Влияние нарушения архитектоники полости носа и носоглотки на развитие околоносовых пазух и формирование в них воспалительных процессов

Abstract

The structure of the paranasal sinuses (PNS) is characterized by pronounced variability and largely depends on the state of the intranasal architectonics, the violation of which may be a predisposing factor for the development of sinusitis. Leading among the disturbances in the architectonics of the nasal cavity and nasopharynx are the nasal septum deviation (NSD), concha bullosa (CB), hypertrophy of the inferior turbinates and pharyngeal tonsil. This review presents an analysis of modern data on the influence of the architectonics of the nasal cavity and nasopharynx on the development of PNS and the formation of inflammatory processes in them. Sources of information - databases Medline, Pubmed, Cochrane, E-library from 2004 to 2019. The search was carried out by keywords. Criteria for inclusion of articles in the review: assessment of multispiral computed tomography of SNP of patients in axial and coronary projections, presence of a control group, sample size of more than 50 people. In the presented review, it is noted that types 3 and 5 of DNP according to the classification of R. Mladina, along with contralateral CB and adenoids, can be predictors of the development of sinusitis. Information about the side of sinusitis formation in relation to the direction of the deformity of the nasal septum, about the effect of other violations of the architectonics of the nasal cavity on sinusitis and the size of the SNP remains controversial. The reasons for the contradictions are the use of different classifications of DNP, the underestimation of the complexes of anatomical anomalies and the mechanisms of aerodynamics of the sinuses, which determine the greater dependence of the volume and ventilation of the sinuses on expiration than on inspiration. Taking these positions into account, the question of the influence of the architectonics of the nasal cavity on the development of the paranasal sinuses and the formation of the inflammatory process in them requires further study.