scholarly journals Comparative analysis of some methods of surgical treatment of vasomotor rhinitis

2019 ◽  
pp. 42-48
Author(s):  
Saifutdin Arifov ◽  
Alexey Rasulov
Keyword(s):  
Surgical Treatment ◽  
Nasal Cavity ◽  
Postoperative Period ◽  
Mucociliary Clearance ◽  
Laser Coagulation ◽  
Nasal Breathing ◽  
Vasomotor Rhinitis ◽  
Optimal Method ◽  
Nasal Concha ◽  
Inferior Nasal Concha

Among chronic forms of rhinitis of great importance is vasomotor rhinitis, which is the most common form of chronic non-allergic rhinitis and the clinician has to deal with it constantly. Treatment of vasomotor rhinitis is a complex and largely unresolved problem, which puts this disease among the important problems of modern rhinology. The variety of methods used in the treatment of patients with vasomotor rhinitis confirms the complexity of the task of choosing the optimal method for clinicians and the difficulty of obtaining a sustainable result from the chosen method. Surgical treatment of patients with of patients with various forms of chronic rhinitis is sometimes the only effective. Currently, the arsenal of methods and means of surgical treatment of the nasal concha is quite wide and varied. The purpose of this study – to study in a comparative aspect the functional state of the nasal cavity after carrying out some methods of surgical treatment ofvasomotor rhinitis. Materials and Methods: The study was conducted in the clinic of the Department of Otorhinolaryngology of the Tashkent institute of postgraduate medical education on 43 patients with vasomotor rhinitis in age from 20 to 46 years, average age 28,0±1,3 years. All patients with BP included in our study, after collecting complaints and anamnesis, underwent an endoscopic examination of the nasal cavity and nasopharynx, a computerized tomogram of the nose and paranasal sinuses, standard laboratory tests and microscopy of a smear from the nasal cavity on eosinophils.Investigated the respiratory (computer rhinopneumocotachometry), transport (saccharin test) functions of the nasal mucosa, performed an adrenaline test and the Flour test (determination of the consistency of inferior nasal concha and the response to pushing with a push-button probe). Results: Studies have shown the highest efficiency of laser coagulation with vasomotor rhinitis. After laser surgery, a long-lasting and sustained improvement in the functions of the nasal cavity was noted, while there was no adverse effect on the mucous membrane of the nasal cavity, which was reflected in the recovery rates of both nasal breathing and mucociliary clearance. Given the well-tolerated laser coagulation, the lack of the need for observation and care of the nasal cavity in the postoperative period, the possibility of outpatient treatment, allows us to recommend this type of exposure as the method of choice in the surgical treatment of patients with vasomotor rhinitis. The simplicity of submucosal vasotomy, the availability of instruments for carrying out, the restoration of free nasal breathing and the positive effect on the functional state of the nasal cavity, although slower than laser coagulation, minimal side effects put it on a par with the laser effect. The need to use tampons after surgery reduces the quality of life of patients, hospital stays and the need to monitor patients in the early postoperative period makes this operation strictly inpatient. Electrocautery of inferior nasal concha demonstrated in our study a negative effect on the function of the nasal cavity, although, of course, there was a definite improvement in nasal breathing, but the severity and speed of improvement was significantly less than during laser exposure and submucosal vasotomy. The slowest and most incomplete restoration of the mucociliary clearance of the nasal cavity once again underlines the disadvantage of this method. Conclusion: Evaluation of the long-term results of surgical treatment based on the combination of effects on the respiratory and transport functions of the nasal cavity, as well as on the clinical manifestations of BP, makes it possible to recommend laser coagulation as the most optimal method providing a long-lasting effect in treating patients with vasomotor rhinitis. Alternatively, you can take a submucosal vasotomy of the inferior nasal concha.

