An overview of common diseases of the nasal cavity and paranasal sinuses

AbstractDiseases of the nasal cavity and paranasal sinuses are a common complaint amongst the general population and service personnel. Chronic rhinosinusitis, with or without nasal polyps, and nasal deformity leading to airway obstruction are some of the commonest ear, nose and throat (ENT) conditions encountered. However, hidden within this generally benign group of conditions are some potentially lethal problems that clinicians need to be able to recognise.This article aims to provide an overview of common conditions affecting the nose and paranasal sinuses, including fractured nasal bones, acute rhinosinusitis and its complications, and chronic rhinosinusitis. Epistaxis and sinonasal malignancies are largely outside the scope of this paper. Background information on pathogenesis will be described, along with guidance on diagnosis and management with particular stress on emergency pre-hospital treatment and indications for referral to an ENT specialist.

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Morphofunctional State of the Maxillary Sinus Mucosa in Patients After Endoscopic Infundibulotomy

International Journal of Advanced Dental Sciences and Technology ◽

10.35940/ijadst.c1006.101321 ◽

2021 ◽

Vol 1 (3) ◽

pp. 6-10

Author(s):

Djuraev Jamolbek Abdukakharovich ◽

◽

Makhsitaliev Mukhammadbobur Ibrokhimovich, Ibrokhimovich ◽

Keyword(s):

Nasal Cavity ◽

Maxillary Sinus ◽

Chronic Rhinosinusitis ◽

Mucous Membrane ◽

Paranasal Sinuses ◽

Pathological Process ◽

Fundamental Factor ◽

Sinus Mucosa ◽

Morphological State

The work carried out made it possible to substantiate the need to apply a method for studying the frequency of beating of cilia of the mucous membrane of the nasal cavity and paranasal sinuses in patients with chronic rhinosinusitis when choosing treatment tactics in an ENT hospital. Analysis of the study of data on the functional and morphological state of the mucous membrane of the nasal cavity and maxillary sinus allows us to judge the severity of the pathological process before surgery, which is the fundamental factor in the algorithm for the treatment of chronic rhinosinusitis.

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Current approaches to the treatment of rhinosinusitis

Terapevt (General Physician) ◽

10.33920/med-12-2111-01 ◽

2021 ◽

pp. 6-15

Author(s):

Oksana. A. Gizinger ◽

Natalia V. Kornova ◽

Artem S. Beloshangin

Keyword(s):

Nasal Cavity ◽

Chronic Rhinosinusitis ◽

Paranasal Sinuses ◽

Viral Infections ◽

Recovery Period ◽

Relative Number ◽

Polymyxin B ◽

Quantitative Composition ◽

Upper Respiratory Tract ◽

Phenylephrine Hydrochloride

Relevance: despite the available methods and medicines, rhinosinusitis occupies a leading place in the structure of diseases of the upper respiratory tract. Rhinosinusitis can be a consequence of respiratory viral infections, can be an independent nosological unit. In recent years, there has been a protracted course of rhinosinusitis with a long recovery period with chronic inflammation in the paranasal sinuses and nasal cavity. Purpose of the study: to analyze the validity and effectiveness of therapeutic approaches to the treatment of chronic rhinosinusitis using the Polydexa with phenylephrinum nasal spray with phenylephrine Materials and мethods: The study included 121 patients — 61 (50.41 %) women and 60 (49.59 %) men aged 25 to 50 years, a history of chronic rhinosinusitis in the stage of clinical exacerbation at the time of the study. All patients underwent: otorhinolaryngological examination, general clinical and radiological (radiography or computed / magnetic resonance imaging of the paranasal sinuses). Cytological examination of the detachable nasal cavity was carried out to study the calculation of the relative number of neutrophilic granulocytes, macrophages, epithelial cells, lymphocytes. Microbiological examination of the detachable nasal cavity and paranasal sinuses included the study of the qualitative and quantitative composition of pathogenic and opportunistic organisms on the surface of the nasal mucosa. Results: in patients with chronic rhinosinusitis in the stage of clinical exacerbation, an increase in the relative content of inflammatory elements was revealed in the nasal secretion against the background of the prevailing content of pathogenic staphylococci and streptococci. The use of topical preparations containing antibacterial components of a broad antimicrobial spectrum of action, dexamethasone, phenylephrine hydrochloride helps to relieve inflammation on the surface of the mucous membranes of the nasal cavity and paranasal sinuses. Conclusions: a method of treating chronic rhinosinusitis in the stage of clinical exacerbation using a combined preparation for topical application containing neomycin sulfate, polymyxin B sulfate, dexamethasone sodium metasulfobenzoate, phenylephrine hydrochloride has a pronounced anti-inflammatory, decongestant, antibacterial effect

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Anatomy of Nasal Cavity and Paranasal Sinuses; Surgical Perspective

