Клинико-лучевые особенности смешанных полипозной и полипозно-гнойной форм хронических риносинуситов в сочетании с зубочелюстной патологией

Abstract

The choice of diagnostic tactics and methods of conservative and surgical treatment of mixed polypous and polypous-purulent types of chronic rhinosinusitis in patients with concomitant dentoalveolar pathology, comorbid somatic pathology depends on the availability of clinic’s technical supply and the patient's mood to make the optimal choice. The literature does not provide a unified algorithm for the examination and management of patients with chronic mixed polypous and polypous-purulent types of sinusitis occurring against the background of dentoalveolar pathology. Aim. Justification of differentiated approach to the diagnosis of chronic mixed polypous and polypous-purulent rhinosinusitis in patients with dentoalveolar pathology. Materials and methods. In 200 patients with these types of rhinosinusitis, pathological changes in the paranasal sinuses, nasal cavity and dentoalveolar apparatus were revealed. Results. In activation of the focus of odontogenic infection, pathological changes in the nasal cavity and paranasal sinuses were more severe at the side of odontogenic infection focus; in inactive odontogenic process and in presence of rhinogenic provoking factors, the severity of pathological changes in the nasal cavity and paranasal sinuses were similar at both sides. With each relapse of activation of the focus of odontogenic infection, the duration and severity of sinusitis increased. Conclusion. The basic diagnostic method for examining patients with mixed polypous and polypous-purulent types of chronic sinusitis in combination with dentoalveolar pathology is cone-beam computed tomography, which let to assess the severity of odontogenic infection focus against the background of pathological changes in the nasal cavity and paranasal sinuses to select the optimal therapeutic tactics.