scholarly journals Therapy of rhinosinusitis in childhood

2021 ◽  
pp. 36-41
Author(s):  
G. V. Santalova

Introduction. The relevance of the problem of rhinosinusitis in different ages is due to their high prevalence. The article presents information with approaches of  the  treatment rhinosinusitis in  children, which allow preventing irreversible changes in the mucous membrane of the nasal cavity and paranasal sinuses. The importance of eliminating dysregulation in biological networks underlying the disease is noted. Such capabilities are possessed by means of bioregulatory medicine.Aim of the study: To carry out a comparative analysis of the effectiveness of chronic rhinosinusitis treatment with Euphorbium compositum and conventional methods of therapy in children.Materials and methods: We conducted retro- and prospective study in children’s polyclinic No. 1 and homeopathic center “Homeopathic medicine” in Samara. There were 66 children aged 7 to 12 years old diagnosed with chronic rhinosinusitis under observation. The children were observed in two groups for 2 years. Results. In chronic sinusitis within 2 weeks after the beginning of the course of therapy significant symptomatic improvement was registered in 75.8% of the patients receiving Euforbium compositum and in 71.3% of the patients receiving conventional medical therapy. During the clinical observations there was not a single case of adverse effects against the background of Euphorbium compositum therapy, the patients’ general condition and nasal breathing parameters reliably improved.Results. Numerous scientific studies noted: the ability of nasal spray Euphorbium compositum to have a complex multi-target effect on the process of inflammation, on the state of nasal mucous membranes; safety and effectiveness.Conclusions. Complex bioregulating action of Euphorbium compositum Nasentropfen C allows to control and optimize the course of chronic inflammatory process in rhinosinusitis. Its application promotes restoration of structure and function of nasal cavity mucosa, it is not accompanied by complications. These characteristics in combination with good tolerability make it possible to use the drug for treatment of rhinosinusitis.

2022 ◽  
pp. 51-55
Author(s):  
I. I. Chernushevich ◽  
A. N. Naumenko ◽  
A. V. Voronov ◽  
A. Y. Golubev ◽  
E. E. Kozyreva

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.


Author(s):  
S.Sh. Gammadaeva ◽  
M.I. Misirkhanova ◽  
A.Yu. Drobyshev

The study analyzed the functional parameters of nasal breathing, linear parameters of the nasal aperture, nasal cavity and nasopharynx, volumetric parameters of the upper airways in patients with II and III skeletal class of jaw anomalies before and after orthognathic surgery. The respiratory function of the nose was assessed using a rhinomanometric complex. According to rhinoresistometry data, nasal resistance and hydraulic diameter were assessed. According to the data of acoustic rhinometry, the minimum cross-sectional area along the internal valve, the minimum cross-sectional area on the head of the inferior turbinate and nasal septum and related parameters were estimated. According to the CBCT data, the state of the nasal septum, the inferior turbinates, the nasal aperture, the state of the nasal cavity, and the linear values of the upper respiratory tract (nasopharynx) were analyzed. The patients were divided into 4 groups according to the classification of the patency of the nasal passages by


Author(s):  
Sergey Bezshapochny ◽  
Andrey Loburets ◽  
Valery Loburets

Topicality: The result of surgical treatment depends largely on the chosen method of management of the postoperative period, the main purpose of which is to reduce the effects of surgical trauma. Despite the wide variety of drugs for local and systemic use, the question of pharmacotherapy of the operated sinus remains open to this day. The main properties that a modern drug should possess are safety and high clinical efficacy. Aim: to study the clinical efficacy of topical application of a complex preparation based on a saline solution containing sodium hyaluronate and dexpanthenol in patients with chronic sinusitis after functional endoscopic sinus surgery (FESS). Materials and Methods: Clinical and laboratory studies were conducted on 47 patients with chronic rhinosinusitis who underwent surgery using the FESS technique. Patients were divided into 2 groups according to the principle of the postoperative period. Patients of research group (n=21), except for traditional therapy, was used locally NASOMER (a preparation based on a water-salt solution containing sodium hyaluronate and dexpanthenol); to the control group (n=26) patients entered, in the postoperative period received traditional therapy. Traditional therapy included a toilet of the nasal cavity, the use of short-course topical decongestants, irrigation of the nasal cavity with water-salt solutions. Criteria of clinical effectiveness: data of endoscopy of the nasal cavity, rhinomanometry, activity of the mucociliary transport system. The effectiveness of functional research methods in the postoperative period was determined on the 7th and 14th day of treatment. Results: On the 3rd day of the study, an increase in the swelling of the nasal cavity was observed in patients of both clinical groups, correlated with difficulty in nasal breathing. On the 7th day, a decrease in edema was observed in patients of both groups, but in the experimental group, the index of nasal breathing, according to rhinomanometry, was significantly (p<0.05) different from the control group, and was respectively 1.54±0.14 and 2.04±0.19 kPa/l*s. On the 14th day of the study, no significant difference was observed between these indicators. When studying the activity of the ciliated epithelium of the mucous membrane of the nasal cavity, it was proved that patients of the experimental group on day 7 after surgery showed a statistically significant difference in this indicator compared to the control group (17.8±1.0 and 22.7±2.1 min. respectively). Conclusions: The use of NASOMER after surgical intervention in patients with chronic rhinosinusitis contributes to more effective treatment compared with traditional therapy, as evidenced by the rapid recovery of the main functional parameters according to active posterior rhinomanometry and mucociliary clearance. Based on the results of the studies performed, the use of NASOMER for pharmacotherapy in the postoperative period is recommended for patients who have undergone rhinosurgical interventions with the aim of reducing the period of postoperative rehabilitation as an effective anti-inflammatory and wound-healing agent.


