Modern Diagnostic Studies in Rhinology: Necessary and Sufficient

Background. Nasal cavity and nasopharyngeal pathology are crucial and common issue in pediatric otorhinolaryngology. One of the major reasons for the nasal breathing difficulties are adenoids, allergic rhinitis, acute rhinitis, rhinosinusitis, nasal septum deviation. All these diseases can occur individually and in combination with each other, while clinical signs can be similar.Objective. The aim of the study is study and estimate the condition of nasal breathing and sense of smell in children with different nasal and nasopharyngeal pathology.Methods. The study included 128 children, all children were divided into 3 groups comparable by gender and age. Children with confirmed acute ENT organ disease were included in the 1st group, children with allergic disease exacerbation were included in the 2nd group, and clinically healthy children (control group) were included in the 3rd group. Survey methodology: rhinomanometry (RMM), rhinoresistometry (RRM), olfactometry.Results. It was revealed that nasal resistance in children with allergic diseases exacerbation is significantly higher both before and after anemisation of nasal mucosa with a solution of nasal decongestants than in children of the control group (according to the RRM). The air flow rate increases by average of 25% in children with various ENT organs diseases, and in children with allergic diseases — by average of 43% after anemisation of the nasal mucosa. The obtained data shows the role of nasal mucosal edema in patients with allergic diseases during exacerbation. Analysis of our RMM and RRM data suggests the importance of further use of these methods in children.Conclusion. The obtained results will allow us to optimize the diagnosis approach and personalize the management of patients with various nasal cavity and nasopharynx pathologies. Nowadays, the study is ongoing.

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Complex Approach to Diagnosis of Nasal Cavity and Nasopharyngeal Pathologies in Children. Initial Results

Namazova-Baranova

Ганковский

Zelenkova

et al. 2022

Pediatr. farmakol.

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Complex Approach to the Diagnosis of Children with Nasal and Nasopharyngeal Pathology. Key Results

et al. 2022

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Background. Nasal and nasopharyngeal pathology is one of the most important and widespread challenge in pediatrics and pediatric otorhinolaryngology. Prolonged nasal breathing difficulty can be caused by various diseases and their combinations. It requires multidisciplinary approach to diagnosis with the involvement of modern examination methods and pathogenetic treatment. Objective. The aim of the study is to develop complex technology for the management of children with nasal and nasopharyngeal pathologies. Methods. The study included 240 children aged from 6 to 18 years. All patients were divided into 3 groups, comparable by sex and age: Group 1 — 85 patients with confirmed ENT-organ disease, Group 2 — 104 patients with confirmed allergic disease, control group — 51 somatically healthy patients who did not have any ENT-organ or allergic diseases. Examination procedures: diagnostic nasopharyngeal endoscopy, rhinomanometry (RMM), rhinoresistometry (RRM), olfactometry. Results. The obtained results (RRM, RMM) have shown that air flow rate in nasal cavity increased due to nasal resistance decrease. Nasal resistance was higher and air flow rate was lower in all children with various ENT-organs or allergic diseases compared to the control group. Nasal resistance decreased in all study groups (significantly in children with aggravation of allergic diseases of airways and ENT-organs diseases) as well as air flow rate increased in all study groups (significantly in Group 1 and 2) after anemisation of nasal mucosa with decongestants. Apparently, it can be associated not only with anatomical features (nasal septum deviation), but also with inflammatory features of nasal cavity and nasopharynx (adenoid hypertrophy and inflammation, persistent swelling of nasal mucosa at allergic rhinitis). We would like to present the algorithm for diagnosis of children with nasal and nasopharyngeal pathologies according to the study results. The following practical guidelines have been proposed: 1) all patients with complaints on prolonged nasal breathing difficulties require not only otorhinolaryngologist examination, but also diagnostic endoscopy of nasal cavity and nasopharynx; 2) in case of nasal septum deviation and complaints on prolonged nasal breathing difficulties, it is necessary to perform functional methods for nasal breathing evaluating (RRM, RMM) to choose adequate treatment method; 3) the use of RRM, RMM would help to choose the optimal treatment approach in children with complaints on prolonged nasal breathing difficulties and confirmed diagnosis of allergic disease (allergic rhinitis, hay fever, etc.), also associated with adenoid hypertrophy and/or nasal cavity and nasopharynx inflammatory diseases; 4) all patients with confirmed chronic diseases of ENT-organs should be examined by allergist, and, if necessary, should undergo comprehensive allergological examination. Conclusion. The developed complex approach to the management of children with nasal cavity and nasopharynx pathology is innovative and represents the technology of personalized use of modern, objective methods for diagnosing the nasal cavity and nasopharynx state. The presented diagnostic algorithm and practical guidelines allow us to establish diagnosis and choose the treatment tactics within a short time. The use of these studies in clinical practice will allow to monitor the therapy efficacy (including various pharmacotherapeutic strategies) for nasal cavity and nasopharynx diseases in children. Timely examination and pathogenetic treatment will allow to prevent the chronization of pathological process in ENT-organs. This is especially crucial in childhood as it provides children with the best chance of healthy growth and development.

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7P pediatrics — Medicine of Development and Health Programming

et al. 2021

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The transition to personalized, predictive, preventive and participatory medicine, due, among other things, to the achievements of fundamental science, digitalization and the development of information and communication technologies, naturally demanded changes in childrens health care. New organizational, methodological and technological changes that have taken place to ensure a highly dynamic, adapted, and, at the same time, permanent provision of the medical process anywhere and at any time, have led to the need for specialists of a new formation a pluriexpert team ready to work in new conditions: how to participate in research in fundamental science, and to the introduction of innovative methods in clinical practice, medical and social support and the educational process. In these conditions, the strategic goal set for pediatrics to analyze absolutely all aspects of health: somatic, neuropsychic, emotional and psycho-social, in the process of growth and development of a child from conception/birth to adolescence / adulthood was implemented in a new direction of clinical and fundamental medicine developmental pediatrics and child health programming. 7P-pediatrics: Programming the development and health of the child, Preventive, Predictive, Personalized, Participatory, Polyprofessional (Pluriexpert), Progressive medicine for children, in which the results of scientific work based on fundamental data and ideas of neurosciences about progressive development and modern methodology of educational support of the entire medical process are fully translated into a clinical practice.

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Modern Diagnostic Studies in Rhinology: Necessary and Sufficient

Cited by 3 publications

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Complex Approach to Diagnosis of Nasal Cavity and Nasopharyngeal Pathologies in Children. Initial Results

Complex Approach to Diagnosis of Nasal Cavity and Nasopharyngeal Pathologies in Children. Initial Results

Complex Approach to the Diagnosis of Children with Nasal and Nasopharyngeal Pathology. Key Results

7P pediatrics — Medicine of Development and Health Programming

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