May, 2025-Yil
787
MODERN APPROACHES TO THE DIAGNOSIS AND MANAGEMENT OF CHRONIC
RHINOSINUSITIS WITH NASAL POLYPS (CRSWNP)
¹Melikulova Maftuna Sanatjonovna
²Asrorov Oybek Akmal oʻg'li
³Lapasov Mirsaid Xasan o‘g‘li
⁴Bekpo‘latov Muxiddin Hakim oʻg'li
¹'²'³'⁴Samarkand State Medical University
2nd year residents of the Department of Otorhinolaryngology No. 2.
https://doi.org/10.5281/zenodo.15521339
Abstract.
Chronic Rhinosinusitis with Nasal Polyps (CRSwNP) is a persistent
inflammatory disease of the nasal mucosa and sinuses, significantly impairing patients' quality of
life. This thesis focuses on updated diagnostic criteria, pathophysiology, and advances in
pharmacological and surgical treatment options.
Keywords:
Chronic rhinosinusitis, nasal polyps, biologics, functional endoscopic sinus
surgery, eosinophilic inflammation, otorhinolaryngology.
Introduction
:
CRSwNP affects approximately 2-4% of the general population and is characterized by
nasal obstruction, rhinorrhea, facial pressure, and hyposmia. The disease has a complex
pathogenesis involving type 2 inflammation, eosinophilic infiltration, and tissue remodeling.
Untreated CRSwNP can lead to complications such as orbital cellulitis and asthma
exacerbation.
Pathophysiology
:
The pathogenesis involves chronic mucosal inflammation driven predominantly by Th2
cytokines (IL-4, IL-5, IL-13), promoting eosinophil recruitment and IgE-mediated responses.
Nasal polyps form due to mucosal edema, extracellular matrix deposition, and epithelial
barrier disruption.
Diagnostic Approach:
Clinical Assessment: Symptoms, nasal endoscopy to visualize polyps, and assessment of
disease severity.
Imaging: CT scan of paranasal sinuses to evaluate extent and anatomical variations.
Laboratory Tests: Eosinophil count, total IgE levels, and allergy testing to identify atopic
status.
Therapeutic Strategies
:
Pharmacological Treatment: Includes intranasal corticosteroids, systemic steroids for
exacerbations, leukotriene receptor antagonists, and recently, biologics targeting IL-4/IL-13
(dupilumab) and IL-5 (mepolizumab).
Surgical Management: Functional Endoscopic Sinus Surgery (FESS) aims to remove
polyps, improve sinus drainage, and facilitate topical therapy delivery. Surgery is reserved for
refractory cases.
May, 2025-Yil
788
Materials and Methods
:
A cross-sectional study conducted at Samarkand State Medical University ENT
Department enrolled 60 patients diagnosed with CRSwNP. Data collected included clinical
presentation, endoscopic findings, CT imaging, laboratory markers, treatment modalities, and
follow-up outcomes over 18 months.
Results
:
Intranasal corticosteroids improved symptoms in 65% of patients, systemic steroids yielded
rapid relief but with side effects in 25%. Biologics showed promising results in reducing polyp
size and symptom severity in 15 patients with severe eosinophilic CRSwNP. FESS was performed
in 20 cases, with significant symptom improvement and reduced recurrence when combined with
postoperative medical therapy.
Discussion
:
CRSwNP management requires an individualized approach considering disease severity,
comorbidities (asthma, aspirin sensitivity), and patient preferences. Biologics represent a
breakthrough for severe cases but require careful patient selection. Surgery remains essential for
mechanical obstruction and refractory disease.
Conclusion
:
Advancements in understanding CRSwNP pathophysiology have led to targeted therapies
improving patient outcomes. Integration of pharmacological and surgical treatments tailored to
patient needs ensures optimal disease control and quality of life.
REFERENCE
S
1.
Taxsinovna N. M. et al. VESTIBULAR VASCULAR REACTIONS IN ASSESSMENT
OF VESTIBULAR DYSFUNCTION IN PATIENTS WITH CRANIOCEREBRAL
TRAUMA //INNOVATIVE ACHIEVEMENTS IN SCIENCE 2024. – 2024. – Т. 3. – №.
29. – С. 104-111.
2.
Uskov A. et al. Modern methods of therapeutic fasting as a way to overcome the
pharmacoresistance of mental pathology //Science and innovation. – 2023. – Т. 2. – №.
D12. – С. 179-185.
3.
Abdukodirova S., SPECIFIC CHARACTERISTICS AND TREATMENT OF ACUTE
OBSTRUCTIVE BRONCHITIS IN CHILDREN OF EARLY AGE //Science and
innovation. – 2023. – Т. 2. – №. D11. – С. 5-8.
4.
Tahirova J. et al. Insomnia problem causes of sleep disorder, help measures at home
//Science and innovation. – 2022. – Т. 1. – №. D8. – С. 521-525.
5.
Sultanov S. et al. Long-term salbi effects of the covid-19 pandemic on the health of existing
residents of alcohol addiction //Science and innovation. – 2023. – Т. 2. – №. D11. – С.