Comparative analysis of the quality of life of patients with some methods of surgical treatment of vasomotor rhinitis

2018 ◽  
pp. 32-38
Author(s):  
Alexey Rasulov ◽  
Saifutdin Arifov
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Nasal Cavity ◽  
Postoperative Period ◽  
Long Term Results ◽  
Laser Coagulation ◽  
Life Questionnaire ◽  
Vasomotor Rhinitis ◽  
Special Equipment

Quality of life (abbr. – QOL) is a category with which it characterizes the essential circumstances of the life of the population, determining the degree of dignity and freedom of the personality of each person and a subjective indicator when evaluating the results of treatment of chronic diseases. To determine the quality of life of patients with cavity problems and SNPs, such as rhinitis and sinusitis, special questionnaires have been created, translated into Russian and adapted. The purpose of this study is to examine in a comparative aspect the indicators of the quality of life of patients with vasomotor rhinitis with various treatment methods. Materials and Methods: The study was conducted in the clinic of the Department of Otorhinolaryngology of the Tashkent institute of postgraduate medical education on 43 patients with vasomotor rhinitis in age from 20 to 46 years, average age 28±1.3 years. All patients with BP included in our study, after collecting complaints and anamnesis, underwent an endoscopic examination of the nasal cavity and nasopharynx, a computerized tomogram of the nose and paranasal sinuses, standard laboratory tests and microscopy of a smear from the nasal cavity on eosinophils. Evaluation of QOL was performed according to a special questionnaire Mini Rhinoconjunctivitis Quality of Life Questionnaire (MiniRQLQ). Results: Studies have shown the highest efficiency of laser coagulation with vasomotor rhinitis. After laser surgery, a rapid improvement in QOL was observed, and there was no adverse effect on the mucous membrane of the nasal cavity. Given the well-tolerated laser coagulation, the lack of the need for observation and care of the nasal cavity in the postoperative period, the possibility of outpatient treatment, allows us to recommend this type of exposure as the method of choice in the surgical treatment of patients with vasomotor rhinitis. However, the need for special equipment and the availability of trained personnel who have access to work with laser systems somewhat limits the widespread use of this method. The simplicity of submucosal vasotomy, the availability of tools for carrying out, the rather rapid restoration of QOL, puts it on a par with the laser effect on efficiency. The need to use nasal tampons after surgery, hospital stay and patient monitoring in the early postoperative period reduces the patients' QL and makes this operation strictly inpatient. In our study, electrocautery demonstrated the lowest rate of improvement in QOL than during laser irradiation and submucous vasotomy. The most slow and incomplete restoration of QOL in this method of treatment emphasizes the disadvantage of this method from the point of view of the patient's QOL. Conclusion: Evaluation of the long-term results of surgical treatment of QL and clinical manifestations of BP makes it possible to recommend laser coagulation as the most optimal method providing a long-lasting effect in treating patients with BP. An alternative is to take a submucous vasotomy of the inferior nasal concha.

Optimization of postoperative management of patients undergoing functional endoscopic sinus surgery

2018 ◽  
pp. 26-31
Author(s):  
Sergey Bezshapochny ◽  
Andrey Loburets ◽  
Valery Loburets
Keyword(s):  
Nasal Cavity ◽  
Postoperative Period ◽  
Sodium Hyaluronate ◽  
Sinus Surgery ◽  
Control Group ◽  
Nasal Breathing ◽  
Traditional Therapy ◽  
Significant Difference ◽  
Water Salt ◽  
Experimental Group

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.

Application of Nasomer in surgical treatment of patients with polyposis rhinosinusitis

2018 ◽  
pp. 39-42
Author(s):  
Vladimir Bereznyuk ◽  
Alexander Chernokur ◽  
Oleg Gospod
Keyword(s):  
Nasal Cavity ◽  
Postoperative Period ◽  
Paranasal Sinuses ◽  
Standard Treatment ◽  
Surgical Intervention ◽  
Sodium Hyaluronate ◽  
Main Group ◽  
Control Group ◽  
Nasal Breathing ◽  
Minimal Invasiveness

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.

