Current approaches to the treatment of rhinosinusitis

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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Complex treatment of diseases of the nasal cavity and paranasal sinuses at the present time

Medical Council ◽

10.21518/2079-701x-2021-18-134-139 ◽

2021 ◽

pp. 134-139

Author(s):

V. M. Svistushkin ◽

K. V. Eremeeva

Keyword(s):

Nasal Cavity ◽

Paranasal Sinuses ◽

Clinical Symptoms ◽

Local Treatment ◽

Silver Ions ◽

Upper Respiratory Tract ◽

Drug Induced ◽

High Incidence ◽

Upper Respiratory ◽

Pain Symptoms

The search for rational treatment of diseases of the nasal cavity and paranasal sinuses is due to the high incidence among the world's population. Despite the absolutely clear recommendations that would seem to greatly facilitate the choice and scope of therapy, it is extremely important to have a differentiated approach to each patient, depending on age, concomitant pathology, the nature of the course of the disease, the severity of clinical, primarily pain symptoms, and the presence of rhinogenic complications. Differential diagnosis of viral and bacterial acute rhinosinusitis (ARS) allows to avoid unreasonable prescription of antibiotics in the former case and choose therapy in such a way as to help relieve clinical symptoms, timely cure the disease and prevent complications. A systematic review of the literature was conducted with the analysis of scientific research data on the evaluation of the effectiveness of protargol or silver proteinate in the local treatment of upper respiratory tract diseases. A review of studies shows that silver proteinate has astringent, antiseptic and anti-inflammatory effects. The spectrum of antimicrobial action of silver is much wider than many antibiotics and sulfonamides. At the same time, pathogenic microflora is more sensitive to silver ions than non-pathogenic microflora. The analysis of the works also demonstrates the absence of adverse reactions when using this drug. The obtained data allow us to recommend preparations based on silver proteinate as a complex therapy for acute and chronic diseases of the nasal cavity and nasopharynx. The vasoconstrictive effect of protargol allows it to be used as an alternative to decongestants in order to avoid the development of drug-induced rhinitis and tachyphylaxis. Sialor® is a new, convenient, affordable, longer-shelf-life form of silver proteinate.

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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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Sinonasal Leiomyoma: Report of 2 Cases

Ear Nose & Throat Journal ◽

10.1177/014556130508400415 ◽

2005 ◽

Vol 84 (4) ◽

pp. 224-230 ◽

Cited By ~ 6

Author(s):

A.K. Agarwal ◽

Ramanuj Bansal ◽

Deepti Singhal

Keyword(s):

Smooth Muscle ◽

Respiratory Tract ◽

Nasal Cavity ◽

Paranasal Sinuses ◽

Alimentary Tract ◽

Subcutaneous Tissue ◽

Upper Respiratory Tract ◽

Therapeutic Modalities ◽

Smooth Muscle Tumors ◽

Upper Respiratory

Leiomyomas are benign smooth-muscle tumors that are common in the alimentary tract, uterus, skin, and subcutaneous tissue. They are very uncommon in the upper respiratory tract and rare in the nasal cavity and paranasal sinuses. To the best of our knowledge, only 23 such cases have heretofore been published in the literature. We report 2 new cases of sinonasal leiomyoma that originated at different sites in the nasal cavity. We also discuss the various investigative and therapeutic modalities available.

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Effective and safe treatment for the inflammatory diseases of the nose and nasopharynx

Russian Medical Inquiry ◽

10.32364/2587-6821-2020-4-4-238-242 ◽

2020 ◽

Vol 4 (4) ◽

pp. 238-242

Author(s):

A.Yu. Ovchinnikov ◽

◽

N.A. Miroshnichenko ◽

Yu.O. Nikolaeva ◽

◽

...

