scholarly journals Anticongestion therapy of sinusitis in children

Author(s):  
Fedir D. Yurochko ◽  
D.B. Kopanska

Sinusitis is one of the most common respiratory diseases in children. Swelling of the nasal mucosa and paranasal sinuses accompanies sinusitis; but this is not only a symptom, edema leads to blockage of the normal sinus drainage pathway, which is key in the pathogenesis of sinusitis. Decongestants are considered a key treatment for sinusitis because they improve the function of the sinuses. According to EPOS-2012, treatment of acute sinusitis in children up to 5 days includes nasal lavage, decongestants, and in the absence of effect within 10 days, endonasal corticosteroids are added to the treatment. Decongestants are prescribed from the onset of sinusitis in children. They not only alleviate the annoying manifestations of nasal congestion, but also keep unlocked paranasal sinuses, prevent the progression of sinusitis to bacterial and prevent complications. In the treatment of sinusitis, we successfully combine the benefit of decongestants (rapid, relatively shortterm anti congestion) with the effect of endonasal corticosteroids (slow, relatively long-acting anti congestion). The article shows our algorithm of topical sinusitis treatment.

Author(s):  
Fedir Yurochko ◽  
Dzvenislava Kopanska

Sinusitis is one of the most common respiratory diseases in children. Swelling of the nasal mucosa and paranasal sinuses accompanies sinusitis; but this is not only a symptom, edema leads to blockage of the normal sinus drainage pathway, which is key in the pathogenesis of sinusitis. Decongestants are considered a key treatment for sinusitis because they improve the function of the sinuses. According to EPOS-2012, treatment of acute sinusitis in children up to 5 days includes nasal lavage, decongestants, and in the absence of effect within 10 days, endonasal corticosteroids are added to the treatment. Decongestants are prescribed from the onset of sinusitis in children. They not only alleviate the annoying manifestations of nasal congestion, but also keep unlocked paranasal sinuses, prevent the progression of sinusitis to bacterial and prevent complications. In the treatment of sinusitis, we successfully combine the benefit of decongestants (rapid, relatively shortterm anti congestion) with the effect of endonasal corticosteroids (slow, relatively long-acting anti congestion). The article shows our algorithm of topical sinusitis treatment.


2021 ◽  
pp. 194589242199131
Author(s):  
Stephen R. Chorney ◽  
Adva Buzi ◽  
Mark D. Rizzi

Background The indication for frontal sinus drainage is uncertain when managing pediatric acute sinusitis with intracranial complications. Objective The primary objective was to determine if addressing the frontal sinus reduced need for subsequent surgical procedures in children presenting with acute sinusitis complicated by intracranial abscess. Methods A case series with chart review was performed at a tertiary children’s hospital between 2007 and 2019. Children under 18 years of age requiring surgery for complicated acute sinusitis that included the frontal sinus with noncontiguous intracranial abscess were included. Outcomes were compared among children for whom the frontal sinus was drained endoscopically, opened intracranially, or left undrained. Results Thirty-five children with a mean age of 11.1 years (95% CI: 9.9-12.3) met inclusion. Most presented with epidural abscess (37%). Hospitalizations lasted 12.9 days (95% CI: 10.2-15.5), 46% required a second surgery, 11% required three or more surgeries, and 31% were readmitted within 60 days. Initial surgery for 29% included endoscopic frontal sinusotomy, 34% had a frontal sinus cranialization and 37% did not have any initial drainage of the frontal sinus. Groups were similar with respect to demographics, severity of infection, need for repeat surgery, length of stay, and readmissions (p > .05). Further, persistence of cranial neuropathies, seizures, or major neurological sequelae after discharge were no different among groups (p > .05). Conclusion Drainage of the frontal sinus, when technically feasible, was not associated with reduced surgical procedures or increased complications and there is unclear benefit on measured clinical outcomes.


Author(s):  
Afanasyeva T.G. ◽  
Lavrova N.N. ◽  
Tumentseva V.R.

