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Siberian Medical Journal, 2009, No. 6
© Snegirev I.I. — 2009
DIAGNOSTICS AND SURGICAL TREATMENT OF TUMORS AND CYSTS OF THE MEDIASTUM
I.I. Snegirev
(Irkutsk State Medical University, Rector - MD, Prof. I.V. Malov, Department of General Surgery
with a course of urology, Head - MD, Prof. S.B. Pinsky; MUZ "Clinical Hospital No. 1 of
Irkutsk", chief physician - L.A. Pavlyuk)
Summary. The article presents the experience of diagnostics and surgical treatment of various tumors and cysts of
the mediastinum. In total, data on 175 patients were studied and analyzed, of which 156 had various tumors and cysts of
the mediastinum, 19 had other diseases and anomalies of the chest cavity that simulated these pathological formations.
115 out of 156 patients had benign tumors and cysts, and 41 had malignant ones. 120 patients underwent surgical
treatment, of which 101 had benign tumors and cysts, and 19 had malignant neoplasms. The long-term results of surgical
treatment of patients with benign tumors of the mediastinum were favorable, while malignant tumors were less favorable.
Key words: diagnostics, surgical treatment, tumors, mediastinal cysts.
Diagnostics and surgical treatment of tumors and cysts of mediastinum
II Snegiryov
(Irkutsk State Medical University, Irkutsk;
Clinical Hospital N 1, Irkutsk)
summary. The article presents the experience of diagnostics and surgical treatment of various tumors and cysts of
mediastinum. Data of 175 cases (156 cases of various non-malignant growths and cysts of mediastinum, 19 other
diseases and abnormalities of thorax which simulated these pathological growths) were studied and analyzed. In 115
patients out of 156 we observed non-malignant growths and cysts, and in 41 – malignant ones. 120 patients were operated
(101 with non malignant growths and cysts and 19 with malignant tumors). The remote outcomes of surgical treatment in
patients with non-malignant growths were favourable, in contrast to patients with malignant growths.
Key words: diagnostics, surgical treatment, tumors, cysts of mediastinum.
Tumors and cysts of the mediastinum, which average
1% of all human tumors [3, 4], are relatively rare diseases.
Despite this, from year to year they attracted a lot of
attention from doctors of various specialties and, above all,
surgeons and radiologists. Such a large and constantly
growing interest in pathological formations of the
mediastinum is due to several reasons. It is known that the
mediastinum, being a part of the chest cavity, is a relatively
limited space in which many vital organs, large vessels,
nerves and lymph nodes are located. Tumors and cysts,
located among these anatomical formations, cause a
number of significant functional and organic changes in
them, which pose a serious danger to human health and
life. This danger is aggravated by the fact that some tumors
are malignant from the moment of their occurrence, while
others, being mostly congenital and completely benign,
often also acquire a malignant character. Considerable
interest in mediastinal neoplasms is also supported by the
fact that the rapid development of radiology, thoracic
surgery, anesthesiology and certain achievements in
chemo- and radiotherapy have created favorable conditions
for their diagnosis and treatment. Thanks to numerous
studies of both domestic and foreign scientists [1, 2, 4, 9,
10], by the 60s of the XX century, significant progress was
made in the study of tumors and cysts of the mediastinum.
Hundreds of cases of successful recognition and treatment
of these pathological formations published in the press
testify to this. However, despite these successes, many
issues of this pathology remained poorly understood. The
issues of histogenesis, morphology and classification of
these tumors and cysts have not been finally resolved.
Widespread surgical practice still experienced significant
difficulties in diagnosis, especially in recognizing their
nature and histomorphological appearance. The frequency
of diagnostic errors in the general medical network reached
75% [1, 3], and in special
analyzed clinics and research institutes - 16.1-50% [1, 2,
4, 8]. There were also no clear indications and
contraindications for surgical, radiation and combined
methods of treatment, the use of one or another type of
anesthesia and surgical access. The long-term results of
surgical treatment of various tumors and cysts of the
mediastinum have been relatively little studied.
The solution of all these issues was difficult due to the
fact that in the mediastinum there are tumors and cysts of
the most diverse origin and histological structure. Individual
researchers and clinics (hospitals) relatively rarely manage
to observe a large number of patients with various tumors
and cysts of the mediastinum, which would allow them to
study the histogenesis, morphology, clinic and diagnosis of
these pathological formations in sufficient depth and
comprehensively and definitely speak in favor of or other
treatment. Therefore, the study of all these issues by many
researchers and specialists (surgeons, radiologists,
pathologists, etc.) will be of great importance in this regard.
