Effectiveness of antral puncture and Proetz displacement procedure in acute bacterial rhinosinusitis

Abstract

The development of antibiotics and topical steroids in the treatment of acute bacterial rhinosinusitis (ABRS) has not changed the attitude to active drainage, which appeared more than 200 years ago, and today in Russia is used in most medical institutions and is included in clinical guidelines. The existing studies do not answer the question about the necessity of such procedures. In this regard, the study of the effectiveness of various methods of active drainage is relevant. The aim of the study was to conduct a comparative evaluation of antral puncture and Proetz displacement procedure in the treatment of acute bacterial rhinosinusitis. Materials and methods. A total of 150 adult patients with a moderate ABRS were examined. All patients received a systemic antibiotic. One group underwent the Proetz procedure, another group underwent an antral puncture, and the third group was a control. Quality of life (SNOT-16), nasal cavity endoscopy, facial pain severity, tolerability, complications, and duration of the procedure were assessed. Results. A single puncture significantly improved QoL, reduced the severity of endoscopic manifestations on day 5-6 of treatment, and reduced facial pain 30 minutes after the procedure. In the Proetz group, the procedure had no effect on the course of the disease. Tolerability of the puncture was satisfactory, and the Proetz procedure was painless. Both procedures significantly increased the duration of the consultation. The proportion of complications obtained indicates the relative safety of the methods studied. Conclusion. There is a need to reconsider the feasibility of routine use of active drainage methods in the treatment of ABRS, since antral puncture is effective only in the presence of pain syndrome, while the Proetz method has no effect on the course of the disease.