Chronic Polypous Rhinosinusitis Research Articles

THE STATE OF LIPID METABOLISM IN PATIENTS WITH ASPIRIN ASSOCIATED POLYPOUS RHINOSINUSITIS

Nowadays it is observed the wide prevalence of polypous rhinosinusitis, associated with intolerance to aspirin. From today positions the main principle of pathogenesis is in presence of “genetic block” of constitutive cyclooxigenase – the node enzyme of metabolism of arachidonic acid that leads to its active accumulation. It leads to the disorder of lipid metabolism and conditions the necessity to study its biochemical features. Aim of research. To study biochemical parameters of the lipid exchange in patients with chronic polypous rhinosinusitis, associated with intolerance to acetylsalicylic acid by determination of the main metabolites. Materials and methods. The results of laboratory examination of 20 patients with aspirin associated polypous rhinosinusitis are presented in the article. The control group included 7 practically healthy donors. There were studied the level of arachidonic acid in condensate of exhaled air, arachidonic, linoleic, eicosapentaenoic acids, phospholipids, malonic dialdehyde and oxide modification of protein in the blood serum. Results. There were determined the changes of lipid exchange, which essence is in increase of the level of arachidonic acid in condensate of exhaled air and blood serum that leads to the decrease of the content of its main predecessors – linoleic and eicosapentaenoic acids and also phospholipids. The increase of arachidonic acid content stimulates the processes of peroxidation and leads to the increase of malonic dialdehyde content and oxide modifications of protein. The features of biochemical disorders testify to the proinflammatory direction of lipids metabolism. Conclusions. The received data confirm the hypothesis of “genetic block” of arachidonic acid metabolism as the main pathogenetic link of polypous rhinosinusitis, associated with intolerance to aspirin, and allow clearly interpret the clinical image and the features of clinical course.

The study of fatty-acid spectrum of blood serum in patients with aspirin associated polypous rhinosinusitis

Aim of research – to study the composition of the main representatives of polyunsaturated and saturated fatty acids in blood serum of patients with chronic polypous rhinosinusitis, associated with intolerance to acetylsalicinic acid.Materials and methods. The fatty-acid composition of blood serum was determined by the method of capillary gas-liquid chromatography in 20 ill and 7 healthy donors.Results: The change of composition of unsaturated fatty acids is in increase of arachidonic acid level, decrease of the content of its main predecessors – linoleic and eicosapentaenoic acids, normal level of intermediate products:α – and γ – linoleic acid and increase of the level of oleic acid. The content of the main saturated fatty acids: palmitic, stearic, arachidic ones is increased. The fatty acids imbalance testifies to the proinflammatory directionality of lipid metabolism.Conclusions:1. The increase of the level of polyunsaturated (arachdonic and oleic acids) leads to the compensatory decrease of the level of the main predecessors of arachinonic – linoleic and eicosapentaenoic acids. This mechanism allows keep the intermediate products of synthesis of arachidonic acid - α – and γ – linoleic acids at the normal level.2. The content of saturated fatty acids with alternative biological effects is increased in blood serum as a compensatory mechanism of leveling of biological effects of polyunsaturated fatty acids and their metabolites,.3. The revealed imbalance of fatty acids testifies to the proinflammatory directionality of the lipid metabolism.4. The changes of fatty-acid spectrum of lipids in the blood serum prove the hypothesis of “genetic block COG1” as the main pathogenetic link of aspirin associated polypous rhinosinusitis

Investigation of the nasal cavity microflora in patients with chronic polypous rhinosinusitis by mass spectrometry of microbial markers

Investigation of the nasal cavity microflora in patients with chronic polypous rhinosinusitis by mass spectrometry of microbial markers

Correlation between immunoglobulin E levels and cytological composition of mucosal secretion in patients with chronic bacterial and chronic polypous rhinosinusitis

Correlation between immunoglobulin E levels and cytological composition of mucosal secretion in patients with chronic bacterial and chronic polypous rhinosinusitis

The possibilities of conservative treatment for chronic polypous rhinosinusitis

The possibilities of conservative treatment for chronic polypous rhinosinusitis

Role of Chronic Polypous Rhinosinusitis in Contraction of Cancer of Nasal Cavity and Paranasal Sinuses

There is a growing number of with malignant tumors of nasal cavity and paranasal sinuses. Majority of with this pathology are hospitalized with III-IV cancer stages. There is no tendency to decrease the advanced stage of cancer. The efficiency of patients treatment can be increased by early diagnostics. The main reason of delayed diagnostics is insufficient oncologic alarm in primary health care. While the background prodromic cancer processes are morphologically detected in 56.7 % of patients, the issues of treatment policy during cavity and paranasal sinuses premalignancy are still unsettled. Chronic polypous rhinosinusitis is one of the most frequent background process of cancer of nasal cavity and paranasal sinuses. Rhinosinusitis morbidity is high; the growth of its incidence is 2-4 % per year in the last decade. There are few works, considering polypous rhinosinusitis as premalignant condition.

Chemoattractant levels in nasal secretions as indicators of clinical severity in chronic polypous rhinosinusitis

Background The local accumulation of activated eosinophils in the nasal mucosa is a feature of chronic polypous rhinosinusitis (CPRS). However, the pathogenesis of chronic hypereosinophilia in nasal polyps is still unknown. An increased production of several chemoattractants, responsible for guiding the inflammatory process, has been reported in this disease. The aim of this study was to evaluate nasal secretion levels of several chemokines and to correlate those levels with clinical characteristics and degree of eosinophilia in asthmatic and non-asthmatic patients with polypous sinusitis.