Keyword(s):

Nasal Cavity ◽

Paranasal Sinuses ◽

Viral Infections ◽

Inflammatory Diseases ◽

Treatment Options ◽

Safe Treatment ◽

Inflammatory Disorders ◽

Acute Rhinosinusitis ◽

Related Quality ◽

Health Related

Inflammatory diseases of the nasal cavity and paranasal sinuses are identified as the leading cause of upper respiratory disorders. Nose breathing is of crucial importance to provide the entry for air to get into the respiratory system. In addition to oxygen saturation, nose breathing provides the exchange of air in the paranasal sinuses. This process is required to maintain normal microflora of the nasal cavity. In contrast, mouth breathing occurring during the inflammatory diseases of the nasal cavity is associated with discomfort and poor health-related quality of life and results in inflammation. Viral inflammatory disorders often exacerbate a patient’s condition and provoke bacterial inflammation. Recent widespread occurrence of antimicrobial resistance forced to change the paradigm in the treatment of inflammatory disorders and to refocus on time-proved topical therapies. Systemic antibiotics are now used only for strict indications. Other treatment options are widely applied. Thus, silver preparations characterized by antiseptic and bactericidal properties allow to avoid complications and to aid the recovery. They are the best choice of topical agents for treating acute rhinosinusitis. KEYWORDS: acute rhinitis, acute rhinosinusitis, acute respiratory viral infections, antibacterial drugs, topical treatment, argentum proteinate. FOR CITATION: Ovchinnikov A.Yu., Miroshnichenko N.A., Nikolaeva Yu.O. Effective and safe treatment for the inflammatory diseases of the nose and nasopharynx. Russian Medical Inquiry. 2020;4(4):238–242. DOI: 10.32364/2587-6821-2020-4-4-238-242.

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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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Aetiology, diagnosis and treatment of chronic rhinosinusitis: a study in a teaching hospital in Telangana

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20160062 ◽

2016 ◽

Vol 2 (1) ◽

pp. 14 ◽

Cited By ~ 3

Author(s):

Harika Surapaneni ◽

Shalini Singh Sisodia

Keyword(s):

Ct Scan ◽

Chronic Rhinosinusitis ◽

Paranasal Sinuses ◽

Chronic Sinusitis ◽

Clinical History ◽

Endoscopic Examination ◽

Lateral View ◽

Upper Respiratory Tract ◽

Deviated Nasal Septum ◽

X Ray

Background: Chronic rhinosinusitis is one of the common problems in ENT Department which can be caused due to infections or anatomical blockage or allergy. We performed this study to assess the cause, clinical features and the effect of treatment on rhinosinusitis.Methods: 60 patients of chronic sinusitis with symptoms persisting beyond three months, Nasal Endoscopic findings with Polyps/Discharge/edematous mucosa were included in the study. A detailed clinical history, with complete Ear, Nose, Throat, and Head and Neck examination, blood tests like complete blood picture, Blood sugar levels, ESR and Hepatitis profile. X ray of paranasal sinuses, (water’s view) and lateral view, Chest x-ray –PA View and CT scan of paranasal sinuses (axial and coronal section with 3mm cuts at OMC) was done for all patients. Diagnostic Nasal Endoscopic examination (DNE) for detection of polyps / discharge / edematous mucosa in middle meatus was also done for the patients where it was necessary. The patients were given medical or surgical treatment according to the symptom and followup was done for 3 months for all patients. Results: Over 75% of the patients had incidence of sinusitis in the age group of 16 – 45 years. The most common etiology was sinusitis caused by infections (26 – 44%) followed by anatomical obstruction (22 – 36%). Of the 22 anatomical obstruction the most common was Deviated nasal septum in 14 (62%) of the cases followed by 4 (19%) CB, 3 (15%) pradixical MT and 1 (4%) prominent aggernasi. The most common sign and symptom was headache and polypoidal changes observed in 36 patients each (60%), followed by nasal obstruction in 35 patients (50%). 12 (20%) of the patients were treated with polypectomy + FESS while 14 (23%) of them were treated with septoplasty + FESS. 34 (57%) were treated with only FESS.Conclusions: Chronic sinusitis doesnot affect a particular age or sex and is more common among patietns with an upper respiratory tract infection. CT scan of the paranasal sinuses is the most useful tool in diagnosing the disease and FESS is the treatment of choice.

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

Journal of The Royal Naval Medical Service ◽

10.1136/jrnms-102-117 ◽

2016 ◽

Vol 102 (2) ◽

pp. 117-123

Author(s):

R Easto ◽

R Shukla ◽

R Williams

Keyword(s):

Nasal Cavity ◽

Chronic Rhinosinusitis ◽

Paranasal Sinuses ◽

Background Information ◽

Hospital Treatment ◽

Nasal Bones ◽

Common Complaint ◽

Sinonasal Malignancies ◽

Benign Group ◽

Nose And Throat

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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