Improvement In Nasal Breathing Research Articles

Comparative analysis of long-term results of surgical treatment of children with basal encephaloceles

Basal encephaloceles (skull base hernias) are a rare pathology manifested by prolapse of altered membranes and brain tissue through a bone defect of the skull base. Endoscopic access is safer and is currently used as the method of choice in the treatment of this pathology. Available literature studies do not cover the quality of life of these patients at follow-up. There is a controversy regarding the impact of endoscopic access on the growth centers of the facial skeleton. Material and methods. A retrospective analysis of a series of 100 patients aged 0 to 18 years with basal encephaloceles who underwent surgical treatment at the N. N. Burdenko National Medical Research Center of Neurosurgery from 2005 to 2022 was carried out to determine the effectiveness and safety of the endoscopic method in the treatment of patients with basal encephaloceles and identify factors affecting the quality of life of these patients. Results and conclusions. Endoscopic endonasal access in the treatment of children with basal encephaloceles is effective and safe. Patients have a high quality of life (>85 points) at follow-up. After the operation, there is an improvement in nasal breathing and an increase in the degree of psychomotor development. Patients have a high quality of life (>85 points) at follow-up. A lower quality of life at follow-up was observed in children with delayed psychomotor development before surgery (OR=0.6; p=0.003). The follow-up study of the dynamics of craniometric parameters did not reliably show any disturbances in the growth of the bones of the facial skeleton in patients after endoscopic surgery.

Patient-Reported Outcome Measures Including Nasal Breathing Improvement After Functional Rhinoplasty Using Endonasal Septal Extension Grafting.

Objective: To measure the change perceived by patients after endonasal rhinoplasty using a, septal extension graft (SEG), as measured by patient-reported outcome measures (PROMs). Methods: A retrospective review of patients with nasal obstruction underwent septoplasty, turbinoplasty, and SEG. PROMs were assessed to compare operative outcomes for breathing (Nose Obstruction Symptom Evaluation [NOSE], Sinonasal Outcome Test [SNOT]-22, Standardized Cosmesis and Health Nasal Outcomes Survey [SCHNOS]), and sleep quality (Epworth Sleepiness Scale [ESS]) Results: Of the 34 patients undergoing rhinoplasty with Endonasal SEG, the median patient age was 38.3 years (range 17-58) and mostly male (n = 18, 52.9%). Additional procedures performed on the patients included septoplasty (n = 34, 100%) and turbinate reduction (n = 34, 100%). Average follow-up was 126.6 days (range 28-573) for a majority of PROMs. There were no complications. The average change in NOSE score was 71.5 and -49.4 (standard deviation [SD] = 19.0, p < 0.001). SNOT-22 change was 35.4 and -24.2 (SD = 14.5, p < 0.001), and ESS scores averaged 6.7 and -3.4 (SD = 4.3, p < 0.001). The average SCHNOS total, functional, and cosmetic scores were 40.6, 67.9, and 22.4, respectively, and -28.0 (SD = 19.8), -44.5 (SD = 22.9), and 17.1 (SD = 24.6) (p < 0.001). Conclusion: In this pilot study, patients reported improvement in nasal breathing after correcting a deviated caudal septum and applying an Endonasal SEG.

THE RESULTS OF SEPTOPLASTY IN PATIENTS WITH VARIOUS FORMS OF DEVIATED OF THE NASAL SEPTUM USING THE TECHNIQUE OF EXTRACORPOREAL REMODELING AND REPLANTATION OF THE SEPTUM

Objective: To present the results of extracorporeal septoplasty in patients with various forms of deviated of the nasal septum, using the technique of replantation of the septum and to discuss the advantages and limitations. Materials and methods: The work is based on clinical observations of 164 patients with curvature of the nasal septum from 2018 to 2023. All patients underwent a standard otorhinolaryngological examination, spiral computed tomography CT of the nose and paranasal sinuses in coronary and axial projections. Endoscopic examination of the nasal cavity carried out by an endoscope of the Karl Storz company. Nasal breathing is objectively evaluated with the help of the "PC 300 nose manometer" by ATMOS, which allows to register the pressure in one half of the nose while the patient breathes through the other. A modified "extracorporeal" septoplasty is used, which consists in the complete isolation and temporary removal of the deformed quadrilateral cartilage, followed by its correction and reimplantation. The operation was performed under general anesthesia with performed oral intubation. Results: No complications were observed during the operation, the patients were satisfied with the aesthetic and functional results of septoplasty. Complications were noted in the remote postoperative period. long-term swelling of the mucous membrane of the nose (partially obstructed nasal breathing), which was stopped by taking antihistamines, in 5 patients. In all clinical observations, stable support of the cartilaginous part of the nasal septum and the absence of its secondary deviation were obtained, which also directly affects the harmonic aesthetic results of the shape of the external nose and free nasal breathing. The indicators of the rhinomanometer showed a significant improvement in nasal breathing and are approaching the values accepted as the norm. Conclusions: Extracorporeal septoplasty in patients with various forms of curvature of the nasal septum is an effective surgical technique that gives optimal functional results.

