Objective. This study was conducted to increase effectiveness of anti-relapse therapy of chronic rhinosinusitis with polyps to create a stable long-term remission in the long-term postoperative period.Patients and research methods. 60 patients with total spread of polyposis process in the nasal cavity and paranasal sinuses were examined. All patients underwent endoscopic polysinusotomy and 3 weeks after surgery, basic anti-relapse therapy of PRS in the form Of nasonex intranasal spray of 400 mcg/day for 6 months in combination with irrigation with isotonic salt solutions was prescribed. At the same time, 30 patients 1.5 months after polysinusotomy were additionally given a short course of systemic corticosteroid therapy with Methylprednisolone, starting at 20 mg/day in combination with Omeprazole at 20 mg /day for 14 days. Subjective assessment of the patients ‘condition was carried out by questionnaire, for objective diagnosis acoustic rhinometry and CT of the paranasal sinuses were used.Results. Simultaneous administration of a short course of corticosteroid therapy in combination with prolonged intranasal use of Nasonex spray in patients with nasal polyps in the postoperative period contributed to the most rapid subjective improvement of nasal breathing. The combined scheme in 27 (90%) subjects showed a statistically significant improvement in intra-nasal aerodynamics (p<0.05) 2 months after polysinusotomy according to the results of acoustic rhinometry, the average MPPS1 was 0.67 ± 0,04 cm2 before and after the decongestant test. In 13 patients (44,3%) who received only intranasal corticosteroids reactive edema from the nasal mucosa were more pronounced, which contributed to the formation of zones of pathological narrowing of the nasal flow and a decrease in МППС1 to 0.43 ± 0,04см2 to test with decongestant. 2 years after surgical treatment in patients undergoing a combined course of corticosteroid therapy in relation to patients receiving only monotherapy with intranasal corticosteroids, there was no recurrence of polyposis in 86.7% of cases (26 patients), against 66.7% (20 patients), receiving only intranasal corticosteroids.
The treatment of infectious diseases in the context of the steady increase in the number of microorganisms that are resistant to antibiotics is one of the most acute problems in otorhinolaryngology. This explains the raise interest in a fundamentally new rational treatment strategy of infections both in Russia and around the world - the use of bacteriophages. These drugs have proven efficacy against antibiotic-resistant strains of bacteria, do not cause toxic and allergic reactions, and have no contraindications to use.
The choice of an optimal tactic for chronic rhinosinusitis treatment is a very topical issue in otorhinolaryngology. Several pieces of existing literature report a positive impact of a herbal-based remedy Sinupret for patients in the post-rhinosurgical period. Objectives of the study: The investigation of the effect of Sinupret on patients with chronic maxillary sinusitis in the early postoperative period.Materials and methods: 15 patients with chronic rhinosinusitis were examined. The age of patients ranged from 20 to 57 years. The examination of patients was carried out right before the surgery and three months after it. The examination also included general otorhinolaryngological examination, assessment of the overall severity of the disease on the VAS scale, endoscopy of the nasal mucosa, assessment of nasal breathing function based on the analysis of the main indicators of anterior active rhinomanometry and computed tomography of the paranasal sinuses. Two days before their surgery, each patient was prescribed to take two tablets of Sinupret 3 times a day up to 14 days.Results: By day 10 of the post-surgery period, all patients reported noteworthy improvement in nasal breathing, a significant decrease in nasal discharge and no discomfort in the projection of the paranasal sinuses. There was a substantial decrease in the severity of oedema, exudation and formation of crusts, fibrin in all examined patients with rhinoscopy. According to the anterior active rhinomanometry, a statistically significant increase in the total nasal flow and a decrease in nasal resistance to physiological values were established 3 months after surgery. Conclusion: This article presents the results of Sinupret usage in the combined therapy before and after surgical treatment of patients with chronic rhinosinusitis and abnormal development of nasal structures. The results of that 14-day treatment evidenced an acceleration of epithelialization and restoration of drainage; as well as an improvement of ventilation function of the nasal cavity and paranasal sinuses. In addition to that, the chosen treatment contributed to the reduction of the rehabilitation period and the absence of relapses of chronic maxillary sinusitis was observed.
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