In this regard, we considered it possible to summarize
our experience in the diagnosis and surgical treatment of
the most common benign and malignant tumors and
mediastinal cysts.
A purposeful study of these pathological formations
was started by the author of these lines in the 60s of the
last century in the faculty surgical clinic of the Irkutsk
Medical Institute. However, for a number of reasons, these
studies had to be continued and completed in the clinic of
general surgery (on the basis of Clinical Hospital No. 1 in
Irkutsk).
Materials and methods
The study of various issues of the clinic and diagnosis
of mediastinal tumors and cysts was carried out by us in
156 patients who were examined and treated for this
pathology in the clinic of general surgery (75 patients),
faculty surgical clinic
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Siberian Medical Journal, 2009, No. 6
(37 patients) and some other medical institutions of the
city of Irkutsk, Angarsk and Bratsk (44 patients). In
addition, observations of 19 patients with other diseases
and anomalies of the chest cavity, simulating mediastinal
tumors and cysts, were used for differential diagnosis.
Thus, in total, we studied and analyzed data on 175
patients, 92 of them were examined directly by us in
clinics. Data on 83 patients were studied using archival
materials from clinics and hospitals (case histories,
radiographs).
Results and discussion
During a thorough clinical and radiological examination
of patients in clinics and hospitals, they were diagnosed
with the most diverse mediastinal tumors and cysts in their
structure and origin (a total of 27 different morphological
structures). Studying and systematizing these pathological
formations, we considered it expedient to divide them into
seven groups (Table 1).
other authors [1, 5, 6, 8]. A relatively large number of
intrathoracic goiters in our material (25.6%) is explained
by a special selection of patients.
Clinical and radiological diagnosis in 133 (35.3%)
patients was confirmed by histological examination. The
diagnosis in the remaining 23 patients (14.7%) is based
on a thorough clinical and radiological examination and
dynamic observation.
The nature of mediastinal tumors and cysts in patients
was different. The vast majority - 115 (73.7%) had benign
tumors and cysts, and only 41 (26.3%) - malignant. In this
regard, our data are consistent with the literature data [4,
5, 9] and show that benign neoplasms and cysts in the
mediastinum are observed
much more common than malignant ones.
Among the patients referred to clinics with a diagnosis
of a tumor or cyst of the mediastinum, there were 19
people who had other diseases and anomalies that
simulated mediastinal tumors and cysts. Most often, these
were aortic aneurysm (7 patients) and right-lying aorta (3
patients).
Our data on the frequency of various tumors and cysts
The age of patients with mediastinal neoplasms was
of the mediastinum almost completely coincide with those
different: the youngest was 7 months old, and the oldest
was 75 years old. Benign tumors and cysts
were most often observed in patients aged
Table 1 21-60 years, and malignant tumors — 11-50
years.
The frequency and type of tumors and cysts of the mediastinum in patients
In children, adolescents and young
Number of patients
people, teratoid formations, neurogenic
Type of tumor and cyst
total operated
tumors, coelomic pericardial cysts, tumors
and hyperplasia of the thymus were more
1. Neurogenic tumors (18):
often diagnosed. Elderly people were
5
5
neuroma
dominated by intrathoracic goiters, lipomas
5
5
nerofibroma
and bronchogenic cysts.
5
5
ganglioneuroma
Tumors and cysts of the mediastinum
were observed in both men and women.
ganglioneuroblastoma
However, in women, diseases were observed
2
histomorphological type of tumor is not specified 2. Mesenchymal
almost twice as often (98) than in men (58),
tumors (11):
and the majority of women (82 out of 98) had
lipoma
benign tumors and cysts, while in men,
4
4
hemangioma
benign and malignant neoplasms occurred
almost equally often (33 and 25).
lymphangioma
one
one
one
one
one
one
hemangioendothelioma
one
one
angiosarcoma
one
one
2
2
one
one
fibroma
fibrosarcoma
3. Tumors of the lymph nodes (30):
lymphogranulomatosis
sixteen
lymphosarcoma (reticulosarcoma) mediastinal
one
4
eight
form of lung cancer
2
2
mesothelioma and seminoma metastases
4
2
4. Tumors and hyperplasia of the thymus (13):
thymoma
hyperplasia of the thymus
eight
7
5
5
5. Teratoid formations (16):
epidermoid cyst
one
dermoid cyst
one
ten
thirteen
teratoma
2
2
35
35
5
5
sixteen
12
eight
4
6. Intrathoracic goiters (40):
partial intrathoracic goiter complete
intrathoracic goiter
7. Cysts (28):
coelomic pericardial cyst bronchogenic cyst
traumatic cyst
2
caseoma
2
2
156
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Total
Localization of tumors and cysts in the
mediastinum was different in patients.
