Azizov E. Optimization of the complicated sinusitis surgical treatment with photohemotherapy method application

The study involved 102 patients having complicated sinusitis with indications for surgical treatment. It has been established that complicated sinusitis features comprised young age of patients, prevalence of the disease chronic form over acute form, intoxication complaints, local pain symptom, neurological status changes, transient changes in the orbit, presence of liquid, a foreign body, bone changes according to spiral computed tomography, as well as the need for sanitation of 2 or more sinuses. The complicated sinusitis course forecasting method was developed. In terms of complicated sinusitis structure, it proved expedient to distinguish a group of patients with local complications and a group of those with complicated pathogenesis and sinusitis course. Regarding the first group the predominant complication was simple periostitis, whereas in terms of the second group secondary sinusitis and related changes in the nervous system showed high proportion. It has been established that surgical stress produces unidirectional effect on all the studied homeostasis components in both patients with complicated sinusitis and those undergoing planned treatment. The first day after surgery was characterized by decrease of adrenocorticotropic hormone (ACTH) and cortisol content level, as well as percentage of eosinophils and lymphocytes, level of T-cells and T-helper cells along with increasing content of 0-lymphocytes, white blood cells, IL-1RA and TNF-.. Methods of conducting preliminary 2 UBI sessions aimed at surgical stress impact correction have been developed (patent pending). Against the background of photohemotherapy positive changes were observed even prior to surgery as follows: ACTH and cortisol baseline level decrease, increase of haemoglobin and red blood cell count, level of T-cells and T-helper cells, qualitative phagocytosis indices along with decreasing content of 0-lymphocytes, IL-1RA and TNF- ? level prompting normalization of clinical indicators. Secondary to surgical stress the excellent dynamics regarding ACTH and cortisol content increase was observed along with no stress response in terms of peripheral blood morphological composition and negative surgical stress impact on the immune system and the cytokine profile.