Difficulty In Nasal Breathing Research Articles

The effectiveness of a synthetic analogue purine nucleoside bases in the treatment of acute respiratory viral infections

Introduction. The aggravation of the comorbid background of patients with ARVI is the main reason for the addition of secondary pathogenic and conditionally pathogenic bacterial flora and, as a result, the development of local and general complications.Аim. To conduct a clinical assessment of the efficacy and safety of the drug Triazavirin based on riamilovir in the treatment of acute respiratory viral infections.Materials and methods. The study conducted on the basis of the medical center of the Federal State Budgetary Educational Institution of the Russian Ministry of Health involved 56 patients with acute recurrent viral infection. Regarding the prescribed therapy, the patients were divided into 2 groups: group 1 (n = 27) from day 2, triazavirin was taken as an antiviral drug (riamilo- vir) 250 mg (1 capsule) 3 times a day for 5 days; group 2 (n = 29) – as an antiviral drug, Kagocel took 2 tablets 3 times a day for 2 days, then 1 tablet 3 times a day for 5 days. The effect of the therapy was assessed by the severity of intoxication syndrome, rhinorrhea, difficulty in nasal breathing, decreased olfactory function, pain syndrome localized in the nasopharynx and throat, cough severity and laboratory results.Results. In patients with 7 days of therapy, the indicator of psychological health increased by 34.7 points in the first group, by 28.8 points in the second group. Vital activity increased by 33.7 points in patients of group 1 and by 23.8 points in the second group. Physical activity tended to increase by 19.5 points and 6.0 points in the first and second groups, respectively.Conclusions. The analysis of changes in the severity of clinical symptoms affecting the quality of life of patients confirmed the effectiveness and safety of the drug Triazavirin.

Возможности консервативной тактики ведения пациентов с гипертрофией и воспалением глоточной миндалины

Patients who suffer from pharyngeal tonsil hypertrophy or inflammation are very common visitors in outpatient physicians’ practice. Hypertrophy of the pharyngeal tonsil may be accompanied by persistent difficulty in nasal breathing and complications whilst adenoditis in the absence of a significant impact on the child’s quality of life and associated complications had not been regarded as a ‘pathology’ in pediatric physicians’ practice until the patient is reached the age of 7 to 9 years old. The purpose of this research was to compare the regimens of the use of the homeopathic medications in patients with pharyngeal tonsil hypertrophy or inflammation. Materials and methods used: a single-center controlled randomized observation of the use of homeopathic medications of a single active substance had been conducted in pediatric patients aged 1 to 18 y/o with pharyngeal tonsil hypertrophy or inflammation. The study included patients with pharyngeal tonsil hypertrophy or inflammation who had previously taken homeopathic single-substance medications, including in combination with standard treatment. Depending on the choice of patients (repetition of the homeopathic single-substance medications intake or prophylactic regimen) the patients were then divided into comparison groups. All of the patients had undergone both the routine examination and the ENT endoscopy, the parents’/caregivers’ satisfaction with the treatment results was then assessed using the 5-point Likert scale as well as the incidence of acute respiratory infections (ARI) in children while taking homeopathic medicines (compared to the period without taking them) and the willingness to use homeopathic medicines in the future. Results: after the ENT endoscopy (reduction in the size of the pharyngeal tonsil in 38% of cases, p≤0.001) and the parents’/caregivers’ survey (reduction in the ARI frequency in 62% of cases and high satisfaction with the treatment results), the majority of parents/caregivers have assessed the repetition of the repetition of the homeopathic single-substance medications intake as rather more effective in treatment of patients with inflammation of the pharyngeal tonsil of varying degrees of hypertrophy. Conclusion: the use of homeopathic medicines in patients with pharyngeal tonsil hypertrophy or inflammation has showed good effectiveness. According to the ENT endoscopy results before v. after the treatment and the parents’/caregivers’ survey it is preferable to repeat the homeopathic single-substance medications intake in the next adenoiditis episode. The parents’/caregivers’ readiness to go on with the homeopathic medicines’ intake ranges from 50% to 78%.

Nasal Airflow Dynamics following LeFort I Advancement in Cleft Nasal Deformities: A Retrospective Preliminary Study.