Pathological formations such as tumors and
hyperplasia of the thymus gland, intrathoracic
goiters, teratoid formations and coelomic
pericardial cysts were observed only in the
anterior mediastinum. Other tumors and
cysts were more common in the anterior
(tumors of the lymph nodes, mesenchymal
tumors) or in the posterior mediastinum
(neurogenic tumors, bronchogenic cysts). In
relation to the midline of the mediastinal
space, in most patients (90 out of 156),
tumors and cysts were located asymmetrically,
protruding into the right (more often) or left
pleural cavities.
one
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When studying the anamnesis in patients
with tumors and cysts of the mediastinum,
great importance was attached to identifying
the duration of the disease. However, with
this pathology, it is almost impossible to
establish the onset of the disease exactly.
Therefore, speaking about the duration of
the disease, we use this concept conditionally,
since in reality we mean the duration of
clinical manifestations. The bulk of patients
with malignant tumors (31 out of 41) were
admitted to clinics and hospitals within 6
months after the first signs of the disease
appeared.
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Siberian Medical Journal, 2009, No. 6
vanity. With benign tumors of the mediastinum, more time
passed from the onset of the disease to admission to a medical
institution. Of the 115 patients, 51 were admitted during the first
year of the disease. The majority (64 out of 115) were admitted
to clinics and hospitals within 2 to 10 or more years from the
onset of the first manifestations of the disease.
histomorphological appearance of a mediastinal tumor
or cysts.
When choosing a method for treating tumors and cysts of
the mediastinum in patients, we proceeded from the instructions
of most domestic and foreign surgeons [1, 4, 5, 6, 8, 11] that
with this development of thoracic surgery and anesthesiology, it
is necessary to adhere to the most early and radical removal of
these pathological formations.
The clinic of tumors and cysts of the mediastinum, with rare
exceptions, was uncharacteristic. Complaints of patients and
objective signs of the disease were determined by a number of
factors:
– localization, size and consistency of pathological formations;
- the nature and rate of tumor growth, the state of
compensation for impaired functions of the mediastinal organs
and the body as a whole;
- the course of the disease and the nature of the
Of our 156 patients with tumors and cysts of the mediastinum,
120 patients (76.9%) underwent surgical treatment (Table 1), 36
patients (23.1%) were discharged without surgery (12 of them
refused surgical treatment, and 24 patients had various
contraindications).
The vast majority of operated patients — 101 (84.2%) out of
120 — had benign tumors and cysts. Malignant neoplasms
occurred only in 19 patients (15.8%).
complication.
The following complaints and objective signs were most
often detected: chest pain (109), shortness of breath (76), cough
(38), palpitations (31), dullness of percussion sound, and
weakened breathing in the area of projection of the tumor or cyst
on the chest wall (67). Significant changes were observed in the
study of the cardiovascular system: tachycardia, deafness of
heart sounds and various changes in the electrocardiogram
(109), systolic murmur at the apex of the heart (42), increased
venous pressure (30) and different filling of the pulse on the
arteries of the hands ( 23).
Our observations have shown that for tumors and cysts of
the mediastinum (mainly benign), the most characteristic is the
chronic course of the pathological process with a gradual
increase in symptoms. The acute onset of the disease was more
common in malignant tumors, especially of the lymphoblastic
type (lymphogranulomatosis, lymphosarcoma). Asymptomatic
course of mediastinal tumors and cysts was observed, according
to our data, in 20.5% of patients.
In the diagnosis of tumors and cysts of the mediastinum, the
leading role belongs to X-ray examination, which allows you to
establish the presence and size of the pathological formation, its
localization, nature and relationship with adjacent organs and
large vessels.