Closure of Nasal Septal Perforations Using a Diced Cartilage in Fascia Graft.

The spectrum of surgical techniques in the repair of nasal septal defects is wide. The objective of this study was to assess the feasibility of using a diced cartilage in fascia (DC-F) graft for successful closure of nasal septal perforations and to evaluate symptom reduction. This was a retrospective study of 18 patients undergoing surgical repair of symptomatic nasoseptal perforations of different etiologies using a DC-F graft from 2020 until 2021. The procedure was feasible in all of the 18 patients. Reconstruction of septal defects with a DC-F graft led to reduction of crust formation, reduction of epistaxis, and improvement of nasal breathing in 13 out of the 18 patients when seen for their 2-month follow-up. Reperforation occurred in three cases, leaving defects of 1, 7, and 5 mm in diameter. In one case, the reperforation was symptomatic. A DC-F graft proved to be a reliable and reproducible method for the closure of nasoseptal perforations of variable sizes, of different locations, and of different etiologies.

Randomized clinical trial of surgically assisted rapid maxillary expansion with two and three segments for nasal breathing.

To evaluate surgically assisted rapid maxillary expansion (SARME), with osteotomies separating the maxilla into two segments (SARME-2S) and three segments (SARME-3S), on obstruction symptoms and nasal cavity dimensions in patients with maxillary transverse skeletal deficiency (MTSD). Sixteen patients with MTSD of 7mm or above were evaluated in each group, for a total of 32 patients. All patients were evaluated pre- and postoperatively up to 10months after the expander activations. The minimum cross-sectional area (MCA) and the volume of the nasal cavities were identified by acoustic rhinometry. The Nasal Obstruction Symptom Evaluation (NOSE) scale questionnaire was applied. The palate surface area (PSA) was measured, via digitized maxillary models, as a criterion for comparison with the other variables studied. There was no difference between the groups (p = 0.370) and was verified a significant increase in PSA postoperatively. MCA showed a small increase without statistical significance, and together with the volume of the nasal cavities remained constant during the study. NOSE scale scores decreased significantly in the postoperative periods, implying a decrease in nasal obstruction symptoms in both groups. SARME with two and three segments show similar results, and both may improve nasal obstruction symptoms when present in patients with MTSD. SARME, regardless of the chosen surgical technique, should follow the recommendation to correct just the MTSD. While an improvement in nasal breathing is expected, this must be understood as likely, but not certain.

The long-term effect of maxillary advancement and impaction on subjective and objective nasal patency: A retrospective case-control study

The aim of this study was to investigate the change of nasal patency after maxillary advancement and impaction (MAXADV + IMP) in subjects with skeletal class III malocclusion (cases) and after removal of maxillary cysts in close proximity to the nasal floor in subjects that served as controls. NOSE score, volume derived by computed tomography (VOL), and acoustic rhinometry and rhinomanometry were retrospectively evaluated, before and one year after surgery. The movement of specific landmarks was also measured. NOSE score did not change after surgery, neither in 17 cases (p = 0.10) nor in 17 controls (p = 0.14). In cases, VOLpostop (10088 ± 4200 mm3) was significantly higher than VOLpreop (7807 ± 3721 mm3; p = 0.036). Maxillary advancement and inferior displacement of the ventral maxilla were noted by the movement of incisive foramen in the coronal (3.9 ± 5.4; p = 0.011) and Frankfurt Horizontal plane (2.2 ± 2.0; p = 0.001), respectively. In controls, VOLpostop (9749 ± 3654 mm3) was also significantly higher than VOLpreop (8473 ± 2624 mm3; p = 0.050). Cross-sectional areas, nasal flow and nasal resistance changed significantly after surgery in cases (6/30 pairs; p < 0.018), but not in controls (all p > 0.066). MAXADV + IMP increased nasal patency, but did not change the feeling of nasal breathing. Physicians should proceed with caution when informing patients about improvement of nasal breathing after MAXADV + IMP.

