Thesis represents the results of a complex clinical-laboratory examination of patients with chronic polyposis rhinosinusitis (CRS with NP), which is a common disease in the population; these results are found in 15-25% of otorhinolaryngological patients and significantly affects the quality of life and the formation of comorbid diseases. If the treatment of CRS with NP using nasal corticosteroid and saline solution is insufficient, it is necessary to consider not only indications for surgery, but also the additional endotyping of the disease. Considering the fact that surgery remains the main treatment strategy for CRS with NP, there is a necessity to find the new approaches to the conservative treatment. The concept of the thesis work was that, in addition to the standard treatment of CRS with NP, the appointment of ACA as a preoperative preparation within the strategy of complex (with the use of surgery) treatment, will show its effectiveness and contribute to a better regression of clinical symptoms and a reduction in the number of surgical interventions. The total study sampling (n - 120) included 35 (58.3%) men and 25 (41.7%) women of the main group (n - 60), and 32 (53.3%) men and 28 (46.7%) women (n - 60) of the control group. The average age of patients in the main group was 45.8 years, in the control group was 47.0 years. During the first visit (V1), all the patients enclosed into the study were prescribed the treatment, which, according to current recommendations, included irrigation therapy with a physiological solution of sea water and a topical mometasone furoate. Besides, the patients of the main group were additionally prescribed aminocaproic acid from the first day of treatment (V1). The study showed that the additional prescription of ACA provided a statistically significant difference in the dynamics of the regression of such symptoms as nasal discharge, nasal congestion, postnasal drip during the V2 and V3 compared to patients of the control group (p<0.05). The evaluation of the results shows that despite the relief of nasal breathing (nasal congestion) during the V2, there was a lack of dynamics in the regression of polyps in the groups. Their decrease is determined during the V3 only in the main group. It was found that the additional appointment of ACA provided a statistically significant difference in the dynamics of regression of polyps during the V3 compared to patients of the control group (p<0.05). The scientific novelty of the results obtained is that it has been demonstrated that the additional use of ACA provides a clinically significant, reliable reduction in the severity of the symptoms of CRS with NP (rhinorrhea, nasal congestion, postnasal drip), quality of life indices during the fifth and the tenth day of treatment compared to the standard therapy as part of preoperative preparation (р< 0.05); it is found that the appointment of ACA as the part of preoperative preparation allows us to reliably reduce the size of polyps during the tenth day of treatment compared to basic treatment (p<0.05); the effectiveness of the additional use of ACA has been proven according to the criterion of the frequency of surgical interventions, which allows to reduce their frequency at 25% (from 81.7% to 56.7%) in control group patients (p<0.05). Specified scientific data: regarding the informativeness of clinical-endoscopic examination methods for the assessment of the dynamics of clinical symptoms of CRS with NP during the tenth day of treatment, which has statistically confirmed the characteristics for determination of further treatment tactics; regarding the evaluation of the results of conservative treatment as part of preoperative preparation and their role as prognostic factors of the course of the disease, determining approaches to clarifying the endophenotype of CRS with NP. There has been improved: the process of choosing an option for the treatment of CRS with NP based on the determination of the clinical characteristics of patients: it was determined that, in addition to standard therapy, the use of ACA as a part of preoperative preparation allows a statistically significant reduction in the number of surgical interventions from 81.7% to 56.7% (p<0.005). Further development was received by: assessment of the situation regarding the frequency of surgical interventions, which showed its compliance with global trends and a 25% decrease in their number (p<0.05); a method of evaluating the results of preoperative preparation as the main indication for the verification of a specific endophenotype of CRS with NP, which, compared to traditional practice, allows to single out a group of patients with suspected intolerance to aspirin and other NSAIDs. Key words: respiratory tract, ENT organs, nasal cavity, allergic rhinitis, rhinosinusitis, microbiocenosis, antibacterial activity, morbidity, therapy, quality of life, medical care. Branh-Medicine.