Based on our own observations and analysis of literature
data, we came to the conclusion that indications for surgery for
tumors and cysts of the mediastinum should be divided into vital
and absolute. Vital indications for surgery arise in cases where
a tumor or cyst of the mediastinum poses an immediate danger
to the life of the patient (compression of the trachea, large veins,
etc.). Out of 120 patients with tumors and cysts of the
mediastinum, 2 people were operated on for health reasons with
the threat of compression of the trachea by complete intrathoracic
goiter. Absolute indications for surgery were established in cases
where there was confidence that only surgical intervention could
save the patient from the disease. Such conditions, in our
opinion, occur in all benign, as well as malignant tumors and
cysts of the mediastinum, with the exception of widespread
damage to the mediastinal lymph nodes by metastases,
lymphogranulomatosis and reticulosarcoma. In case of thymus
hyperplasia, surgery is indicated in cases of significant
compression of surrounding organs and vessels or in combination
with generalized myasthenia gravis of moderate and severe
forms with a steady progressive course and ineffective
conservative treatment. Absolute indications for surgery were
also established in patients in whom it was not possible to
establish the nature of the neoplasm and especially the
histomorphological type of a malignant tumor using clinical and
radiological methods. Most patients (118 out of 120) had absolute
indications for surgery.
X-ray examination was performed in our patients in a certain
sequence. In addition to multi-projection transillumination using
various functional tests, radiography in standard projections, all
patients are targeted for
Some or other additional X-ray methods of investigation were
used leniently. In the overwhelming majority of cases, these
were relatively simple and safe methods: superexposed images,
contrast examination of the esophagus, X-ray kimography and
tomography. More complex methods of X-ray examination, such
as bronchography, pneumomediastinography, angiography, etc.,
were used less frequently and only for certain indications. Due
to the rational use of clinical and radiological research methods,
in 95 (71.4%) of 133 patients in whom the nature and type of
mediastinal tumors and cysts were confirmed by histological
examination, it was possible to correctly diagnose. It was not
correctly or with complete certainty established in 38 (28.6%)
patients.
Another, no less important problem of surgical treatment of
mediastinal tumors and cysts is the issue of contraindications to
surgery. When establishing them, we proceeded, first of all, from
the nature of the indications and the presence of general and
local conditions in patients that make surgical intervention
ineffective or more dangerous than the disease itself. At the
same time, we considered it expedient to divide all
contraindications to surgery into absolute and relative ones. Of
156 patients with tumors and cysts of the mediastinum, 24
people (16%) were not operated on due to the presence of
contraindications, of which 21 had absolute contraindications,
and 3 had relative ones.
Absolute contraindications for surgery in patients were:
An analysis of erroneous diagnoses showed that they were
mainly reduced to errors in determining the histomorphological
type of a tumor or cyst (24) and less often to errors in establishing
the exact localization (9) and their nature (5).
– a common lesion of the mediastinal lymph nodes with
lymphogranulomatosis, reticulosarcoma and mesothelioma
metastases (17 patients);
– malignant tumors that invaded vital organs, large vessels
and chest wall and metastasized to regional lymph nodes,
internal organs, spine and pelvic bones (4 patients).
Of course, at present, thanks to the use of various modern
instrumental research methods (ultrasound, CT, MRI, etc.), if not
in all, then in many cases it is possible to correctly recognize and
Relative contraindications to surgery in patients (3) were
mainly severe concomitant diseases.
187
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Siberian Medical Journal, 2009, No. 6
The clinical result of surgical treatment of tumors
novocaine solution, which is a kind of hydraulic
and cysts of the mediastinum largely depends on the
chemical preparation of tissues. In addition, in 6 patients,
preoperative preparation of patients. Before surgery, it
when removing large cysts that had significant adhesions
is necessary not only to carefully examine patients, but
to surrounding organs, the technique of B.V. Petrovsky
also to improve their general condition, taking into
was used. Thanks to these techniques, in most patients,
account the severity of the upcoming operation and the
tumors and cysts of the mediastinum were relatively
various changes associated with it in the postoperative period.
easily mobilized and removed.
Preoperative preparation of our patients with
During surgery in conditions of altered mediastinal
pathological formations of the mediastinum was carried
topography under the influence of tumors and cysts,
out mainly according to generally accepted rules for
various complications can be observed: shock, bleeding,
thoracic patients. At the same time, individual
organ damage, etc. In our observations, there were a
relatively small number of complications during surgery:
characteristics of patients, the nature, type and size of
the tumor (cyst), the presence of complications and
2 patients had place shock, 8 - moderate bleeding and
concomitant diseases were taken into account.
