Deviated nasal septum (DNS) is a wide-spread pathology observed in 75.0–89.2 % of all the people and leads to disturbed nasal breathing, chronic rhinitis, pathology of the paranasal sinuses, auditory tube and middle ear, inflammatory diseases of the pharynx, larynx, and lower respiratory tract, olfactory dysfunction (OD) in the form of hyposmia or anosmia, emotional stress, depression, and poor quality of life. The purpose of the study is to improve the effectiveness of diagnosis and treatment of patients with deviated nasal septum and olfactory dysfunction based on the use of surgical methods (endoscopic septoplasty, conchotomy) and cell therapy with platelets automesoconcentrate. Scientific novelty of the obtained results. The frequencies of variants of the olfactory fossa within the framework of the Keros classification were studied in patients with DNS and OD, patients with DNS and OD who had COVID-19, DNS + K19 induced OD that important for preoperative planning of endoscopic septoplasty volume and prevention of the ethmoid bone lateral lamella penetrating. It was established that 52.3 % of patients with DNS + K19 induced OD have an olfactory pit of type ⅠⅠⅠ according to the Keros classification, a large olfactory pit can be a favorable factor in the pathogenesis of post-infectious olfactory dysfunction. Practical significance of the obtained results. An algorithm for complex diagnosis of the functional and anatomical state of the olfactory analyzer in patients with DNS with OD, DNS with K19 induced OD based on the use of the saccharin test, the Sniffin’ Sticks test system, anterior active rhinomanometry (AARM), cone-beam computed tomography (CBCT), magnetic resonance imaging (MRI) and endovideoscopy was developed. The diagnostic and treatment algorithm “clinical examination + Sniffin’ Sticks test + saccharin test + AARM + MRI + CBCT + endovideoscopy + endoscopic septoplasty (“autocartilage” implant)/conchoplasty + PAMC cell therapy + monitoring → Sniffin’ Sticks test + gustometry + saccharin test has been developed + AARM + MRI + CBCT + endovideoscopy”.
The objective diagnostic criteria have been determined based on the data of the complex clinical and instrumental examination, which allows to evaluate the changes in patients after septoplasty. The method of obtaining PAMC by double centrifugation of the patient's blood, cryoactivation during cryopreservation, defrosting and double centrifugation of the lysate product has been developed. The use of PAMC after septoplasty significantly reduces the frequency of postoperative complications, accelerates the recovery of smell and improves the quality of life.
