Sinus aspirates in chronic rhinosinusitis: fungal colonization of paranasal sinuses, evaluation of ICAM-1 and IL-8 and studying of immunological effect of long-term macrolide therapy

The aim of this study was to evaluate prevalence of chronic rhinosinusitis (CRS) and nasal polyps in adult patients with cystic fibrosis (CF) in Russian Federation. Additionally, we investigated the clinical course of CRS and developed the optimal therapeutic strategy.Methods. Three hundred and forty eight CF patients were involved in the study. Physical examination, computed tomography (CT) of paranasal sinuses and audiometry, if needed, were used. CRS and bilateral nasal polyps were diagnosed in 28 patients. Nasal endoscopy, SNOT-20 questionnaire, rhinomanometry, micro - biological examination of sputum and mucus from paranasal sinuses (obtained during puncture or surgery), spirometry, and measurement of serum markers of inflammation were used. Endoscopic sinus surgery was used in 14 patients (the group 1) and others were treated non-surgically (the group 2). Both group were treated during 6 months using intranasal mometasone, mucolytics and antibiotics via PARI SINUSTM nebulizer.Results. An improvement in symptoms, CT signs, rhinomanometry parameters and endoscopic signs was seen in both groups after treatment and was more prominent in the surgical treatment group compared to the non-surgical treatment group. Bacterial load reduction in nasal sinuses, decrease in the rate of pulmonary disease exacerbations, and an improvement in oxygen blood saturation were found in the surgical treatment group only. Treatment of CRS did not affect lung function, sputum microbiology and serum inflammatory markers.Conclusion. Endoscopic sinus surgery followed by intranasal mucolytics and antibacterials is an effective and well-tolerated treatment in adult CF patients with CRS.

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The treatment of patients with chronic rhinosinusitis in the conditions of sanatorium and preventive measures

Russian otorhinolaryngology ◽

10.18692/1810-4800-2020-2-57-63 ◽

2020 ◽

Vol 19 (2) ◽

pp. 57-63

Author(s):

S. I. Pshenichnyi ◽

◽

R. K. Tulebaev ◽

T. M. Azhenov ◽

◽

...

Keyword(s):

Chronic Rhinosinusitis ◽

Nasal Mucosa ◽

Paranasal Sinuses ◽

Comparison Group ◽

Treatment Method ◽

Functional Disorders ◽

Acid Base Balance ◽

Natural Factors ◽

Base Balance ◽

Chronic Rhino Sinusitis

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.

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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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Efficacy of Endoscopic Posterior Nasal Neurectomy in Treating Eosinophilic Chronic Rhinosinusitis

ORL ◽

10.1159/000519724 ◽

2021 ◽

pp. 1-5

Author(s):

Manman Chen ◽

Ming Xu ◽

Xuefeng Lei ◽

Bin Zhang

Keyword(s):

Chronic Rhinosinusitis ◽

Surgical Recurrence ◽

Eosinophilic Chronic Rhinosinusitis ◽

Group A ◽

Sinonasal Outcome Test ◽

Random Number Table ◽

Group B

Objectives: Recent guidelines have revealed that eosinophilic chronic rhinosinusitis (ECRS) exhibits a strong tendency for recurrence after surgery and impairs quality of life. Neuropeptides play an important neuroimmunological role. The aim of this study was to determine the efficacy of posterior nasal neurectomy (PNN) for the treatment of ECRS by inhibiting type 2 cytokine expression. Methods: Forty-six patients were divided into group A and group B according to a random number table. Group A underwent conventional functional endoscopic sinusitis surgery (FESS) combined with PNN, and group B underwent conventional FESS alone. The subjective and objective symptoms included a 10-cm visual analog scale (VAS), 22-item SinoNasal Outcome Test (SNOT-22) score, nasal speculum Lund-Kennedy score, and paranasal sinus computed tomography (CT) Lund-Mackay score at the 1-year postoperative follow-up. Results: Postoperative VAS (10.33 ± 2.18 vs. 8.38 ± 2.11, p < 0.01) and Lund-Kennedy score (1.95 ± 1.32 vs. 3.14 ± 1.35, p < 0.01) were significantly improved. The rhinorrhea score (1.76 ± 0.83 vs. 2.90 ± 1.14, p < 0.001) in the VAS and the discharge (0.43 ± 0.51, vs. 0.95 ± 0.67, p < 0.01) and edema (0.57 ± 0.60 vs. 0.95 ± 0.59, p < 0.05) scores in the Lund-Kennedy score were observed to have improved significantly in group A compared with those in group B. Conclusions: FESS combined with PNN suppresses edema symptoms, which might significantly decrease the surgical recurrence rate of ECRS in the long term.