Эффективность топических глюкокортикостероидов у больных полипозным риносинуситом

The study included 112 patients with polypous rhinosinusitis aged 25 to 64 years (mean age 47.05 ± 11.64 years) who were scheduled for functional endoscopic sinus surgery. All patients were divided into 2 groups: in the first group, topical glucocorticosteroids (tGCs) were prescribed in combination with nasal irrigation, in the second (control) group, IT was prescribed. A comprehensive assessment of the dynamics of the course of polypous rhinosinusitis in patients was carried out, including changes in symptoms according to the SNOT-22 scale, data from endoscopic examination of the nasal cavity, anterior active rhinomanometry (AARM), and CT data of the paranasal sinuses (PNS). In the first group, while taking tGCs, 31 (55.4%) patients showed a significant improvement in nasal breathing in combination with positive dynamics according to the examination, AARM, and CT PNS. At the time of the final examination at the end of the course of therapy, 18 (32.1%) patients of the first group did not reveal the need for surgical intervention. In the second group in most cases, there was no significant change. At the time of the final examination, all patients of the second group still needed surgical treatment.

Efficacy and safety of a hypertonic nasal wash solution containing sea algae extracts in patients that underwent surgical correction of a deviated nasal septum and radiofrequency turbinate volume reduction.

The objective of this study was to evaluate efficacy and safety of a Hypertonic Seawater Solution (2.3% NaCl) containing brown and blue-green Algae (HSS-A) in comparison to Isotonic Saline Solution (ISS) regarding the improvement of nasal breathing in patients that have undergone surgical correction of a deviated nasal septum and radiofrequency turbinate volume reduction. A total of 101 individuals were enrolled in the study (HSS-A: 57; ISS: 44). Nasal breathing was evaluated using a Peak Nasal Inspiratory Flow (PNIF) measurement device at four timepoints: prior to surgical intervention (up to 30 days pre-surgery) and at the 2nd, 10th and 20th postoperative days. On the 20th postoperative day, patients also answered a Nasal Surgical Questionnaire (NSQ) evaluating breathing ability and overall satisfaction from the use of both nasal sprays. No significant differences were observed in PNIF measurements between groups at different points. On the 20th postoperative day, NSQ analysis showed that ISS-treated patients had more frequently moderate nasal bleeding compared to the HSS-A group (85.7% vs. 14.3%, p=0.038). No other statistically significant differences were observed between groups. When NSQ parameters were evaluated in a binary mode, a trend for reduced crusting scores was seen in the HSS-A group (15.9% vs. 35.5% in ISS, p=0.053). No safety concerns were reported throughout the study. In patients that have undergone surgical correction of a deviated nasal septum and radiofrequency turbinate volume reduction, PNIF values did not differ significantly in patients receiving HSS-A and ISS solutions. Nasal bleeding was more frequent in ISS patients versus HSS-A. Overall, both solutions provided symptomatic relief and use satisfaction in the absence of side effects.

Application of Ultrasonic Piezoelectric Technology for Rhinoplasty.

Application of Ultrasonic Piezoelectric Technology for Rhinoplasty.

Effect of alar nasal valve stent on nasal breathing

PurposeLateral nasal wall insufficiency has previously been a surgical challenge. In 2018, the Alar Nasal Valve Stent (Medtronic) was taken into use at Helsinki University Hospital. The alar cartilages are repositioned and locked into position with the Alar Nasal Valve Stent on the mucosa. The stent gives support and widens the alar valve while cartilages scar into their new position presumably facilitating breathing after removal of the stent. The aim of this prospective, observational study was to investigate whether the Alar Nasal Valve Stent has an effect on nasal breathing in patients with lateral nasal wall insufficiency. Materials and methodsSymptom questionnaires (Sino-Nasal Outcome Test-22, Nasal Obstruction Symptom Evaluation, five-step symptom score) were analyzed preoperatively and at 3, 6, and 12 months postoperatively. Acoustic rhinometry, rhinomanometry, and peak nasal inspiratory flow were analyzed preoperatively and 3 months postoperatively. The patients performed a stress ergometry preoperatively and 3 months postoperatively, with their noses being photographed and filmed. ResultsIn a series of 18 patients, a significant positive difference was seen in subjective symptom scores preoperatively versus postoperatively. The difference remained stable throughout the follow-up. No difference in objective symptom measurements was observed. ConclusionsPatients suffering from lateral nasal wall insufficiency experience a significant subjective improvement in nasal breathing after Alar Nasal Valve Stent surgery.