Influence of shape of middle turbinate on development of recurrent rhinosinusitis

2021 ◽  
Vol 20 (3) ◽  
pp. 108-114
Author(s):  
S. A. Karpishchenko ◽  
◽  
E. V. Bolozneva ◽  
A. Yu. Golubev ◽  
E. E. Kozyreva ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Postoperative Period ◽  
Middle Turbinate ◽  
Structural Features ◽  
Lateral Part ◽  
Lateral Nasal Wall ◽  
Nasal Breathing ◽  
Deviated Nasal Septum ◽  
Nasal Turbinate ◽  
Air Jet

In the presence of a paradoxically curved middle nasal turbinate, treatment tactics may be different. To achieve the best effect in the treatment of chronic rhinosinusitis, in some cases, a complete resection of the middle nasal turbinate is performed. However, in this group of patients in the postoperative period, complaints may appear from the quality of nasal breathing, which is associated with the development of paradoxically difficult breathing, when with sufficient passage of the air jet, the patient complains of difficulty in nasal breathing. Also, these patients are characterized by a decrease in the sense of smell. It is important that the absence of the middle nasal turbinate during repeated surgical interventions deprives the surgeon of an important anatomical landmark. We want to share a clinical example in which we received a positive outcome of surgical treatment in a patient with chronic left-sided rhinosinusitis in the presence of a paradoxically curved middle nasal turbinate and a slightly deviated nasal septum. In order to restore ventilation of the anterior group of the paranasal sinuses, the lateral part of the paradoxically curved middle nasal turbinate was removed with its preservation and expansion of the natural anastomosis of the maxillary sinus. In the postoperative period, the patient noted a significant improvement in her condition and did not make any previous complaints. This clinical case demonstrates that the middle nasal turbinate plays an important role in the functioning of the nasal cavity, in particular the osteomeatal complex, and in various anatomical variants can disrupt its work, both in combination with other structural features of the lateral nasal wall, and in isolation. In this connection, during the surgical treatment, a sparing, organ-preserving technique was chosen in order to preserve the functions of the middle turbinate, which in the postoperative period led to the achievement of a stable positive result.

scholarly journals Dynamics of Recovery of Functions of the Nasal Cavity in Patients with Aspirin-Intolerant Polypous Rhinosinusitis in the Postoperative Period

2016 ◽  
Vol 22 (2) ◽  
pp. 201621
Author(s):  
Ivanna Koshel
Keyword(s):  
Nasal Cavity ◽  
Postoperative Period ◽  
Recovery Process ◽  
Main Group ◽  
Control Group ◽  
Nasal Breathing ◽  
Rapid Improvement ◽  
Postoperative Rehabilitation ◽  
Physiological Functions ◽  
Surgical Interventions

Surgical interventions in the nasal cavity are accompanied by reactive phenomena in the postoperative period. On their background the process of physiological regeneration is disorganized resulting in impaired physiological functions of the nasal cavity.The objective of the research was to study the recovery process of the main physiological functions of the nasal cavity in patients with aspirin-intolerant polypous rhinosinusitis in the postoperative period.Materials and methods. 80 patients with aspirin-intolerant polypous rhinosinusitis at the age of 24-57 years were operated on.All the patients were divided into 2 groups: the control group included 30 patients; the main group comprised 50 patients.Patients of the control group received nasal cavity cleaning, nasal mucosa anemisation, irrigation therapy since the first day of the postoperative period.Patients of the main group received an herbal drug BNO-101 additionally. The effectiveness was assessed on the 3rd, 7th and 10th days of treatment.Results. The postoperative rehabilitation with the inclusion of botanical preparation BNO-101 provided a significant improvement of nasal breathing, mucociliary transport rate and indicators of nasal peak flowmetry compared to the control group. Despite subjective improvement of nasal breathing the indicators of the peak expiratory flow rate in the main group were 34.2% lower than the norm while in the control group they were 54.7% lower than normal ones thereby justifying further treatment.Conclusions. The postoperative rehabilitation of patients with aspirin-intolerant polypous rhinosinusitis provided more rapid improvement of the main functions of the nasal cavity compared to the control group.