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Biological therapy of chronic rhinosinusitis

Otorinolaryngologie a foniatrie ◽

10.48095/ccorl2021109 ◽

2021 ◽

Vol 70 (2) ◽

pp. 109-114

Author(s):

Zuzana Balatková ◽

Zdeněk Knížek ◽

Jan Vodička ◽

Jan Plzák

Keyword(s):

Chronic Rhinosinusitis ◽

Nasal Polyps ◽

Biological Therapy ◽

Immunoglobulin E ◽

Sinus Surgery ◽

Therapeutic Choice ◽

First Choice ◽

Intranasal Steroids

The aim of this paper is to present an up-to-date information about therapeutical options in chronic rhinosinusitis with nasal polyps. First choice therapy is a long term regular application of intranasal steroids in combination with salinic solution douches. If this treatment is not eff ective enough, then the pulses of systemic steroids are indicated. If the sufficient control of the disease is not achieved, then surgery is a therapeutic choice; it means functional endoscopic sinus surgery in the extent corresponding to the extension of the sinus disease. However, there remains a certain group of patients in whom the results with this treatment are not optimal. The type 2 immunopathological response affects relevantly the course of the disease. Nowadays, the research is done in this field. Specific agents, which are able to block circulating inflammatory mediators or bind receptors for these mediators are developed and studied. The results of the studies having been completed by now are promising. Keywords: biological therapy – chronic rhinosinusitis – nasal polyps – dupilumab – immunoglobulin E – interleukin

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Long term outcomes of balloon sinuplasty for the treatment of chronic rhinosinusitis with and without nasal polyps

American Journal of Otolaryngology ◽

10.1016/j.amjoto.2020.102825 ◽

2021 ◽

Vol 42 (1) ◽

pp. 102825

Author(s):

Afonso Castro ◽

Miguel Furtado ◽

Ângela Rego ◽

Daniela Serras ◽

Marisol Plácido ◽

...

Keyword(s):

Chronic Rhinosinusitis ◽

Nasal Polyps ◽

Long Term Outcomes ◽

Balloon Sinuplasty

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Long-term outcomes of different endoscopic sinus surgery in recurrent chronic rhinosinusitis with nasal polyps and asthma

Rhinology Journal ◽

10.4193/rhin19.184 ◽

2020 ◽

Vol 0 (0) ◽

pp. 0-0

Author(s):

L. Zhang ◽

Y. Zhang ◽

Y. Gao ◽

K. Wang ◽

H. Lou ◽

...

Keyword(s):

Chronic Rhinosinusitis ◽

Endoscopic Sinus Surgery ◽

Nasal Polyps ◽

Sinus Surgery ◽

Long Term Outcomes

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A 10-Year Follow-Up of a Randomized Prospective Study of 2 Treatments for Chronic Rhinosinusitis Without Nasal Polyps and Investigation of the Impact of Gastroeosophageal Reflux Disease in the Resistance to Treatment

Ear Nose & Throat Journal ◽

10.1177/0145561319892460 ◽

2019 ◽

pp. 014556131989246

Author(s):

Jerome R. Lechien ◽

Gersende Debie ◽

Virginie Mahillon ◽

Marie-Paule Thill ◽

Alexandra Rodriguez ◽

...

Keyword(s):

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Chronic Rhinosinusitis ◽

Reflux Disease ◽

Nasal Polyps ◽

Sinus Surgery ◽

Amoxicillin Clavulanate ◽

The Impact

Objectives: To compare the 2 long-term medical strategies in chronic rhinosinusitis without nasal polyps (CRSnNP) and to identify the role of gastroesophageal reflux disease (GERD) and Helicobacter pylori as factors of treatment failure. Material and Methods: Fifty-seven patients with CRSnNP were randomized into 2 therapeutic groups. The first group was treated with 4 weeks of amoxicillin/clavulanate and a short course of oral steroids. The second group received 8 weeks of clarithromycin. Sinonasal Outcome Test-20 (SNOT-20) and Lund and Mackay scores were assessed at baseline and after treatment, and GERD Health-Related Quality of Life (GERD-HRQL) questionnaire was evaluated in all patients. Patients with a GERD-HRQL score >8 received esogastroscopy and H pylori detection. Patients were followed during a 10-year period for clinical course and GERD evolution. The 10-year evolution of patients was described in terms of recurrence, medical, and surgical treatments. Results: Thirty-seven patients completed the study; SNOT-20 and Lund and Mackay scores similarly improved in both groups. Amoxicillin/clavulanate group had significantly more adverse reactions than the clarithromycin group (P = .03). After the therapeutic course, 35% (amoxicillin/clavulanate) and 41% (clarithromycin) of patients needed functional endoscopic sinus surgery (FESS). During the long-term follow-up, 54% (amoxicillin/clavulanate) and 40% (clarithromycin) of patients had late CRSnNP recurrence; FESS was performed in less than 15% of cases of recurrence. Gastroesophageal reflux disease complaint’s severity was associated with late recurrence of CRSnNP. Conclusion: Amoxicillin/clavulanate and clarithromycin would be competitive treatments for CRSnNP. Gastroesophageal reflux disease seems to be a negative factor for treatment response and recurrence.

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