Rhinitis is an inflammation of the nasal mucosa; today, according to the World Health Organization, the prevalence of the disease is 40% of the world's population. Allergic rhinitis is the most common type of chronic rhinitis, affecting 10–20% of the world's population, and the severity of the disease is associated with a significant deterioration in the quality of life, sleep and performance. Allergic rhinitis is an inflammatory disease of the nasal mucosa caused by exposure to an allergen, causing IgE-mediated inflammation. Clinically, the disease is characterized by the following main symptoms: rhinorrhea, sneezing, itching and nasal congestion. Despite the general symptoms of allergic rhinitis, its impact on the quality of life of patients and the significant cost of treatment, including pharmacotherapy, many patients do not adhere to drug treatment regimens due to their insufficient effectiveness in eliminating the emerging symptoms. Pharmacoeconomic research identifies, measures and compares the costs and effects of drug use. This framework includes research methods related to cost minimization, cost-effectiveness, decision analysis, cost of illness, and patient quality of life. This article will consider one of the four main methods for assessing pharmacoeconomics - cost minimization analysis. A cost-minimization analysis is a pharmacoeconomic assessment by comparing the costs of two or more drug alternatives regardless of outcome. Since the pharmaceutical market is represented by a wide range of original, reference and generic drugs for the treatment of allergic rhinitis, an important aspect of our research is the selection of effective and economically acceptable therapy for outpatients.


2020 ◽  
Vol 19 (2) ◽  
pp. 57-63
Author(s):  
S. I. Pshenichnyi ◽  
◽  
R. K. Tulebaev ◽  
T. M. Azhenov ◽  
◽  
...  

The objective of the research is to study of clinical and functional disorders of the nasal mucosa and paranasal sinuses of patients with chronic rhino sinusitis, as well as to make the choice of the optimal treatment method in a sanatorium using natural factors. A survey of 145 patients (94 men and 51 women) with chronic rhinosinusitis at the age of 18 to 65 years was conducted. Of these, male accounted for 64.8%, female – 35.2%. In patients with pathology of the paranasal sinuses, functional disorders of the nasal mucosa and paranasal sinuses were revealed. Particularly, violations of mucociliary clearance, acid-base balance of the nasal mucosa, and a decrease in nasal patency according to the data of active anterior rhinomanometry were defined. The use of natural factors as a treatment: inhalation of natural mineral water Maibalyk and mud applications on the paranasal sinus area significantly improved the course of way of chronic rhinosinusitis and led to normalization of the functional parameters of the nasal mucosa, in contrast to the comparison group (60 people). The comparison group did not use with Maibalyk natural water inhalations and mud applications from Lake Maybalyk, but used only ordinary alkaline inhalations.


2019 ◽  
Vol 39 (7) ◽  
Author(s):  
Bin Lin ◽  
Bijuan Cai ◽  
Huige Wang

Abstract Honeysuckle has antiviral, antioxidative and anti-inflammatory properties. Allergic rhinitis (AR) is induced by immunoglobulin E (IgE)-mediated inflammatory reaction. Our study investigates whether honeysuckle extract (HE) has therapeutic effect on AR. An AR model of mice was established by ovalbumin (OVA). Hematoxylin–Eosin staining was used to assess nasal mucosa damage. Enzyme-linked immunosorbent assay (ELISA) was performed to determine serum histamine, IgE and interleukin (IL)-2, IL-4, IL-17 and interferon-γ (IFN-γ) from nasal lavage fluid. Western blot was carried out to analyze the protein level from nasal mucosa tissue. We found that HE not only decreased nasal rubbing and sneezing in AR mice, but also reduced AR-induced damage to nasal mucosa. Moreover, HE lowered the levels of serum IgE and histamine and inhibited IL-4 and IL-17 levels from AR mice but raised IL-2 and IFN-γ levels in AR-induced nasal lavage fluid. Our results also showed that HE elevated the protein levels of forkhead box P3 (Foxp3) and T-box transcription factor (T-bet) in AR-induced nasal mucosa tissue, whereas it inhibited signal transducer and activator of transcription (STAT) 3 and GATA binding protein 3 (GATA-3) protein levels. By regulating AR-induced inflammatory reaction and autoimmune response, HE also relieved OVA-induced AR. Thus, HE could be used as a potential drug to treat AR.


1994 ◽  
Vol 114 (2) ◽  
pp. 203-208 ◽  
Author(s):  
Nobuhisa Terada ◽  
Akiyoshi Konno ◽  
Setsuya Fukuda ◽  
Tetsuji Yamashita ◽  
Koji Shirotori ◽  
...  

2019 ◽  
Vol 8 (1) ◽  
pp. 15-24
Author(s):  
Jan Woś ◽  
Agnieszka Remjasz

Inflammation of the paranasal sinuses is a common condition that affects the upper respiratory tract. The pathomechanism and course of sinusitis are multifaceted, depending on the etiological factors, duration of the disease, anatomical abnormalities, and additional conditions exacerbating the inflammation of the nasal mucosa and paranasal sinuses. The gold standard of diagnostic imaging is computed tomography (CT), performed in particular cases. An auxiliary examination is a magnetic resonance imaging (MRI) for soft tissue imaging when there is a suspicion of a neoplastic process. The treatment of patients with rhinosinusitis is very complex and long-lasting, associated with the use of nasal or systemic corticosteroids, irrigation with physiological saline, as well as antibiotic therapy, antihistamines or herbal supplements. The treatment is selected individually for the patient's condition or the sinus phenotype, and in exceptional cases, surgical intervention is undertaken. Work is continuing on genetic, molecular and immunological research to search for new and effective methods of treatment of rhinosinusitis.


