Open AccessVERIFICATION AND TREATMENT OF RESISTANT CHRONIC RHINOSINUSITIS WITH NASAL POLYPS AT MULTIMORBID CARDIOVASCULAR PATHOLOGY
Author(s) -
М. А. Афлитонов,
М. А. Афлитонов,
S. A. Artyushkin,
С. А. Артюшкин,
S A Partsernyak,
С А Парцерняк,
А Н Мироненко,
А Н Мироненко,
A S Partsernyak,
А С Парцерняк,
S Y Naumov,
С Ю Наумов,
Е. В. Безрукова,
Е. В. Безрукова,
А. А. Топанова,
А. А. Топанова
Publication year - 2017
Publication title -
vestnik severo-zapadnogo gosudarstvennogo medicinskogo universiteta im. i.i. mečnikova
Language(s) - English
Resource type - Journals
eISSN - 2618-9704
pISSN - 2618-7116
DOI - 10.17816/mechnikov20179290-96
Subject(s) - medicine , nasal polyps , coronary artery disease , paranasal sinuses , gastroenterology , surgery
Objective: Identify the diagnostic signs for chronic rhinosinusitis with nasal polyps (CRSwNP & resistant forms) with multimorbid cardiovascular pathology (MCVP) (coronary artery disease (CAd), hypertension, metabolic syndrome (MS). Identify effectiveness of photodynamic therapy in CRSwNP treatment. Design and methods: The study included 75 patients (mean age 35,8±7,93, 39,2% - female,60,8% - male) with CRSwNP and MCVP divided into 3 groups by simple random sampling. Patients in group 1 (n = 27) received standard therapy CRSwNP, hypertension, CAd, NPMd, 8-weeks anti- bacterial and leukotriene receptor antagonists treatment. Surgical interventions history of the last 5 five years: from 1 to 2. Patients in group 2 (n = 28) received standard therapy CRSwNP, hypertension, CAd, NPMd, 8-weeks antibacterial and leukotriene receptor antagonists treatment. Surgical inter- ventions history of the last 5 five years: more than 3. Patients of group 3 (n = 20) received standard therapy CRSwNP, hypertension, CAd, NPMd, 8-weeks antibacterial treatment, 8-weeks leukotriene receptor antagonists treatment and sessions of photodynamic therapy of the paranasal sinuses. Surgical interventions history of the last 5 five years: more than 3. used in the study: complex psychological test methods, ENT and laboratory-instrumental evaluation of the cardiovascular system. Results: depres- sion was detected in 46,3%, 71,9%, 58,3% of patients, (first, second, third groups). Types «non-dipper» and «night-peaker» found in patients 2nd and 3rd groups- corresponds with (CRSwNP & resistant forms). Bone transformation zone as a result of chronic inflammation within the ethmoidal labyrinth and maxillary sinuses identified in the second and third patients group (85% of cases). The use of pho- todynamic therapy in the resistant CRSwNP forms treatment improves the functional indicators of the nasal cavity and paranasal sinuses. Conclusions: Patients with CRSwNP have symptoms of depression and «non-dipper» and «night-peaker» patterns. All CRSwNP patients are defined trigger points with areas of chronic osteitis and odontogenic osteomyelitis. The use of photodynamic therapy for CRSwNP treatment, reduces the number of CRSwNP recurrence.