Оценка эффективности дренирования околоносовых пазух назальным катетером в лечении острого бактериального риносинусита

Abstract

There are various ways to treat acute bacterial rhinosinusitis (ABRS), the main one being systemic antibiotic therapy (SAB), which seems logical today. However, the role of the method of active noninvasive drainage of the paranasal sinuses (PNS) with a nasal catheter (NC) in the treatment of this disease is not yet completely clear. Based on the pathogenesis of acute sinusitis, there are good reasons to use it as a possible treatment option. However, clinical studies are needed to confirm the effectiveness of the method. Objective. To evaluate the effectiveness of drainage of the paranasal sinuses with a nasal catheter in the treatment of acute bacterial rhinosinusitis. Materials and methods. Adult patients with ABRS were divided into 2 groups of 50 people. In the first group, SAB, irrigation of the nasal mucosa with saline, and intranasal decongestants were prescribed, in the second group, in addition to similar treatment, the procedure for draining PNS using NC was performed. The quality of life and the severity of sinonasal symptoms were assessed using the SNOT-16; the severity of the endoscopic picture, according to the modified Lund–Kennedy score (m-LK). In addition, in the second group, complications, duration of manipulation, and pain during the procedure were assessed according to the VAS (visual analogue scale). Results. The use of NC statistically significantly (p < 0.05) reduces the severity of the disease according to the SNOT-16 and on the m-LK score on days 5–6 relative to treatment without NC, although this decrease is small. More long-term results in the groups do not differ (p > 0.05). In the second group, facial pain stopped faster than in the first group (p < 0.05). The severity of pain during the procedure with a catheter was 2,0 [1,0; 3,0] points, the procedure time was 12,0 [12,0; 13,0] minutes, complications were observed in 12% of cases. Conclusion. Treatment of OBRS with SAB in combination with NC is effective, well tolerated as well as relatively safe, but it does not affect the outcome of the disease compared to treatment with antibiotics alone. Given the effectiveness of the NC procedure with respect to facial pain, this procedure is indicated as an adjunct to the SAB in the presence of this symptom.