Korean Journal of Otorhinolaryngology - Head and Neck Surgery ◽

10.3342/kjorl-hns.2020.00227 ◽

2020 ◽

Vol 63 (5) ◽

pp. 189-198

Author(s):

Seung-Kyu Chung

Keyword(s):

Surgical Treatment ◽

Medical Treatment ◽

Nasal Cavity ◽

Chronic Rhinosinusitis ◽

Paranasal Sinuses ◽

Endoscopic Sinus Surgery ◽

Treatment Method ◽

Functional Endoscopic Sinus Surgery ◽

Sinus Surgery

Endoscopic sinus surgery is a treatment method for chronic rhinosinusitis not controlled with medical treatment. It had started with functional endoscopic sinus surgery and the concept of reboot approach was introduced recently. For safe surgical treatment, understanding the anatomy especially personal variations between well-known structures is important. The practical points of surgical concept during endoscopic sinus surgery was suggested.

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#57: The Clinical Significance of Changes in the Microbial Communities of the Nasal Cavity in Patients with Solid Tumors of Parameningeal Localization During Radiation Therapy

Journal of the Pediatric Infectious Diseases Society ◽

10.1093/jpids/piaa170.020 ◽

2021 ◽

Vol 10 (Supplement_1) ◽

pp. S6-S7

Author(s):

Tatyana Gorbunova ◽

Anastasia Rodina ◽

Oleg Merculov ◽

Vladimir Polyakov

Keyword(s):

Radiation Therapy ◽

Nasal Cavity ◽

Chronic Rhinosinusitis ◽

Paranasal Sinuses ◽

The Body ◽

Purulent Discharge ◽

Special Treatment ◽

Microbial Culture ◽

Staphylococcus Haemolyticus ◽

Treatment Standard

Abstract Background Immunosuppressive therapy places pediatric patients at risk of developing life-threatening sinonasal infections. Radiation-induced rhinitis is poorly studied and considered in clinical practice. Recognition of the unique microbial cultures of the nasal cavity and their antimicrobial susceptibility is of great importance when selecting antimicrobial therapy. Radiation therapy can affect nasal cavity microbiota. Despite considerable research, the pathogenesis of rhinitis remains poorly understood. Materials and Methods The study included 10 patients (boys 6; girls 4). Of them, the number of patients with rhabdomyosarcoma is 6 patients (60%), nasopharyngeal cancer 3 (30%), and hemangiopericytoma 1 (10%). The average age is 12.4 g. The observation period is 9–18 months. Tumors were localized in the nasopharynx 30%, paranasal sinuses on the one hand 50%, and on both sides 20%. Chemotherapy (ChT) included 8–16 courses. Radiation therapy (RT) was carried out after 4–6 courses, SOD 40–50 Gy. Examination of the otorhinolaryngologist and endoscopic examination of the nasal cavity were performed for all patients before and after the completion of special treatment. Standard microbial culture studies are carried out before (T0), in the middle of the course of radiation therapy (RT) (T1), and at the end (T2) RT. A repeat study microbial culture 12 months after completion of RT (T3). An analysis of the results will be compared with clinical data. Results All patients showed symptoms of chronic rhinosinusitis before the start of special treatment. Clinically determined: hyperemia and swelling of the mucosa of the lower and middle turbinates in 100% of cases, unilateral mucopurulent and purulent discharge in 70%, and bilateral in 30%. Complications and concomitant pathology were diagnosed in the form of dysfunction of the auditory tube in 30%, signs of tubo otitis in 60%, unilateral catarrhal otitis media in 10% of cases. During the bacteriological examination of a nasal swab against the background of chemotherapy, bacteria of the family Staphylococcaceae and Streptococcaceae with the same purity of 30%, fungi of the genus Candida in 20%, H. parainfluenzae and Corynebacterium amycolatum were equally divided in 10% of cases. Symptoms of exacerbation of chronic inflammation were detected in 100% of patients after 18–24 Gy was added to the tumor. After 3 months the completion treatment, gram-negative bacteria were obtained in smears: Enterobacter cloacae in 30%, Pseudomonas aeruginosa in 20%, Acinetobacter species in 10%, and mixed flora (Staphylococcus haemolyticus and Staphylococcus haemolyticus MRS), in 10% of patients. Conclusion Clinical manifestations of chronic rhinosinusitis accompany the growth of malignant tumors of the nasopharynx and paranasal sinuses. An increase in the concentration of pathogenic and conditionally pathogenic bacteria in the nasal cavity during CRT reflects a decrease in nonspecific immunity and the general immune resistance of the body.

