Abstract
The sinonasal symptoms inherent in chronic polypositis rhinosinusitis have a complex effect on the central structures of the patient's nervous system. The study of impaired cognitive and mnestic functions in this category of patients allows us to form a comprehensive understanding of the symptom complex of clinical manifestations and affect therapeutic tactics. Objective: to conduct a comprehensive comparative analysis of clinical and functional indicators characterizing nasal symptoms in patients with chronic polypous rhinosinusitis and cognitive tests in the pre- and postoperative period. Materials and methods: testing was performed in 45 patients with polypous rhinosinusitis (PRS) with a long history of the disease (M= 117 months). The age of the study group was from 22 to 65 years (M=48.964 years), without concomitant chronic pathology. The scope of clinical testing included the SNOT-22 sinonasal symptoms scale, Lund-Mackey tests and active anterior rhinomanometry (ml/sec). Changes in X-ray examinations (CT ONP) were evaluated on the Lund-Kennedy scale. Cognitive abilities were tested on the basis of the MoCA test in points with subsequent interpretation by a psychiatrist. The evaluation of the indicators was carried out before the surgical treatment of PRS, after 1 and 6 months. Results: The results were obtained to reduce the indicators of sinonasal symptoms on the SNOT-22 scale from M=31.42 before surgery and up to 4.04 points after 6 months; the Lund-Kennedy scale from M=7.87 to M=0.38 points; the Lund-Mackey scale from M=15.49 to M =0.47 points at the final stage. The indicators of active anterior rhinomanometry tended to increase from M=399.04 ml/sec before surgery and M=856.60 ml/sec after six months. Testing of neurocognitive disorders according to MoHS in patients preoperatively demonstrated average values of 21.49 points, which indicated the presence of mild variants of disorders. Further testing made it possible to obtain indicators of 25.38 points after 1 month, which were fixed during the study after 6 months. Conclusion. An interdisciplinary approach to the assessment of clinical manifestations in patients with polypous rhinosinusitis, based on the inclusion of testing of neurocognitive disorders in the study, allows for a more complete assessment of the impact of the pathological process on the patient's body. The inclusion of the MOS test in the complex of pre- and postoperative studies allows us to form an individualized approach to the implementation of therapeutic and rehabilitation measures in this category of patients.
Published Version
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