Efficacy of anti-IL-5 therapy with mepolizumab for severe bronchial asthma and concomitant inflammatory nasal diseases in real clinical practice

BACKGROUND. T2 inflammation underlies non-allergic eosinophilic severe bronchial asthma and chronic rhinosinusitis with nasal polyposis (CRSwNP). Existing targeted anti-IL-5 drugs can improve clinical and functional parameters in patients with a combination of severe asthma and CRSwNP.&#x0D; AIM: to evaluate mepolizumab efficacy in patients with non-allergic severe asthma and concomitant inflammatory nasal diseases (CIND) in real clinical practice.&#x0D; MATERIALS AND METHODS. The study was conducted without a control group, by comparing related populations (before-after analysis) and based on the Sverdlovsk regional register of adult patients with severe asthma and CIND. The primary endpoint was asthma control achievement (ACT questionnaire) and decrease in the proportion of patients with uncontrolled severe asthma. The number of asthma exacerbations, emergency calls and hospitalizations, quality of life according to AQLQ questionnaire, peripheral blood eosinophils level and respiratory function (FEV1, FVC, FEV1/FVC) were also assessed. Dynamics of nasal symptoms was assessed using SNOT22 questionnaire and visual analogue scale (VAS).&#x0D; RESULTS. During 12 months of therapy with mepolizumab, ACT increased from 9 (Q1-Q3: 7-11) to 22 points (Q1-Q3: 21-24) (p0.001). The proportion of patients with uncontrolled asthma decreased from 100% to 10% (p0.001). The number of asthma exacerbations decreased from 3.182.8 per patient per year to 0 (p0.001) and hospitalizations from 0.570.9 per patient per year to 0 (p=0.007). Quality of life according to AQLQ increased from 3.481.05 (95% CI 2.734.24) to 5.590.88 (95% CI 4.966.22) points (p0.001). The number of blood eosinophils decreased from 442 (Q1-Q3: 336-853) to 90 (Q1-Q3: 73-117) cells/l (p0.001). There was increase in FEV1 from 63.9%24.2 (95% CI 46.681.2) to 80.5%18.3 (95% CI 67.493.6) (p=0.015). There was decrease in SNOT22 questionnaire score by 33 points (from 4530 to 2215) (p=0.006) and decrease in VAS score by 5 points (from 8 (Q1-Q3: 5-8) to 3 (Q1-Q3: 3-5)) (p=0.017).&#x0D; CONCLUSIONS. According to the study results, there were asthma control improvement, asthma exacerbations decrease, quality of life improvement according to AQLQ. Statistically significant peripheral blood eosinophils decrease and respiratory function improvement were also revealed. In patients with CIND, significant improvement in nasal breathing was noted, which was confirmed by scores of SNOT22 and VAS questionnaires.

The Orthodontic Management of Obstructive Sleep Apnea : A Systematic Review

Background: Obstructive Sleep Apnea (OSA) is considered to be a real public health problem, often unrecognized or underdiagnosed, requiring multidisciplinary care including orthodontics that plays an essential role in the screening and the management of ventilation. Objective: The aim of our study is to explain the important place of orthodontic therapies, whether orthopedic or surgical, in the multidisciplinary management of OSA and in the improvement of nasal breathing through a systematic review. Material and methods: A search of the literature was performed in the following databases: PubMed, ScienceDirect, Cochrane Library . The search was limited to publications written in English and French from 2010 to January 2022. Results: On the basis of the keywords, eighty-three references were initially identified. After the elimination of duplicates, the number of articles was reduced to seventy-nine. The study of the titles and abstracts made it possible to select fifty articles. After reading the full text, sixteen publications were included in this systematic review. Eight studies have investigated rapid maxillary expansion (RME), five studies have evaluated the effect of mandibular advancement (MA) and three studies have investigated the effect of genioplasty in children with OSA. Conclusion: Orthodontic arsenal, whether orthopedic, orthodontic, or surgical correction of jaws, is well suited and extremely beneficial for OSA treatment.