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Morphofunctional State of the Maxillary Sinus Mucosa in Patients After Endoscopic Infundibulotomy

International Journal of Advanced Dental Sciences and Technology ◽

10.54105/ijadst.c1006.101321 ◽

2021 ◽

pp. 6-10

Author(s):

Djuraev Jamolbek Abdukakharovich ◽

◽

Makhsitaliev Mukhammadbobur Ibrokhimovich ◽

Keyword(s):

Nasal Cavity ◽

Maxillary Sinus ◽

Chronic Rhinosinusitis ◽

Mucous Membrane ◽

Paranasal Sinuses ◽

Pathological Process ◽

Fundamental Factor ◽

Sinus Mucosa ◽

Morphological State

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The use of intranasal glucocorticosteroids in patients with chronic rhinosinusitis in the preoperative period

Medical Council ◽

10.21518/2079-701x-2021-21-2-51-55 ◽

2022 ◽

pp. 51-55

Author(s):

I. I. Chernushevich ◽

A. N. Naumenko ◽

A. V. Voronov ◽

A. Y. Golubev ◽

E. E. Kozyreva

Keyword(s):

Blood Loss ◽

Nasal Cavity ◽

Chronic Rhinosinusitis ◽

Paranasal Sinuses ◽

Control Group ◽

Preoperative Period ◽

Nasal Breathing ◽

Intraoperative Bleeding ◽

Ostiomeatal Complex ◽

Intraoperative Period

Introduction. Chronic rhinosinusitis is a disease that occurs everywhere, characterized by inflammation of the mucous membrane of the paranasal sinuses and nasal cavity. If it is impossible to eliminate the causes of the recurrent disease with medical therapy, the use of surgical treatment help to recover the normal functioning of the ostium, including the ostiomeatal complex to improve ventilation and drainage of the paranasal sinuses and recover nasal breathing to relieve chronic inflammation.Purpose of the study. Assessment of the degree of intraoperative bleeding in patients with chronic rhinosinusitis.Materials and methods. On the basis of the FGBU SPB Research Institute of ENT of the Ministry of Health of the Russian Federation in the period from 2020 to 2021. the study of the effect of local intranasal glucocorticosteroids (INGKS) in the intraoperative period in patients with chronic polypous rhinosinusitis was carried out. The total amount of blood loss during surgery for chronic polypous rhinosinusitis in patients who used mometasone furoate preoperatively and in patients not taking topical hormonal drugs was analyzed.Results. In the study group, the average blood loss per operation was 257 ml, in the control group – 401 ml. In patients who took intranasal glucocorticosteroids during surgery, the intensity of bleeding is less pronounced. Undoubtedly, there are many reasons that affect the intensity of bleeding in general, however, a decrease in the inflammatory response in the nasal cavity and a decrease in inflammatory metabolites have a beneficial effect on the state of the nasal mucosa.Conclusion. The use of intranasal glucocorticosteroids in the preoperative period has a positive effect on reducing the inflammatory process in the nasal cavity, which helps to reduce the intensity of intraoperative bleeding.

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Surgery with Post-Operative Endoscopy Improves Recurrence Detection in Sinonasal Malignancies

Annals of Otology Rhinology & Laryngology ◽

10.1177/00034894211011449 ◽

2021 ◽

pp. 000348942110114

Author(s):

Gurston Gordon Nyquist ◽

Prachi N. Patel ◽

Swar Vimawala ◽

Chandala Chitguppi ◽

Tawfiq Khoury ◽

...

Keyword(s):

Nasal Cavity ◽

Paranasal Sinuses ◽

Tumor Recurrence ◽

Retrospective Chart Review ◽

Physical Exam ◽

Nasal Endoscopy ◽

Radiologic Evaluation ◽

Time To Recurrence ◽

Sinonasal Malignancies ◽

Operative Endoscopy

Objective: The mainstay of treatment in sinonasal malignancy (SNM) is surgery, and when combined with chemoradiation therapy, often leads to the best overall prognosis. Nasal endoscopy is essential for post-treatment surveillance along with physical exam and radiologic evaluation. The ability to directly visualize the sinus cavities after surgery may also improve early detection of tumor recurrence and is another reason to potentially advocate for surgery in these patients. Methods: A retrospective chart review of medical records of patients with pathologically proven SNM was conducted from 2005 to 2019. Results: The nasal cavity and maxillary sinus were the most common primary tumor sub-sites. The most common pathology was squamous cell carcinoma (42%). The median time to recurrence was 9.8 months. Recurrence was initially detected endoscopically in 34.3% patients, by imaging in 62.7% patients, and by physical exam in 3.0% patients. 67 (29%) total recurrences were detected on follow-up, of which 46 (68.7%) were local. Twenty-three of the local recurrences were identified via nasal endoscopy. Thirteen recurrences were identified via endoscopic surveillance within the surgically patent paranasal sinuses while 13 were identified within the nasal cavity; 5 patients had multiple sites of recurrence. Conclusion: Local recurrence of SNM is the most common site for recurrent disease and nasal endoscopy identified half of these cases. 50% of these recurrences were within the paranasal sinuses and would not have been easily identified if the sinuses were not open for inspection. Thus, open sinus cavities aid in the detection of tumor recurrence and is another advantage of surgery in the management of SNM.

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