Unilateral cleft lip and palate (UCLP) nasal deformity impacts airflow patterns and pressure distribution, leading to nasal breathing difficulties. This study aims to create an integrated approach using computer-aided design (CAD) and computational fluid dynamics (CFD) to simulate airway function and assess outcomes in nasal deformities associated with unilateral cleft lip and palate (UCLP) after LeFort I osteotomy advancement. Significant alterations were observed in nasal geometry, airflow velocity, pressure dynamics, volumetric flow rate, and nasal resistance postoperatively, indicating improved nasal airflow. The cross-sectional area increased by 26.6%, airflow rate by 6.53%, and nasal resistance decreased by 6.23%. The study offers quantitative insights into the functional impacts of such surgical interventions, contributing to a deeper understanding of UCLP nasal deformity treatment and providing objective metrics for assessing surgical outcome.

Rhinosinusitis in children with acute respiratory infection: quality of life and features of drug therapy

BACKGROUND: The relevance of the study is due to limited information on the impact of various forms of rhinosinusitis that have arisen against the background of acute respiratory infection on the quality of life of children and effective treatment methods. AIM: To conduct a clinical assessment of the effect on the recovery time and quality of life in children with acute rhinosinusitis and exacerbation of polypous rhinosinusitis that occurred against the background of a respiratory infection, including antiviral drugs in complex treatment in the early stages. MATERIALS AND METHODS: A simple controlled randomized comparative clinical trial was conducted, involving 74 children aged 15 to 18 years. The clinical efficacy and safety of the use of antiviral drugs in complex therapy, which are neuraminidase inhibitors on the 5th, 7th and 10th days of treatment, were evaluated in comparison with groups receiving pentanedioic acid imidazolylethanamide. The inclusion criterion was acute rhinosinusitis and exacerbation of chronic polypous rhinosinusitis against the background of acute respiratory infection. To establish the diagnosis, an examination of ENT organs, computed tomography of the nose and paranasal sinuses were performed, patients subjectively assessed clinical complaints and quality of life in the Russian version of the standard form of the SF-36 questionnaire. RESULTS: Positive dynamics was noted in the early stages in the 2nd subgroup of the 1st group who took neuraminidase inhibitors in addition to complex therapy. Manifested by a decrease in the average score for VAS to 80.0%, difficulty in nasal breathing to 1.7 points on the 10th day of treatment, relative to those taking imidazolylethanamide pentanedioic acid, where there was a decrease in the average score for VAS by 22.4%, difficulty in nasal breathing to 2.54 points. A similar pattern was observed with nasal congestion, rhinorrhea, and quality of life indicators according to the SF-36 questionnaires. CONCLUSION: Improvement of clinical symptoms and quality of life indicators at an earlier date in children with polypous rhinosinusitis and acute rhinosinusitis against the background of a previous respiratory infection with the inclusion of neuraminidase inhibitors in complex therapy confirmed higher efficacy.

DENTAL STATUS OF PATIENTS WITH NEW CORONAVIRUS INFECTION COVID-19.

The aim of the investigation was to clarify the features of the clinical symptoms of patients with the new coronavirus infection COVID-19.
 Material and methods: A total of 156 patients undergoing treatment in COVID-hospitals were examined. The examination included the determination of the prevalence of: COVID 19 clinical symptoms, COVID 19 clinical manifestations in the oral cavity, concomitant diseases.
 Results. In the structure of general symptoms, complaints of hyperthermia, general weakness and cough (more often dry) played a leading role, which were noted by the overwhelming majority of the examined. Two-thirds of the patients reported body pain. The leading symptoms were also anosmia (in 68.6% of cases) and sweating (64.1%).More than half of the patients complained of shortness of breath (60.2%), difficulty in nasal breathing (55.1%), a feeling of tickling (58.3%) and pain (60.2%) in the throat. Among dental pathology, loss of taste (57.5%) and hyposalivation (38.5%) were the most common in patients. Bleeding gums were detected in 22.4% of the examined patients, which is most likely due to violations of the rheological properties of blood and changes in the hemodynamic provision of the periodontal during Covid19. Clinical manifestations of periodontal pathology do not occur immediately, but in the form of long-term complications. In this regard, it seems necessary to dynamically monitor the condition of patients who have undergone COVID-19 in different time periods.
 Conclusions. Hemostasis disorders characteristic of the new COVID-19 coronavirus infection certainly have an impact on the state of dental status, further destroying periodontal tissues. However, clinical manifestations of pathological effects may not occur immediately, but in the form of long-term complications. In this regard, it is necessary to dynamically monitor the condition of patients who have undergone COVID-19 in different time periods.