Breathing Reeducation after Surgical Maxillary Expansion: A Systematic Review

Background: Surgically assisted maxillary expansion has been used for the treatment of transverse maxillary deficiency in adult patients. The aim of this study is to evaluate, through a systematic review, the effect of this therapy on the dimensions of the aeropharyngeal dimensions and on the improvement of nasal ventilation. Materiel and method: 5 databases have been explored from 2010 (Pubmed, Scopus, Embase, Cochrane and Web of Science) using keywords expansion AND airway AND volum. After evaluating title, abstract and full text of articles found from databases, only 11 matching the inclusion criteria were included in the systematic review. Results: All the studies have shown that, in addition to its action on the maxillary bone, surgically-assisted maxillary expansion induces also an enlargement of the nasal floor and a reduction in airflow resistance, which promotes an improvement in nasal breathing. Conclusion: this surgical approach may lead to a modification in upper airway’s dimension and improvement of nasal ventilation.

Результаты лечения ронхопатии и синдрома обструктивного апноэ сна у детей с гипертрофией аденоидных вегетаций

Introduction. There are various sleep disorders that are striking and depressing at the same time in their diversity. One of the urgent problems that modern medicine is working on is problems with breathing during sleep, including obstructive sleep apnea syndrome (OSAS). The prevalence of this disease in children ranges from 1.2 to 5.7%. Adenotomy is an absolute indication for children with OSAS and adenoid hypertrophy. Aim. To study the frequency of occurrence of the OSAS in patients admitted to their hospital otorhinolaryngological department of Rauhfus Children’s Municipal Multi-Specialty Clinical Center of High Medical Technology for the planned surgical treatment of adenoid hypertrophy; to assess the effect of adenotomy on the course of OSAS in children. Materials and methods. 42 children aged from 4 to 12 years were examined; all patients underwent computer-based pulse oximetry, rhinomanometry, and nasopharyngeal endoscopy. Results. After adenotomy, nasal patency in children improved significantly: from 289.26 ml/s to 467.00 ml/s; the mean night saturation and desaturation nadir values in children during treatment improved from 97.31 to 97.68% and from 87.58 to 91.52%, respectively; sleep apnea syndrome was detected in 88% of all patients; 1 month after adenotomy, in 66.67% of the examined children OSAS was not detected. Conclusion. Improvement of nasal breathing after adenotomy, confirmed by rhinomanometry data, contributes to improved sleep, as evidenced by the results of computer-based pulse oximetry.

Коррекция носовой перегородки у детей с хирургической патологией околоносовых пазух (обзор литературы)

Diseases of a nose and paranasal sinuses are in the lead among pathology of upper respiratory tract. The incidence of chronic sinusitis in children ranges from 16 to 34%. Deviation of a nasal septum is detected in 74% of children at the age of 14 years. There are researches proving efficiency of one-stage performing septoplasty and FESS operations at adult patients. At the same time, data on efficiency and safety of carrying out onestage septum-operation and FESS at children’s age aren’t enough. Improvement of nasal breathing and providing broad access to the surgical area is a result of such interventions. It is also possible to refer decrease anesthesiology load of the child and readmission number. Carrying out low-invasive operations on structures of nose and paranasal sinuses under endoscopic control allows to reduce traumatization of a mucous membrane and improves visibility of the surgery field for the operator. Simultaneous surgical treatment of paranasal sinuses and a nasal septum deviation using methods of FESS in children is a perspective and safe method of treatment. Such surgery demands good practical skills, up-to-date equipment, correct algorithm of performing surgical intervention and also thorough observation of the patient in preoperative and postoperative periods.

Новый взгляд на латерализацию нижней носовой раковины

By performing lateralization of the inferior turbinate, the surgeon achieves an improvement in nasal breathing by increasing the lumen of the common nasal passage. However, to date, there are no clear indications for lateroposition of the inferior turbinate and there are no scientific data on its clinical efficacy. The aim of the study was to develop an original method of selective HHR osteotomy with its subsequent lateralization (luxation) based on the analysis of CT anatomy of the HHR bone framework. The article describes the measurements and makes a comparative assessment of the effectiveness of the “classical” lateralization of HNR and the original technique according to CT data. According to the results of CT analysis of SNP before and after surgery, patients were divided into 2 subgroups depending on the effectiveness of lateralization. The second stage was the analysis of the data obtained by CT of SNP in patients operated on with the original technique (n = 30). A positive result was obtained (achieved) in 100% of cases. The original technique of HNR lateralization developed by us has proven its effectiveness and safety, can be recommended as a minimally invasive, organ-preserving method of surgical treatment of vasomotor rhinitis and can reduce the number of reoperations.