10 - damage to the mediastinal pleura and diaphragm.
About 1/3 of patients undergoing surgical treatment
In the vast majority of patients (93 out of 120) operated
on for tumors and cysts of the mediastinum, the
for various tumors and cysts of the mediastinum did not
need any special preoperative preparation. Functional
postoperative period was uneventful. In 27 patients,
parameters in these patients were normal or had minor
complications of different nature and severity occurred
deviations from the norm.
at different times after the operation. The most common
of them were: pneumonia (in 7 patients), partial
Special preoperative preparation had to be carried
suppuration of the surgical wound (in 6 patients), paresis
out in elderly patients (17) and those suffering from
of the recurrent nerve (in 5 patients), various neurological
malignant tumors and large benign neoplasms (12),
disorders (in 5 patients) and respiratory disorders (in 5
since almost all of these patients had signs of pulmonary patients). ). Most of the complications only slightly
and cardiovascular insufficiency.
aggravated the course of the postoperative period and
were cured by conservative methods.
Successful mediastinal surgery for a tumor or cyst
largely depends on the correct type of anesthesia. Most
of our patients with tumors and cysts of the mediastinum
(77 out of 120) were operated under endotracheal
anesthesia in combination with muscle relaxants and
controlled breathing. Local anesthesia according to A.V.
Vishnevsky was used mainly in 1954-1958, when
endotracheal anesthesia in cli-
Out of 120 operated patients with tumors and cysts
of the mediastinum in clinics and hospitals, 2 people
died, which is 1.7%. In both cases, death occurred in
the postoperative period: in one case, on the 3rd day
after the operation due to respiratory disorders, in the
other, on the 28th day, due to severe hypoxia that developed
table 2
nikah was just learning.
One of the important conditions that
ensure the successful performance of the
operation is also the correctly chosen
surgical approach to the mediastinum. The
latter was chosen by us depending on the
location of the pathological formation in the
mediastinum and its size. The nature of the
neoplasm and complications were also
taken into account. Various approaches
were used (Table 2).
All the surgical approaches we used
made it possible to examine the position of
the tumor or cyst in the mediastinum, to
determine their relationship to neighboring
anatomical structures, and provided room
for manipulations.
For tumors and cysts of the mediastinum,
patients underwent various surgical
interventions (Table 3).
The choice of surgical interventions
was determined mainly by the nature and
size of pathological formations and their
relationship to nearby organs and vessels.
All benign tumors and cysts (101) were
radically removed. With malignant
neoplasms, radical operations were
performed only in 6 out of 19 operated
patients.
Many tumors and cysts of the
mediastinum (neurogenic tumors, teratoid
formations, tumors and hyperplasia of the
thymus, etc.) in our patients were soldered
to the adjacent anatomical structures
(adhesions of varying degrees were found
in 76 out of 120 operated patients). Taking
this into account, we injected 0.25% around
the tumor or cyst in almost all operations.
Types of surgical approaches in patients with tumors and cysts of the
anterior and posterior mediastinum
Tumors and cysts of
Tumors and
the anterior
posterior cysts
mediastinum
mediastinum
Types of surgical access
Anterolateral
21
3
-
7
Posterolateral Lateral
intercostal Suprasternal
fifteen
fourteen
Total
24
7
29
41
-
41
Transverse transverse bipleural Combined:
6
-
6
suprasternal extrapleural and anterolateral
7
-
7
extrapleural Transsternal longitudinal
suprasternal extrapleural and transsternal
longitudinal posterolateral with laminectomy
-
one
one
Extrapleural posterior mediastinomia
according to Nosilov Total:
-
2
-
one
2
one
-
2
2
93
27
120
Table 3
Types of surgical interventions in patients with benign and malignant
tumors and cysts of the mediastinum
Types of surgical
interventions
Extirpation of the tumor
Malignant
benign
tumors and cysts
Total
tumors and cysts
101
6
107
-
7
7
-
5
5
cysts
Tumor resection or
cysts
Trial thoracotomy
-
one
one
laminectomy
Total
101
188
nineteen
120
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Siberian Medical Journal, 2009, No. 6
due to the germination of a metastatic tumor of the vital
organs and vessels of the mediastinum.