Management of Posttraumatic Cerebrospinal Fluid Leak with Secondary Diffuse Pneumocephalus Complicated by Meningitis and Communicating Hydrocephalus – Illustrative Case Report

Rhinorrhea is a possible complication after different types of traumatic brain injury or neurosurgical procedures, such as skull base operations. Pneumocephalus is a rarely noted complication after severe traumatic brain injury, and it may be accompanied by meningitis and ventriculitis, especially when treatment has been delayed. Treatment of these entities includes conservative and surgical approaches. Pneumocephalus may result in neurologic disturbances threatening a life. Therefore, active patient management with a multidisciplinary team is required to prevent poor outcomes. In the literature, limited cases of rhinorrhea and pneumocephalus are available, including in our country. Pneumocephalus may also occur spontaneously. In 2015, Pishbin et al. identified 10 cases of spontaneous pneumocephalus. The precise incidence of diffuse pneumocephalus after traumatic brain injury is unknown, reported as <1% of cases with rare complications. In this case, a 41-year-old male patient presented at a tertiary university hospital with the chief complaint of headache. A month prior to admission, the patient was discharged from another hospital with multiple skull and facial fractures, pneumocephalus, and traumatic subarachnoid hemorrhage in the left frontal lobe due to fights (Le Fort III). During the second hospitalization, the patient’s clinical status deteriorated. A repeated brain CT demonstrated diffuse pneumocephalus. Rhinorrhea was still present. The external lumbal drainage procedure was performed without stopping the cerebrospinal fluid leak. In children, pediatric inferior turbinate hypertrophy is a frequent cause of nasal breathing difficulties. In this case, no such hypertrophy was observed. It should be considered a nasal obstructive disease not necessarily related to adult entities, frequently associated with other nasal or craniofacial disorders. Early diagnosis and endoscopic management of rhinorrhea, nasal obstruction, and associated complications is vital, as delays can lead to life-threatening issues like hydrocephalus/meningitis. Eventually, the patient developed meningitis and acute communicating hydrocephalus. Right ventriculostomy with a programmable ventriculoperitoneal shunt placement was done (pressure 110 cm H<sub>2</sub>O), stopping the rhinorrhea. This is an extremely rare case where a patient, after cerebrospinal fluid (CSF) leakage, develops severe complications, including pneumocephalus, meningitis, ventriculitis, and acute communicating hydrocephalus. In the literature, we did not come across case reports presenting all the complications as in this case. This case report will raise knowledge and awareness of such entities, adding to the rare, similar cases reported so far.

Parallels between clinical and genetic characteristics in children with primary ciliary dyskinesia

Primary ciliary dyskinesia (PCD) is a rare genetic disorder that leads to chronic inflammatory damage to the airways and auditory organs. This article presents current information and a study aimed at investigating parallels between the course of PCD and clinical and genetic variant of the disease, which contributes to a timely diagnosis and enables personalized treatment approach.The aim of the study was to identify phenotypic characteristics and chronological patterns of PCD course depending on the genotype.Methods. The study was conducted at the Veltischev Research Clinical Institute of Pediatrics and Pediatric Surgery of the Pirogov Russian National Research Medical University (Pirogov Medical University), Ministry of Health of Russia. The study included children with PCD who underwent next generation sequencing (NGS) of the exome.Results. Significant differences were found in the course of PCD based on clinical and genetic characteristics. Children with defects in the genes encoding central pair proteins are characterized by an earlier onset of daily productive cough and recurrent respiratory infections. A similar pattern is typical for patients with defects in the genes encoding the cilia assembly proteins. The first episode of respiratory infection occurs later in patients with defects in the genes encoding dynein handle proteins. Patients who do not have defects in PCD-associated genes are characterized by a late onset of persistent difficulty in nasal breathing, productive cough and respiratory diseases.Conclusion. Identification of clinical and genetic variants of PCD allows prediction of chronological features of the course of the disease.

Tomo-PIV in a patient-specific model of human nasal cavities: a methodological approach

The human nose serves as the primary gateway for air entering the respiratory system and plays a vital role in breathing. Nasal breathing difficulties are a significant health concern, leading to substantial healthcare costs for patients. Understanding nasal airflow dynamics is crucial for comprehending respiratory mechanisms. This article presents a detailed study using tomo-Particle Image Velocimetry (PIV) to investigate nasal airflow dynamics while addressing its accuracy. Embedded in the OpenNose project, the work described aims to provide a validation basis for different numerical approaches to upper airway flow. The study includes the manufacturing of a transparent silicone model based on a clinical CT scan, refractive index matching to minimize optical distortions, and precise flow rate adjustments based on physiological breathing cycles. This method allows for spatial high-resolution investigations in different regions of interest within the nasopharynx during various phases of the breathing cycle. The results demonstrate the accuracy of the investigations, enabling detailed analysis of flow structures and gradients. This spatial high-resolution tomo-PIV approach provides valuable insights into the complex flow phenomena occurring during the physiological breathing cycle in the nasopharynx. The study’s findings contribute to advancements in non-free-of-sight experimental flow investigation of complex cavities under nearly realistic conditions. Furthermore, reliable and accurate experimental data is crucial for properly validating numerical approaches that compute this patient-specific flow for clinical purposes.