Experience of using herbal medicine sinupret for patients with chronic maxillary sinusitis during the post-surgery period

The choice of an optimal tactic for chronic rhinosinusitis treatment is a very topical issue in otorhinolaryngology. Several pieces of existing literature report a positive impact of a herbal-based remedy Sinupret for patients in the post-rhinosurgical period. Objectives of the study: The investigation of the effect of Sinupret on patients with chronic maxillary sinusitis in the early postoperative period.Materials and methods: 15 patients with chronic rhinosinusitis were examined. The age of patients ranged from 20 to 57 years. The examination of patients was carried out right before the surgery and three months after it. The examination also included general otorhinolaryngological examination, assessment of the overall severity of the disease on the VAS scale, endoscopy of the nasal mucosa, assessment of nasal breathing function based on the analysis of the main indicators of anterior active rhinomanometry and computed tomography of the paranasal sinuses. Two days before their surgery, each patient was prescribed to take two tablets of Sinupret 3 times a day up to 14 days.Results: By day 10 of the post-surgery period, all patients reported noteworthy improvement in nasal breathing, a significant decrease in nasal discharge and no discomfort in the projection of the paranasal sinuses. There was a substantial decrease in the severity of oedema, exudation and formation of crusts, fibrin in all examined patients with rhinoscopy. According to the anterior active rhinomanometry, a statistically significant increase in the total nasal flow and a decrease in nasal resistance to physiological values were established 3 months after surgery. Conclusion: This article presents the results of Sinupret usage in the combined therapy before and after surgical treatment of patients with chronic rhinosinusitis and abnormal development of nasal structures. The results of that 14-day treatment evidenced an acceleration of epithelialization and restoration of drainage; as well as an improvement of ventilation function of the nasal cavity and paranasal sinuses. In addition to that, the chosen treatment contributed to the reduction of the rehabilitation period and the absence of relapses of chronic maxillary sinusitis was observed.

Comparative analysis of some methods of surgical treatment of vasomotor rhinitis

Among chronic forms of rhinitis of great importance is vasomotor rhinitis, which is the most common form of chronic non-allergic rhinitis and the clinician has to deal with it constantly. Treatment of vasomotor rhinitis is a complex and largely unresolved problem, which puts this disease among the important problems of modern rhinology. The variety of methods used in the treatment of patients with vasomotor rhinitis confirms the complexity of the task of choosing the optimal method for clinicians and the difficulty of obtaining a sustainable result from the chosen method. Surgical treatment of patients with of patients with various forms of chronic rhinitis is sometimes the only effective. Currently, the arsenal of methods and means of surgical treatment of the nasal concha is quite wide and varied. The purpose of this study – to study in a comparative aspect the functional state of the nasal cavity after carrying out some methods of surgical treatment ofvasomotor rhinitis. Materials and Methods: The study was conducted in the clinic of the Department of Otorhinolaryngology of the Tashkent institute of postgraduate medical education on 43 patients with vasomotor rhinitis in age from 20 to 46 years, average age 28,0±1,3 years. All patients with BP included in our study, after collecting complaints and anamnesis, underwent an endoscopic examination of the nasal cavity and nasopharynx, a computerized tomogram of the nose and paranasal sinuses, standard laboratory tests and microscopy of a smear from the nasal cavity on eosinophils.Investigated the respiratory (computer rhinopneumocotachometry), transport (saccharin test) functions of the nasal mucosa, performed an adrenaline test and the Flour test (determination of the consistency of inferior nasal concha and the response to pushing with a push-button probe). Results: Studies have shown the highest efficiency of laser coagulation with vasomotor rhinitis. After laser surgery, a long-lasting and sustained improvement in the functions of the nasal cavity was noted, while there was no adverse effect on the mucous membrane of the nasal cavity, which was reflected in the recovery rates of both nasal breathing and mucociliary clearance. Given the well-tolerated laser coagulation, the lack of the need for observation and care of the nasal cavity in the postoperative period, the possibility of outpatient treatment, allows us to recommend this type of exposure as the method of choice in the surgical treatment of patients with vasomotor rhinitis. The simplicity of submucosal vasotomy, the availability of instruments for carrying out, the restoration of free nasal breathing and the positive effect on the functional state of the nasal cavity, although slower than laser coagulation, minimal side effects put it on a par with the laser effect. The need to use tampons after surgery reduces the quality of life of patients, hospital stays and the need to monitor patients in the early postoperative period makes this operation strictly inpatient. Electrocautery of inferior nasal concha demonstrated in our study a negative effect on the function of the nasal cavity, although, of course, there was a definite improvement in nasal breathing, but the severity and speed of improvement was significantly less than during laser exposure and submucosal vasotomy. The slowest and most incomplete restoration of the mucociliary clearance of the nasal cavity once again underlines the disadvantage of this method. Conclusion: Evaluation of the long-term results of surgical treatment based on the combination of effects on the respiratory and transport functions of the nasal cavity, as well as on the clinical manifestations of BP, makes it possible to recommend laser coagulation as the most optimal method providing a long-lasting effect in treating patients with vasomotor rhinitis. Alternatively, you can take a submucosal vasotomy of the inferior nasal concha.

