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DIAGNOSIS OF THE ORIGIN OF CHRONIC RHINOSINUSITIS AND THE
ADVANTAGES OF MODERN CLINICAL DIAGNOSTIC METHODS
Elmurodov Doston
Yo'ldoshov Elchinbek Qosim o'g'li
Qosimov Mirkamol Erkinboy o'g'li
Samarkand State Medical University, Department of Otorhinolaryngology No. 2, 1st year
clinical resident
Khayitov A.A.
Scientific supervisor: Associate Professor
Associate Professor, Department of Otorhinolaryngology No. 2, Samarkand State Medical
University
https://doi.org/10.5281/zenodo.14623376
Relevance of the experience:
Chronic rhinosinusitis is characterized by a long course and
usually occurs without a significant increase in temperature. The acute condition is always
accompanied by high fever, begins unexpectedly and has more pronounced painful symptoms.
The main reason for the development of chronic inflammation of the maxillary sinuses is
a violation of their normal drainage. This occurs due to long-term infectious or non-infectious
edema in the area of the maxillary nasal anastomosis (allergy, drug-related edema) or impaired
mucous clearance. Also, the background for the formation of chronic inflammation are anatomical
obstacles in the nose that disrupt normal drainage (deviation of the septum, expansion of the
middle turbinates).
Object of investigation:
Long-term allergic swelling of the nasal mucosa;
frequent respiratory infections;
septal deformity;
hypertrophy of the middle turbinates;
long-term swelling of a non-allergic nature (drug rhinitis);
chronic inflammatory process in the area of the upper teeth (periodontitis, odontogenic
cysts);
foreign bodies (filling material, sinus lift material, tooth roots, etc.);
neoplasms in the nasal cavity or paranasal sinuses;
other diseases: cystic fibrosis, gastroesophageal reflux, HIV infection, immunodeficiency
states.
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Examination materials:
The likelihood of rhinosinusitis becoming chronic increases if
one or more of the following factors are present:
smoking;
immune system disorders;
frequent contact with irritants (chemicals, smoke, suspension of small particles, dust,
allergens).
Complications of chronic rhinosinusitis
Long-term inflammation poses many risks because the sinuses are located close to
important structures such as the eyes and brain:
Examination methods:
A flexible, soft tube (endoscope) with a fiberoptic light allows the
doctor to see the nasal passages, sinus area, and sometimes the inside of the sinuses.
X-ray. Images from a computed tomography (CT) scan can show details of your maxillary
sinuses and nasal area. The doctor can determine the size and nature of sinus lesions and assess
the patency of the sinus-nasal connections.
Culture of the mucous membrane for flora. Allows you to identify the infectious cause of
sinus inflammation (if any) (fungi, bacteria) and prescribe the necessary treatment.
Allergy testing. If your doctor suspects that your condition is caused by an allergy, you
should have an allergy test (rhinocytogram, blood IgE, eosinophil cationic protein).
Observable results:
The goal of treatment is to reduce the number of exacerbations of
sinusitis and reduce or eliminate the symptoms of the disease. The main therapy is aimed at
improving the drainage of the paranasal sinuses, as well as improving the local immunity of the
mucous membranes. This requires eliminating the blockage of the sinus-nasal anastomosis,
reducing the viscosity of the mucous secretion, and conducting immunotherapy. Sometimes
surgery is required to clear the sinuses.
Conclusion
: With low effectiveness of conservative therapy, surgical treatment of chronic
rhinosinusitis is indicated. This is done to eliminate mechanical obstruction to sinus drainage
(enlarged turbinate, deformed nasal septum, anatomical narrowing of the sinus anastomosis area,
polyps in the anastomosis area, etc.), as well as foreign bodies in the sinuses (fungal bodies, tooth
roots, filling material, material for lifting the sinus), cysts, polyps. In cases where conservative
treatment does not help, endoscopic surgery is performed. To perform this procedure, the doctor
uses an endoscope (a thin tube with a video camera and light) to examine the nasal passages. In
addition, depending on the nature of the obstruction, the doctor may use various instruments to
remove tissue or destroy polyps that block the outflow of contents from the paranasal sinuses.
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In surgical treatment of the nasal cavity and sinuses, we follow the concept of Walter
Messerklinger, which in recent years has become a whole field of surgery (functional endonasal
sinus surgery, FESS). Functional endonasal (through the nostril) microsurgery is based on the
principle of gentle surgical intervention in specific areas. With this approach, using a razor
(microrazor), only affected or abnormally located tissues are removed with maximum preservation
of the "healthy" mucosa.
The goal of surgical treatment with FESS surgery is to restore natural ventilation and
drainage pathways (gastric).
Avoid upper respiratory infections. Minimize contact with people who have colds. Wash
your hands often with soap, especially before eating.
Monitor and manage your allergies, if any.
Avoid smoky rooms and areas with polluted air. Tobacco smoke and other pollutants can
cause irritation and inflammation in the nasal passages and lungs.
Use a humidifier. If the air in your home is dry, such as if you have air conditioning, using
a humidifier can help prevent sinusitis. Keep the unit clean and make sure it is free of mold.
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