Long-term results of surgical treatment of benign tumors
and mediastinal cysts were studied by us in 94 out of 101
surgical patients in terms of 6 months to 17 years. 79 of
them were subjected to a comprehensive study, the fate of
15 patients was
Separate results of surgical treatment of malignant
tumors of the mediastinum were studied by us in 16 out of
18 patients. The follow-up period ranged from 4 months to
7 years.
Of the 16 patients, 6 were radically operated on, 7
patients underwent tumor resection, 2 trial thoracotomy, and
1 patient decompressive laminectomy. In addition, 10
patients in the postoperative period and later in the
conditions of an oncological dispensary underwent radiation
therapy.
known from the questionnaires that they filled out themselves or their
relatives.
According to the quality of the results, we divided the
patients into three groups: with good, satisfactory and
unsatisfactory results.
The group with good results included 82 patients who
noted the complete disappearance of the symptoms of the
disease after surgery and the absence of complaints about
any painful phenomena associated with surgery.
chenie.
Of the 16 patients, 2 live: one of them lives without
recurrence and metastases for 2 years (the patient was
radically operated on for malignant thymoma), the other
lives for 7 years (the patient had a seminoma metastasis removed). AT
postoperative period and periodically during
active intervention.
2 years they were subjected to radiation therapy. One of
All these patients consider themselves practically
these patients does not work and receives an allowance for
disability group II; the second patient works as a mechanic,
healthy. They returned to their usual way of life, study and
work. The same group included 7 children, all of them are
as before the operation. All other patients (14) died 1.5
developing well, they have no recurrence of the tumor and cysts.months - 3 years after the operation from the ongoing growth
In the group with satisfactory results, we included 11
of the tumor, its recurrence or metastases.
patients in whom the main complaints and objective signs
Analysis of our observations showed that the best longof the disease disappeared after the operation, but slight
term results were obtained in the surgical treatment of
chest pains, shortness of breath or palpitations remained,
benign tumors and mediastinal cysts; long-term results of
or complaints appeared in connection with the surgery: pain
surgical treatment of malignant mediastinal tumors are less
along the postoperative scar, impaired sweating, Horner's
favorable.
syndrome, etc. The same group included 4 patients who
Thus, a wider coverage of the population with preventive
had benign tumors and hyperplasia of the thymus,
medical examinations and greater awareness of physicians
accompanied by symptoms of myasthenia gravis. The
intensity of myasthenic symptoms decreased, the dose of
about this pathology will contribute to the earlier detection
anticholinesterase drugs was reduced by 1/3. No tumor and
of tumors and cysts of the mediastinum and thereby lead to
cyst recurrence was found in this group of patients.
an increase in their operability, improvement of immediate
and long-term results.
Literature
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3. Lukyanchenko B.Ya. Recognition of tumors and cysts
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5. Kolesov A.P., Zheludev S.I., Davydenko V.A. et al. Clinic, diagnosis
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9. Bariety YA, Caury C. Le mediastin sa pathologie. - Paris, 1958. 190 rubles.
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Address for correspondence: 664023, Irkutsk, st. Piskunova, 106, apt. 48, Snegirev
Ivan Ignatievich - Candidate of Medical Sciences, Assistant of the Department of General Surgery with the course of Urology,
tel. (3952) 54-88-01, e-mail: [email protected]
© Fedchishin O.V., Trofimov V.V., Klimenov V.A. — 2009
Effect of ultrasonic treatment on the structure and physical and mechanical properties of titanium VT 1-0
O.V. Fedchyshyn1 , V.V. Trofimov1 , V.A. Klimenov2
(1 Irkutsk State Institute for Postgraduate Medical Education, Rector – Doctor of Medical Sciences, Prof. V.V. Shprakh,
Department of Orthopedic Dentistry, Head – Doctor of Medical Sciences, Prof. V.V. Trofimov;
2 Tomsk Polytechnic University, rector - Doctor of Technical Sciences, prof. P.S. Chubik,
Federal State Unitary Enterprise Research Institute of Introscopy of Tomsk Polytechnic University, Director — Doctor
of Technical Sciences V.A. Klimenov)
Summary. Low, in relation to alloyed titanium alloys, the strength of commercially pure titanium significantly limits the
possibilities of its application. In order to improve the mechanical properties and modify the surface, titanium samples were
subjected to ultrasonic surface treatment.
Key words: titanium, microhardness, ultrasound.
189