразвит. В тяжелых случаях верхний край завитка находится на одном уровне с козелком. Вся ушная раковина смещается кпереди и книзу. Сочетание этих изменений с дисплазией лицевого скелета является синдромом жаберной дуги. Просвет слухового прохода зачастую сращен, слух на стороне поражения резко снижен или полностью отсутствует. Малая ушная раковина – разновидность заболевания, при которой имеется относительно сформированный завиток и мочка, недостаточно развитые противозавиток и углубления наружного уха, слуховой канал стенозирован или отсутствует.</span></p>",
"image": null,
"image_alt": null,
"standard_type": 0,
"danger": 30,
"published": 1,
"parent": 7097,
"block_rubric": 177,
"standards": []
}
]
}