Features of the clinical course, diagnosis and treatment of paranasal sinusitis in patients with type 2 diabetes mellitus
The issue of treating paranasal sinusitis, improving the methods of their treatment and prevention remains relevant to the present. Particular attention shall be paid to patients with concomitant somatic pathology, which contributes to the chronicity of inflammatory processes in the paranasal sinuses and increases the frequency of their recurrence. Among the pathology of ENT organs, acute sinusitis is most common (5–10%). Inflammatory diseases of the nose and paranasal sinuses are fraught with various complications. Thus, the percentage of orbital rhinogenic complications ranges from 6.6 to 12.4%. Patients with a history of diabetes mellitus are more exposed to various diseases, including ENT organs, with their rapid development and subsequent complications. The clinic of purulent sinusitis in them is characterized by a prolonged course with periodic exacerbations and the involvement of nearby anatomical structures in the pathological process with atypical data of radiation studies and frequent complications. The disease proceeds against the background of pronounced changes in the immune status, which affect all links of immunity, including a significant decrease in phagocytosis indicators and an increase in the content of circulating immune complexes of small size. Prolonged exposure of the body to products of free radical oxidation, especially in excess volume, leads to metabolic disorders at all levels and also disrupts the immune status, which leads to a complicated course of diseases. The presence of a pronounced imbalance towards the production of free radicals and a weakening of antioxidant protection leads to the development of oxidative stress and destructive changes at different levels. Treatment of this category of patients is a difficult task, in the solution of which the state of immunity and antioxidant system plays an important role.