Modern pharmacotherapy of acute bacterial sinusitis: results of an open randomized clinical trial of the therapeutic equivalence of Cefixime EXPRESS and Suprax Solutab

Acute bacterial sinusitis is one of the most common causes of prescribing systemic antibacterial drugs in otorhinolaryngology. With bacterial etiology of the disease, beta-lactam antibiotics are prescribed, in particular cefixim. Cefixim in the form of dispersible tablets has high clinical and bacteriological efficiency, as well as good tolerability in patients with acute sinusitis. To study the therapeutic equivalence of two drugs of cefixim (reproduced drug Cefixim Express and reference drug Suprax Solutab) in patients with acute bacterial sinusitis. 60 adult patients with a diagnosis of acute bacterial sinusitis took part in a randomized open comparative clinical study. Patients of group 1 (n=30) received the drug Cefixim Express in the form of dispersible tablets 400 mg once a day. Group 2 (n=30) received Suprax Solutab in the form of dispersible tablets 400 mg once a day. The duration of treatment course was 7 days. All patients conducted general clinical and otorhinolaryngological examinations, assessment of symptoms of acute sinusitis, assessment of the general clinical impression of the therapy, tolerance of treatment, analysis of the frequency of unwanted phenomena before treatment, 3 days after the beginning of therapy and after the course completion (7 days). Recovery occurred in 63.3% of patients in group 1 according to the inspection on the 7th day of treatment and in 66.67% of patients in group 2. The rate of clinical symptoms regression by the end of therapy was comparable in the comparison groups. Hyperemia of the nasal mucosa, purulent nasal discharge and difficulty in nasal breathing (p<0.01) regressed by the 7th day in patients of both treatment groups. The incidence of adverse reactions on the 7th day of treatment in group 1 was 10%, in group 2 - 6.7% (p>0.05). The drug Cefixim Express has high therapeutic effectiveness in the treatment of acute bacterial sinusitis, comparable to Suprax Solutab. Cefixime EXPRESS has demonstrated a good tolerability and a favorable safety profile.

Cytokine profile of nasal polyps and clinical characteristics of patients with polypous rhinosinisitis at different degree of therapeutic control and disease severity

The issues of recurrencies in chronic rhinosinusitis with nasal polyps (CRSwNP) still remain unresolved. Therefore, detection patients with uncontrolled clinical course of CRSwNP is required.The aim of the present study was to assess cytokine profile in nasal polyps as well as clinical characteristics of patients with CRSwNP at varying levels of therapeutic control.The study included 99 patients with chronic rhinosinusitis. The contents of interferon IFNγ, interleukin IL- 1β, IL-4, IL-5, IL-13, tumor necrosis factor TNFα, transforming growth factors TGF-β1, TGF-β2, TGF-β3 were measured in polyp tissue samples by means of multiplex analysis. The patients were treated according to a stepwise СRSwNP therapeutic algorithm [9]. Following observation for 5 years, all patients were divided into groups, as based on medical control degree. Group 1 included patients with mild CRSwNP, who mainly received stage I and II treatment for the entire observation period. Group 2 was presented by moderate- severity CRSwNP, with stage II or III therapy according to the referred algorithm. Group 3 included the patients with severe CRSwNP who received one or more stage IV courses. The patients underwent repeated SNOT-22 questionnaire, endoscopic examination, clinical assessment. In case of bronchial asthma (BA), ACQ-7 was repeated. Initial cytokine profile of nasal polyps was analyzed by the mentioned clinical groups.Results:After 5 years of observations in group 1 (mild CRSwNP), we found a minimal decrease in quality of life (SNOT-22), severity of nasal congestion, or smell impairment. Bronchial asthma duration in these patients was significantly lower compared to group 3, the patients had better asthma control level. Cytokine profile of nasal polyps was characterized by the highest IL-4 concentration, average values IL-1β, TNFα, IFNγ and minimal TGF-β1 values.In group 2 (moderate CRSwNP), we noted more pronouced impairment of smell, nasal congestion and quality of life. Bronchial asthma was less controlled than in group 1. The maximal concentrations of IFNγ, IL-1β, TNFα, IL-5, TGF-β1, TGF-β2 were registered.In group 3 with poor CRSwNP control, the highest SNOT-22 scores, severity of difficulty in nasal breathing, impaired sense of smell were revealed. Duration of bronchial asthma was longer, with lowest levels of medical control. In nasal polyps, minimal levels of IFNγ, IL-1β, TNFα, IL-4, IL-5, TGF-β2, TGF-β3 were noted.Treatment of patients depending on the clinical phenotypes of CRSwNP in the presence/absence of allergic rhinitis or bronchial asthma may improve control and reduce incidence of relapses in CRSwNP.