Author(s):  
Vladimir Bereznyuk ◽  
Alexander Chernokur ◽  
Oleg Gospod

Relevance: Modern endonasal surgery allows to remove polyps from all affected paranasal sinuses, following the principles of minimal invasiveness. Minimal traumatic of surgical intervention gives the best results, accompanied by less progression of the disease. Minimal invasiveness of surgical intervention and its obligatory combination with postoperative medical treatment are common practice in many countries. One of the drugs that actively effect the restoration of the mucous membrane of the nasal cavity and paranasal sinuses in the early postoperative period is Nazomer, which includes sodium hyaluronate and dexpanthenol in saline solution. The purpose of the study is to investigate the effectiveness of the drug Nazomer in patients with polyposis rhinosinusitis after endoscopic polyposynosotomy. Results and discussion: The main group consisted of 30 patients with polyposis rhinosinusitis, who were prescribed Nasomer in addition to standard treatment in the postoperative period. The control group included 30 patients who underwent standard treatment in the postoperative period. As criteria for clinical efficacy, data from endoscopic examination of the nasal cavity and indicators of anterior rhinomatometry, measured by the «Optimus» device, were selected. In the main group, the index of nasal breathing according to rhinomatometry was better than the results of patients in the control group on the 3rd and 5th day of the postoperative period by 26% and 24%, respectively. Conclusion: The use of the drug Nazomer in the postoperative period in patients with polyposis rhinosinusitis contributes to more active restoration of respiratory function of the nasal cavity compared with the control group, according to rhinomatometry, up to 26%. Based on the results obtained, the drug Nazomer is an effective anti-inflammatory and regenerative agent in the postoperative period in patients with polyposis rhinosinusitis.


2012 ◽  
Vol 9 (5) ◽  
pp. 55-59
Author(s):  
A A Tsyvkina ◽  
L V Luss ◽  
S V Tsarev ◽  
N V Shartanova

Background. To study of efficacy, tolerability and safety of nasal spray Prevalin in the treatment of allergic rhinitis patients. Methods. 30 patients with allergic rhinitis in the age of18 till 45 years were observed. Prevalin was given as one insufflation into each nasal cavity 3 times a day for 21 days. Results of treatment were assessed by the dynamics of clinical symptoms and the results of functional methods . Results. The positive clinical effect was observed in 22 patients (73,3%), using Prevalin. Clinical effect was characterized by the restoration of nasal breathing, reduce swelling of the nasal mucosa. We did not establish a good result of treatment in 8 patients. Conclusion. The study demonstrated clinical efficacy and safety of spray Prevalin.


Author(s):  
Djuraev Jamolbek Abdukakharovich ◽  
◽  
Makhsitaliev Mukhammadbobur Ibrokhimovich, Ibrokhimovich ◽  

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.


2018 ◽  
Vol 32 (2) ◽  
pp. 98-100
Author(s):  
Ryan H. Belcher ◽  
Allison K. Ikeda ◽  
John M. DelGaudio

Background Endoscopic sinus surgery is performed for many reasons, most commonly for chronic rhinosinusitis refractory to medical treatment. A paradoxical middle turbinate is an anatomic variant that can hinder endoscopic access to the sinuses. No publication has addressed how to surgically treat a paradoxical middle turbinate. Method We present a basic endoscopic surgical approach to conservatively resect a paradoxical middle turbinate in order to improve access to the middle meatus and the sinuses while preserving support and function. Conclusion Conservative remodeling of the paradoxical middle turbinate can provide access to the sinuses while maintaining a significant portion of the middle turbinate.


2018 ◽  
Vol 25 (6) ◽  
pp. 876-879 ◽  
Author(s):  
James Triplett ◽  
Srimathy Vijayan ◽  
Richard Prince ◽  
Allan Kermode

Background: Dimethyl fumarate (DMF) is a commonly used and effective treatment for relapsing and remitting multiple sclerosis. Its use results in impairment of the transcription factor nuclear factor erythroid-derived 2 (E2)-related factor (Nrf2), which is involved in both immunomodulation and bone health. DMF has not previously been reported to cause bone marrow complications, though other fumarates including tenofovir have. The mechanism of fumarate-associated bone toxicity remains unclear with altered osteoblastic gene expression and function suggested. Methods: We present a case of a 54-year-old female with relapsing remitting multiple sclerosis (RRMS) treated for 30 months with DMF who developed relapsing atraumatic lower limb bone pain. Results: Serial imaging revealed multifocal areas of bone marrow oedema and trabecular fractures. The patient was diagnosed with transient bone marrow oedema syndrome. Management consisted of cessation of therapy and treatment with the pro-osteobalstic agent denosumab. Conclusion: In this instance of DMF-associated bone marrow oedema, cessation of DMF and treatment with denosumab resulted in symptomatic improvement. DMF therapy may potentially result in bone marrow oedema due to inhibition of common upstream signalling pathways, including the Nrf2 signalling pathway.


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