VERIFICATION AND TREATMENT OF RESISTANT CHRONIC RHINOSINUSITIS WITH NASAL POLYPS AT MULTIMORBID CARDIOVASCULAR PATHOLOGY

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Abstract

Objective: Identify the diagnostic signs for chronic rhinosinusitis with nasal polyps (CRSwNP & resistant forms) with multimorbid cardiovascular pathology (MCVP) (coronary artery disease (CAd), hypertension, metabolic syndrome (MS). Identify effectiveness of photodynamic therapy in CRSwNP treatment. Design and methods: The study included 75 patients (mean age 35,8±7,93, 39,2% - female,60,8% - male) with CRSwNP and MCVP divided into 3 groups by simple random sampling. Patients in group 1 (n = 27) received standard therapy CRSwNP, hypertension, CAd, NPMd, 8-weeks anti- bacterial and leukotriene receptor antagonists treatment. Surgical interventions history of the last 5 five years: from 1 to 2. Patients in group 2 (n = 28) received standard therapy CRSwNP, hypertension, CAd, NPMd, 8-weeks antibacterial and leukotriene receptor antagonists treatment. Surgical inter- ventions history of the last 5 five years: more than 3. Patients of group 3 (n = 20) received standard therapy CRSwNP, hypertension, CAd, NPMd, 8-weeks antibacterial treatment, 8-weeks leukotriene receptor antagonists treatment and sessions of photodynamic therapy of the paranasal sinuses. Surgical interventions history of the last 5 five years: more than 3. used in the study: complex psychological test methods, ENT and laboratory-instrumental evaluation of the cardiovascular system. Results: depres- sion was detected in 46,3%, 71,9%, 58,3% of patients, (first, second, third groups). Types «non-dipper» and «night-peaker» found in patients 2nd and 3rd groups- corresponds with (CRSwNP & resistant forms). Bone transformation zone as a result of chronic inflammation within the ethmoidal labyrinth and maxillary sinuses identified in the second and third patients group (85% of cases). The use of pho- todynamic therapy in the resistant CRSwNP forms treatment improves the functional indicators of the nasal cavity and paranasal sinuses. Conclusions: Patients with CRSwNP have symptoms of depression and «non-dipper» and «night-peaker» patterns. All CRSwNP patients are defined trigger points with areas of chronic osteitis and odontogenic osteomyelitis. The use of photodynamic therapy for CRSwNP treatment, reduces the number of CRSwNP recurrence.

About the authors

M A Aflitonov

Northwestern State Medical university named after I.I. Mechnikov

S A Artyushkin

Northwestern State Medical university named after I.I. Mechnikov

S A Partsernyak

Northwestern State Medical university named after I.I. Mechnikov; City hospital № 15

A N Mironenko

Northwestern State Medical university named after I.I. Mechnikov; City hospital № 15

A S Partsernyak

Military medical academy named after S.M. Kirov

S Y Naumov

City hospital № 40

E V Bezrukova

Northwestern State Medical university named after I.I. Mechnikov

A A Topanova

Northwestern State Medical university named after I.I. Mechnikov

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Copyright (c) 2017 Aflitonov M.A., Artyushkin S.A., Partsernyak S.A., Mironenko A.N., Partsernyak A.S., Naumov S.Y., Bezrukova E.V., Topanova A.A.

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