1992 ◽  
Vol 107 (6_part_2) ◽  
pp. 841-844 ◽  
Author(s):  
Hueston C. King

The precise mode of action of the well-studied cromolyn sodium and the newer nedocromil sodium has not been completely elucidated. Because the drugs do not pass the cell membrane and enter the cell, they are virtually not metabolized, do not exert a systemic action, and therefore are associated with only minimal systemic toxicity. To be effective either drug must be applied topically and directly to the nasal mucosa. Proper contact with the nasal mucosa is essential for efficacy; in patients with nasal congestion and secretions, vasoconstrictors or saline lavages are indicated before cromolyn or nedocromil use. Both products are highly effective in patients who have IgE-mediated allergic rhinitis but must be administered prophylactically before exposure to an allergen to prevent development of the allergic event. Neither drug is effective in vasomotor rhinitis, exercise-induced rhinitis, or in the management of nasal polyps. Correct diagnosis is essential before therapy.


2013 ◽  
Vol 10 (6) ◽  
pp. 20-24
Author(s):  
Yu A Tyurin ◽  
A A Sharifullina ◽  
I G Mustafin ◽  
R S Fassakhov

Background. Determination of local epithelial cells expressing TLR2 as an indicator of local immunity in allergic rhinitis (AR) patients with opportunistic species of staphylococci nasal mucosa colonization. Methods. Washed epithelium samples obtained from patients with seasonal AR (n=8) aged 19—42 years, and perennial AR (n=15) aged 19 —45 years, as well as a control group (20 patients) aged 19—45 years without allergic diseases were investigated. Epithelial cells expressing TLR2 receptors were determined by flow cytometry. Results. The level of epithelial cells expressing TLR2 receptor in patients with seasonal AR was almost in 1,9 times, in perennial AR group — in 1,7 times lower then in healthy individuals. In patients with perennial AR S. aureus was obtained in 96,0% (CI: 79,5—99,2), in association with Str. pyogenes in 29% (CI: 14,9—49,2), Neisseria spp. — in 63,0% (CI: 42,7—78,8). Seasonal allergic rhinitis was characterized by association of S. aureus and S. hemolyticus (70,0%, 44,4—85,8). Conclusion. Ratio of epithelial cells positive for TLR2 in nasal lavage from patients with AR was lower than in healthy volunteers. Indicators proportion of epithelial cells expressing TLR2 in nasal lavage in patients with seasonal AR during an exacerbation period was significantly reduced (1,7—1,9 times), in comparison with healthy volunteers. In AR patients with increased density of staphylococci strains in nasal mucosa increased local epithelial cells expressing TLR2 in nasal lavage was established.


2020 ◽  
Vol 10 (4) ◽  
pp. 36-45
Author(s):  
M. А. Tubekova ◽  
Tatiana N. Bilichenko

Background. Smoking is a preventable risk factor of chronic respiratory diseases. Aim. To study the incidence of smoking and assess its impact on the prevalence of respiratory symptoms in the young population. Methods. Based on the GA2LEN questionnaire, a survey of 1252 residents of one Moscow district aged 1524 years was conducted (response rate 85.0%). The statistical analysis was performed using the Statistica software package, version 10; EPINFO, version 7 (WHO). Results. The incidence of smoking was 13.2% among men and 13.0% among women (p=0.895). Regular smoking in young people is registered from the age of 10 years and older. The intensity of smoking was higher in men than in women. The prevalence of respiratory symptoms in smokers (S) was higher than that in non-smokers (NS). 19.1% of NS and 26.3% (p0.001) of S among men, as well as 15.9% of NS and 29.5% of S (p0.001) among women noted wheezing in the chest; 30.3% of S and 19.3% of NS (p0.001) among men and 33.0% of NS and 38.6% of S (p=0.009) among women experienced symptoms of allergic rhinitis in the last 12 months; 20.3% of NS and 25.0% of S (p=0.012) among men and 18.1% of NS and 27.3% of S (p0.001) among women had nasal congestion for at least 12 weeks. Conclusions. The adverse effects of smoking on the respiratory health of young people requires an active prevention to reduce the prevalence of respiratory symptoms and the severity of chronic respiratory diseases.


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