POLYPOUS RHINOSINUSITIS

In modern literature, there is observed morbidity growth of malignant tumors of the nasal cavity and the paranasal sinuses. Absolute majority of patients with this pathology start treatment already having III-IV stage of the disease. There is no tendency of a decreased neglect rate of malignant tumors of the nasal cavity and the paranasal sinuses. Treatment efficiency of patients with tumors of the nasal cavity and the paranasal sinuses depends on timely diagnostics. The main reason of late diagnostics is insufficient oncologic alarm in primary health care. All said above is actual, because the problems of therapeutic approaches to treatment of premalignant states havent been solved. At the same time, background processes preceding tumors of the nasal cavity and the paranasal sinuses are morphologically revealed in 56.7 % of patients. One of the most frequent background processes of malignant tumors development is chronic polypous rhinosinusitis. Prevalence of chronic polypous rhinosinusitis is high. There is observed an increase of the chronic polypous rhinosinusitis incidence 2-4 % annually in the last ten years. Higher frequency of inflammatory diseases of the nasal cavity and the paranasal sinuses is a result of serious ecological changes. There are only isolated literary data considering the chronic polypous rhinosinusitis as a premalignant state.

Clinical and functional featuresof respiratory heat exchange and cold airway hyperresponsiveness in patients with bronchial asthma and chronic polypous rhinosinusitis

The aim of the study was to investigate airway conditioning function and cold hyperresponsiveness in patients with bronchial asthma (BA) and nasal polyps. One hundred and eleven asthma patients with or without chronic polypous rhinosinusitis (CPR) were examined. Respiratory heat exchange and cold airway hyperresponsiveness were assessed using thermometry of expired air during quiet breathing and isocapnic hyperventilation with cold air in comparison with a group of healthy persons. The conditioning nasal function was worsened in BA patients with CPRS. Disorders of nasal heat exchange led to decreased temperature of the exhaled air during quiet breathing and cold hyperventilation. These disorders were closely related to increased frequency and severity of cold airway hyperresponsiveness.

Chronisch polypöse Rhinosinusitis

The prevalence of chronic polypous rhinosinusitis is high at 1-2%. In the present study, the predisposing factors for this condition, the clinical symptomatology, results of surgical interventions, significance of computed tomography diagnosis, as well as histology and post-operative therapy with steroids were investigated. A 15% stratified sample, made up of 194 post-paranasal sinus surgery patients of 5 surgical years was investigated. Above all, the eosinophil dominated type led to the formation of polyps. In the diagnosis of chronic polypous rhinosinusitis computed tomography is only sufficiently sensitive for the ethmoid bone. The complication rate was, with 4.6%, in the lower range of comparable pre-examinations. In addition, the 18% relapse rate in the patient population, of whom 49% had already been operated on once or several times, corresponds to a good result when compared at an international level. These data confirm that surgical experience and a consistent post-surgical treatment can reduce the relapse frequency of chronic polypous rhinosinusitis. This is indicated by the on average late occurrence of a relapse.

A-mode Ultrasound in the Diagnosis of Chronic Polypous Sinusitis

A-mode ultrasound (A-US) is a simple, non-invasive and non-ionizing method for detecting fluid or even mucosal swelling in inflamed maxillary and frontal sinuses. A-US has been shown to be a quite reliable tool in the diagnosis of acute maxillary sinusitis. However, controversy still exists over the reliability of A-US in detecting fluid retention or mucosal swelling in patients suffering from chronic polypous rhinosinusitis or in transantrally operated maxillary sinuses. We have compared the results of maxillary sinus A-US with computed tomography (CT) images in a selected series of chronic polypous rhinosinusitis comprising 40 patients. Fluid retention was seen in 20 of 79 maxillary sinuses on CT scanning. Only 6 of these 20 retentions were detected with A-US. There were 11 false positive findings. In six of these cases a back-wall echo was received through polypoid masses in the sinus. Mucosal swelling was also difficult to diagnose. The results of A-US were not easily reproduced; only in 50% of cases were identical results obtained by two investigators. We do not recommend the use of A-US to diagnose fluid retention or mucosal swelling in a patient with chronic mucosal changes in the maxillary sinus or if surgery has been performed on the anterior wall of the maxillary sinus.

Miniature endoscopes in otorhinolaryngologic applications

SummaryProgressive miniaturization of rigid and flexible endoscopes enables the practising otorhinolaryngologist (head and neck surgeon) to visually inspect regions of the upper respiratory tract that could never have been inspected directly before, or had only been accessible for direct view by massive traumatization of the anatomic surroundings. For the otologist, microendoscopy opens up the possibility of using an endoscope to assess the luminal situation of the Eustachian tube, in order to detect morphological obstructions of this normally collapsed connection between the middle ear compartment and the nasopharynx. The first basic laser surgery on polyps and oedematous soft tissues to restore the essential proper ventilation and drainage of the tympanic cavity have been performed and data about this topic are soon to be published. The ‘mother-baby endoscope’ technique allows us to reach into the nasopharynx and paranasal sinuses via the natural orifices, for a direct visual diagnosis of chronic secretory and polypous rhinosinusitis. Even small recurrences can be treated using minimally invasive techniques by fibre-delivered laser surgery in hidden areas of facial skull cavities. This painless technique is particularly useful in children. The development of ‘sialendoscopy’ i.e. microendoscopy of the salivary glands, is the first procedure to identify the real cause of obstructive disorders of the major salivary glands. Direct visual inspection allows the examiner to differentiate between stenoses, secretion plugs and calculi. In cases of sialolithiasis, laser-induced shock wave lithotripsy (LIL) can be performed by transferring short laser pulses via an inserted fibre onto the surface of the stone to disintegrate it.