Nasal Valve Lift in Nasal Valve Stenosis—A 2 Years Clinical Trial

A clinical study was conducted to determine the effect of nasal valve lift treatment using absorbable, polylactic acid, self-retaining cone threads (Silhouette Soft) in patients with nasal valve stenosis. Sixty patients (n = 60) were included in this prospective study which was performed from January 2015 until December 2018, 19 patients dropped out due to noncompliance. Initially, participants were divided into two equal groups. One was treated by nasal valve lift only, the other additionally received turbinoplasty. A visual analog scale (VAS) was used to rate the sense of nasal ventilation. Patients' satisfaction was examined by a categorical scale, preoperatively, after 1 week, and after 1, 6, 12, 18, and 24 months. For statistical analysis, an univariant variance analysis was conducted to test the significance of differences in nasal breathing within one group at different points of postoperative controls, with the statistical significance set at p < 0.05. Moreover, the two groups were compared with each other regarding results of the categorical scale. After surgical treatment, an improvement is reported by all participants. Average VAS scores were significantly lower between preoperative and every postoperative rating. Although a decline in the effect of breathing improvement is recognizable as threads are dissolved, patients' satisfaction in improvement of nasal breathing is persistent in most cases, even at long-term observation. Overall, these results demonstrate that valve lift is an effective method to treat patients with nasal valve stenosis.

Опыт применения препарата Арника монтана С9 (БУАРОН) у детей после операции аденотомии

The efficacy of Arnica Montana C9 (BOIRON) during the recovery period after adenotomy in 60 children aged 3 to 10 years was evaluated. All patients were randomly divided into 2 groups for further comparison. Each was composed of 30 patients. Patients of the control group were prescribed standard therapy: a sparing diet and regimen for 5 days, nasal vasoconstrictor drugs (nazivin 0.025% – 0.05%) at an age dosage of 5 days, inside-Nurofen at an age dosage (with pain in the throat and increased body temperature). Children of the main group received standard therapy + Arnica Montana C9 (BOIRON). Reception of the drug Arnica Montana C9 (Boiron) began from the second day after adenotomy with a dosage of 5 granules 4 times a day, from the 3rd to the 10th day-5 granules 3 times a day. Complaints and objective examination data were analyzed during 4 visits-observation by a doctor: on the second day after adenotomy (1st visit), on the 4th day (2nd visit) and on the 10th day after surgery (3rd visit), as well as 1 month after the end of therapy (4th visit). The study made it possible to draw a conclusion about the manifestation of positive changes in clinical indicators in children of the main group (reduction of pain intensity and intoxication, improvement of nasal breathing) on the 4th day after adenotomy relative to the control group. There was a significant decrease in the intake of painkillers in the group of children receiving Arnica Montana C9 (BOIRON). Given the result, we can talk about the possibility of reducing the drug load in patients. Thus, the inclusion Of Arnica Montana C9 (BOIRON) in the therapy of patients after adenotomy can lead to a significant reduction in the recovery period.