The possibilities for the use of mineral water in the combined treatment of acute maxillary sinusitis

The present article was designed to report the results of the investigations into the mucociliary activity of mucosal epithelium in the nasal cavity and the local immunity status of the patients presenting with acute maxillary sinusitis during their combined treatment with the use of Talaya nitrous siliceous water as elimination therapy and endonasal electrophoresis. The study included 120 patients with acute suppurative maxillary sinusitis and 15 health subjects. The patients of group 1 (control, n = 48) were given standard medicamental therapy and underwent the maxillary sinus puncture followed by the administration of an antibiotic. The patients of group 2 (n = 72) received the standard medicamental treatment with the puncture of the maxillary sinuses into which mineral water was introduced; this procedure was supplemented by mineral water electrophoresis in the nasal cavity using the specially developed method. The effectiveness of the treatment was assessed based on dynamics of clinical symptoms, results of rhinoscopy and X-ray studies of the paranasal sinuses. In addition, the transport function of ciliary epithelium was evaluated from the results of the saccharin test and the examination of the nasal mucus smears. The lavage from the maxillary sinuses obtained during their puncture or with the help of the sinus-catheter were used to determine concentrations of albumin, immunoglobulins IgA, M, G, E, and secratory sIgA. The study has demonstrated that the clinical effectiveness of the treatment with the use of mineral water as elimination therapy in combination with endonasal electrophoresis was attributable to the improvement of mucociliary clearance , reduction of the inflammatory reaction, and correction of the local immune protection factors. The duration of the mucociliary transport in the patients of groups 1 and 2 decreased by 39.8% and 44.2% respectively. The analysis of rhinocytograms revealed a significant decrease in the number of phagocytizing neutrophils, the enhancement of autoflora phagocytosis, the decrease in percentage of destroyed phagocytes, and the increase in the number of lymphocytes. The comparative analysis of dynamics of the local protective factors has demonstrated the advantages of the treatment with the use of mineral water as well as significant differences in the degree of reduction of IgA, sIgA, IgM, and IgE levels. It is concluded that the results of this study provide a basis for the introdution of mineral water in the combined treatment of the patients presenting with acute suppurative maxillary sinusitis and the extension of the scope of physiotherapeutic methods for the treatment of this pathology.

mineral water, elimination therapy, electrophoresis, mucociliary transport, immunity, acute maxillary sinusitis