430-438.
6.
Madaminov M., Breast cancer detection methods, symptoms, causes, treatment //Science
and innovation. – 2022. – Т. 1. – №. D8. – С. 530-535.
7.
Khaitov A. A. et al. Optimization of one-stage sanitation of the nasopharynx and tympanic
8.
cavity in case of recurrent exudative otitis media // Current scientific research in the
modern
May, 2025-Yil
789
9.
world. - 2018. - No. 1-8. - P. 81-84. (in Russ)
10.
Jalalova D. et al. СОЧЕТАННАЯ СТОМАТОЛОГИЧЕСКАЯ И ГЛАЗНАЯ
ПАТОЛОГИЯ //Science and innovation. – 2022. – Т. 1. – №. D8. – С. 91-100.
11.
Tohirova J. D. Jalalova TYPES OF HEMORRHAGIC DISEASES //CHANGES IN
NEWBOENS, THEIR EARLY DIAGNOSIS.-2022.
12.
Tahirova J. et al. Neurose causes and mechanisms of development, symptoms, treatment,
prevention //Science and innovation. – 2022. – Т. 1. – №. D8. – С. 515-520.
13.
Kiyomov I., IMPROVING SURGICAL TREATMENT METHODS FOR PATIENTS
WITH NASAL PATHOLOGY //Science and innovation. – 2023. – Т. 2. – №. D11. – С.
226-231.
14.
Sarkisova V. et al. CYTOKINE PROFILE IN PATIENTS WITH GRANULOMATOSIS
WITH POLYANGIITIS (WEGENER'S) //Science and innovation. – 2023. – Т. 2. – №.
D11. – С. 336-343.
15.
Sarkisova V., Lapasova Z., O. Rakhmanov INFLAMMATORY DISEASES OF THE
PELVIC WOMEN ORGANS. – 2023.
16.
Jalalova D., Raxmonov X., РОЛЬ С–РЕАКТИВНОГО БЕЛКА В ПАТОГЕНЕЗЕ
СОСУДИСТЫХ
ЗАБОЛЕВАНИЙ
ОРГАНА
ЗРЕНИЯ
У
БОЛЬНЫХ
АРТЕРИАЛЬНОЙ ГИПЕРТЕНЗИЕЙ //Science and innovation. – 2022. – Т. 1. – №. D8.
– С. 114-121.
17.
Malakhov A. et al. Modern views on the treatment and rehabilitation of patients with
dementia //Science and innovation. – 2023. – Т. 2. – №. D12. – С. 322-329.
18.
Jalalova D., Raxmonov X., ЗНАЧЕНИЕ ДИСФУНКЦИИ ЭНДОТЕЛИЯ В РАЗВИТИЕ
РЕТИНОПАТИИ У БОЛЬНЫХ АГ И ПУТИ ЕГО КОРРЕКЦИИ //Science and
innovation. – 2022. – Т. 1. – №. D8. – С. 101-113.
19.
Madaminov M., Acute tonsillitis (angina) causes, complications, diagnosis, treatment,
prevention //Science and innovation. – 2022. – Т. 1. – №. D8. – С. 771-779.
20.
F. The problem of insomnia causes of sleep disorder, remedies at home //Science and
innovation. – 2023. – Т. 2. – №. D1. – С. 79-84.
21.
Sattarova S., FEATURES OF ELECTROPHYSIOLOGICAL METHODS FOR
GUILLAIN–BARRÉ SYNDROME //Science and innovation. – 2023. – Т. 2. – №. D10. –
С. 199-204.
22.
F. Hymoritis symptoms, treatment, methods of folk medicine, prevention //Science and
innovation. – 2023. – Т. 2. – №. D1. – С. 72-78.
23.
Zhalalova D. et al. INFORMATION POINT OF PERIPHERAL BLOOD INDEXES IN
THE DIAGNOSIS OF THE ETIOLOGY OF OPTIC NERVE DAMAGE //Science and
innovation. – 2023. – Т. 2. – №. D11. – С. 124-130.
24.
Takhsinovna N. M., Musinovna R. K. CHARACTERISTICS OF COMPLAINTS FROM
WORKERS IN NOISE PROFESSIONS, HAVING HEARING IMPAIRMENTS //Health
Horizon: Congress on Public Health and Biomedical Sciences. – 2025. – Т. 1. – №. 1. – С.
28-30.
25.
Rotanov, A. (2023). Elderly epilepsy: neurophysiological aspects of non-psychotic mental
disorders. Science and innovation, 2(D12), 192-197.
May, 2025-Yil
790
26.
Taxsinovna N. M. et al. VESTIBULAR VASCULAR REACTIONS IN ASSESSMENT
OF VESTIBULAR DYSFUNCTION IN PATIENTS WITH CRANIOCEREBRAL
TRAUMA //INNOVATIVE ACHIEVEMENTS IN SCIENCE 2024. – 2024. – Т. 3. – №.
29. – С. 104-111.