scholarly journals Results of use of seawater spray with brown algae extract in the early postoperative period in children after adenotomy

2020 ◽  
Vol 65 (1) ◽  
pp. 128-132
Author(s):  
D. V. Konischev ◽  
A. M. Elovikov ◽  
A. I. Ivanov ◽  
D. V. Shabunin
Keyword(s):  
Nasal Cavity ◽  
Postoperative Period ◽  
Brown Algae ◽  
Sea Water ◽  
Early Postoperative Period ◽  
Study Group ◽  
Nasal Breathing ◽  
Scale Scores ◽  
Isotonic Sodium Chloride ◽  
Group 2

Adenotomy is one of the most common surgeries on the part of ENT organs in childhood, it is usually performed under endotracheal anesthesia.Purpose. To evaluate the effectiveness of the spray containing sea water and brown algae extract in the early postoperative period in children after adenotomy.Characteristics of the children and research methods. 24 patients aged from 4 to 10 years (12 boys and 12 girls) were examined and treated in the Otorhinolaryngology Department of the Perm Regional Children’s Clinical Hospital. All patients underwent adenotomy due to hypertrophy of the pharyngeal tonsil of the II–III degree, they received antibiotics for 5 days after surgery. The patients were divided into 2 groups: Group 1 (study group, n=12) used, Aqualor Protect spray for irrigation therapy of the nasal cavity and nasopharynx; Group 2 (comparison group, n=12) used a spray with isotonic sodium chloride solution for irrigation therapy. 2 doses of saline solution were sprayed into each nostril 4 times for 4 days. Results. According to the medical examination, the study group demonstrated more pronounced improvement of the following indicators (visual analogue scale scores): overall health (p<0.05), swelling of the nasal cavity (p<0.05), hyperemia of the mucous membrane of the nasal cavity (p<0.05), improved nasal breathing (p<0.034), the presence of mucous-hemorrhagic crusts in the nasal cavity (p<0.0001), general feelings (p<0.02). Conclusion. The spray with seawater and brown algae extract is more effective than nasal spray with isotonic solution in the early postoperative period in children after adenotomy. 

Tactics and treatment results for uveal complications of laser coagulation with retinopathy of prematurity

2021 ◽  
pp. 375-379
Author(s):  
Y.D. Kuznetsova ◽  
◽  
I.B. Astasheva ◽  
I.E. Hatsenko ◽  
A.N. Zvereva ◽  
...  
Keyword(s):  
Birth Weight ◽  
Surgical Treatment ◽  
Postoperative Period ◽  
Retinopathy Of Prematurity ◽  
Inflammatory Process ◽  
Surgical Intervention ◽  
Cataract Extraction ◽  
Laser Coagulation ◽  
Complete Relief ◽  
Iol Implantation

A pronounced inflammatory process from the anterior and posterior parts of the eye may occur, as a complications after laser coagulation in retinopathy of prematurity (ROP), in which there is a need for surgical treatment. Purpose. To determine the optimal tactics for the treatment of uveal complications of laser coagulation in ROP. Material and methods. For 2014-2020 we examined and performed surgical intervention in 21 children with uveal complications after laser coagulation (27 eyes), Most of the children were deeply premature (born at 24-26 weeks of gestation) with a birth weight of 500 g to 900 g with concomitant pathology from the central nervous system. Сomplicated cataracts developed for all children. All children underwent surgical treatment: reconstruction of the anterior chamber, microinvasive cataract extraction, vitrectomy (if necessary, schvartectomy). A single surgical intervention was performed on 24 eyes. In 3 eyes with a post-aggressive form of ROP and a history of sepsis, reoperative treatment was required. All children had no primary IOL implantation. IOL implantation was performed in one childe at an older age. Results. As a result of the treatment, in 89% of cases (24 eyes), there was a complete relief of the inflammatory process and restoration of the transparency of the media after a single surgical intervention. In childe who underwent secondary IOL implantation in the long term, there was a complicated course of early postoperative period and repeated reconstructive surgery required. Conclusions. Uveal complications after laser coagulation of the retina for ROP are observed mainly in children born in early gestation (24-26 weeks) with low birth weight (less than 1000 g). When carrying out the surgical treatment of uveal complications - cataract extraction, which has developed as a result of laser coagulation for ROP, vitrectomy is mandatory, and, if necessary, schwartectomy. When deciding on the secondary implantation of IOLs, it is necessary to take into account the high probability of an unfavorable course of the postoperative period in children with previous uveitis after laser treatment for retinopathy and prematurity. Key words: retinopathy of prematurity, uveal complications, cataract.

