Yushchenko V. Polypous rinosinuit: clinical and morphological manifestations, pathogenetic approach to treatment

The dissertation is devoted to clinical and morphological features, rationale, and postoperative relapse pathogenetically directed therapy in patients of polypous rinosinuitis. The material presented in this paper was obtained during the examination and treatment of 120 patients, of which the control group consisted of 60 patients with PRS. We used clinical, instrumental, functional and statistical methods. Before and after treatment with long-term periods (1, 3,12 and 24 months) studied the frequency of recurrence of polypoid managering in the nasal cavity, the functional state of the mucous membrane. A series of thorough postmortem studies of polypous tissue that was obtained during surgery. Polypous rinosinuit temple is characterized by the frequency of recurrence of polyps after surgical treatment - 35 % of patients previously operated on the PRS, the presence of a large number of concomitant diseases of the nasal cavity, which lead to difficulty nasal breathing (bends, spikes and ridges of the nasal septum 22 % of patients with chronic vasomotor and hypertrophic rhinitis, 18 % of patients). Patients of polypous rinosinuites revealed violations of the physiological functions of the nasal cavity, defined by an increase in resistance to air flow during inspiration to total obstruction in comparison to healthy persons (1,14 ± 0,051), the transport function of ciliary epithelium and scents. Patomorfologic study made it possible to distinguish several types of pathology of nasal polyps: edematose (44 % of patients), fibroinflamation (29 % of patients), with hyperplasia of the glands (7 % of patients), mixed type (edematose + fibroinflamation) - 19 % of patients and mixed type (fibroinflamation + hyperplastic glands) - 1 %. Based on the data was formed two groups - basic and control. In the main groups in conjunction with basic therapy in the postoperative period was used pathogenesis of anti-directed scheme of medical treatment. Control group received only basic therapy in the form of a nasal corticosteroid mometasone furoate. Noted a more rapid recovery of patients from the main group and the restoration of the physiological functions of the nasal cavity. Demonstrated a lower incidence of recurrence polypous tissue in the nasal cavity in remote terms of observation.