scholarly journals Evaluation of the Golden Ratio in Nasal Conchae for Surgical Anatomy

2019 ◽  
Vol 100 (1) ◽  
pp. NP57-NP61
Author(s):  
Emine Petekkaya ◽  
Mahinur Ulusoy ◽  
Hassan Bagheri ◽  
Şükrü Şanlı ◽  
Mehmet Seyit Ceylan ◽  
...  
Keyword(s):  
Nasal Cavity ◽  
Golden Ratio ◽  
Fibonacci Numbers ◽  
Fractal Model ◽  
Ct Images ◽  
Surgical Anatomy ◽  
Nasal Valve ◽  
Nasal Concha ◽  
Inferior Nasal Concha ◽  
Intersection Points

Purpose: The golden ratio is reached by the fractal model of the number sequence which is known as the “Fibonacci series” and has a convergent ratio of approximately 1.618 between 2 consecutive Fibonacci numbers. Golden ratio relationships have been shown in several plants in the nature and several organs and structures in the human body. The conchae, which form an important part of the nasal valve, have a special geometric significant in terms of providing turbulence to the laminar airflow that passes to the nasal cavity. Methods: This study made golden ratio calculations on 34 adults aged 20 to 45 years over computed tomography (CT) images. Totally, 34 volunteers (male, n = 18 and female, n = 16) with no nasal pathologies participated in the study. Using Adobe Photoshop, golden ratio calculations were made by applying the Fibonacci spiral on the images that best showed the conchae and meatuses on the CT images. Results: The intersection points of the spiral that was projected on the inferior and middle nasal concha were determined as S0, S1, S2, S3, and S4. The distances of S0-S1, S1-S2, S2-S3, and S3-S4 were measured. The concha measurements of the women showed significantly similar values to the golden ratio constant of ∼1.618 in the RS3/S4 and LS3/S4 measurements. Conclusion: We found that the S3/S4 region that captured the golden ratio in our study corresponds to the base part of the inferior nasal concha, and its place of spiraling in the nasal cavity is observed to have an important role in creating vortices.

scholarly journals Surgical Treatment of Atresia in the Nasal Cavity with Using a Superelastic TiNi Foil

2017 ◽  
Vol 2 (1) ◽  
pp. 404
Author(s):  
M.N. Shakirov ◽  
M.M. Shakirov ◽  
A.M. Khodjaeva ◽  
V.J. Mitasov ◽  
I.D. Tazin
Keyword(s):  
Surgical Treatment ◽  
Nasal Cavity ◽  
Nasal Passage ◽  
Nasal Breathing ◽  
Donor Area ◽  
Aesthetic Results ◽  
Titanium Foils ◽  
Results Of Surgery

The use of superelastic NiTi (nickelid titanium ) foils for patients with atresia of the nasal cavity as a structural device provide a firm fit of the flap and its engraftment in the donor area. Due to its superelasticity and reverse formability the construction reliably ensures the formation of the nasal passage and restoration of nasal breathing. Immediate and long-term functional and aesthetic results of surgery and absence of recurrence in these patients demonstrates the effectiveness of the proposed method with the recommendations of its use as a method of choice.

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