On the comparison between pre- and post-surgery nasal anatomies via computational fluid dynamics

Nasal breathing difficulties (NBD) are widespread and difficult to diagnose; the failure rate of their surgical corrections is high. Computational fluid dynamics (CFD) enables diagnosis of NBD and surgery planning, by comparing a pre-operative (pre-op) situation with the outcome of virtual surgery (post-op). An equivalent comparison is involved when considering distinct anatomies in the search for the functionally normal nose. Currently, this comparison is carried out in more than one way, under the implicit assumption that results are unchanged, which reflects our limited understanding of the driver of the respiratory function. The study describes how to set up a meaningful comparison. A pre-op anatomy, derived via segmentation from a CT scan, is compared with a post-op anatomy obtained via virtual surgery. State-of-the-art numerical simulations for a steady inspiration carry out the comparison under three types of global constraints, derived from the field of turbulent flow control: a constant pressure drop (CPG) between external ambient and throat, a constant flow rate (CFR) through the airways and a constant power input (CPI) from the lungs can be enforced. A significant difference in the quantities of interest is observed depending on the type of comparison. Global quantities (flow rate, pressure drop and nasal resistance) as well as local ones are affected. The type of flow forcing affects the outcome of the comparison between pre-op and post-op anatomies. Among the three available options, we argue that CPG is the least adequate. Arguments favouring either CFR or CPI are presented.

Chronic Vasomotor Allergic Rhinitis

In recent years, there has been a significant increase in the prevalence of diseases of the nose and paranasal sinuses (NPS). Inflammatory diseases of the nasal mucosa (rhinitis) are accompanied by difficulty in nasal breathing and nasal discharge. Chronic forms of rhinitis affect 10–20% of the population, and in epidemiological studies, 40% of respondents report symptoms of rhinitis. In this article, specific aspects of chronic vasomotor allergic rhinitis and treatment methods are considered

Unusual Presentation of SET::NUP214-Associated Concomitant Hematological Neoplasm in a Child-Diagnostic and Treatment Struggle.

Simultaneous multilineage hematologic malignancies are uncommon and associated with poorer prognosis than single-lineage leukemia or lymphoma. Here, we describe a concomitant malignant neoplasm in a 4-year-old boy. The child presented with massive lymphoproliferative syndrome, nasal breathing difficulties, and snoring. Morphological, immunocytochemical, and flow cytometry diagnostics showed coexistence of acute myeloid leukemia (AML) and peripheral T-cell lymphoma (PTCL). Molecular examination revealed a rare t(9;9)(q34;q34)/SET::NUP214 translocation as well as common TCR clonal rearrangements in both the bone marrow and lymph nodes. The disease showed primary refractoriness to both lymphoid and myeloid high-dose chemotherapy as well as combined targeted therapy (trametinib + ruxolitinib). Hence, HSCT was performed, and the patient has since been in complete remission for over a year. This observation highlights the importance of molecular techniques for determining the united nature of complex SET::NUP214-positive malignant neoplasms arising from precursor cells with high lineage plasticity.

Septoplasty- Does It Change the Quality of Life in Patients Having Nasal Obstruction?

Introduction: Deviated nasal septum (DNS) is one of the most common causes of nasal obstruction. However, there are several other etiologies which cause difficulty in nasal breathing. The definitive treatment of symptomatic DNS is septoplasty. The efficacy of septoplasty remains controversial as there are no solid tools for clinical evaluation of patients for establishment of reliable statistical data. Our aim was to evaluate patients who have undergone septoplasty for symptomatic DNS, by following them up with the NOSE questionnaire for predicting the surgical efficacy of septoplasty. Materials and Methods: This was a prospective observational study, conducted over 1 year. 50 cases of either sex of 18-65 years, having symptomatic DNS not relieved by medical management, and corrected by isolated septoplasty were included. The primary outcome was measured by the NOSE questionnaire, applied before surgery, and 6th week and 12th week after the procedure from which the 12th week nasal score was taken into consideration. Results: The paired T test done among the variables showed a clear significance, proving the efficacy of the NOSE score in predicting the symptom reducing efficiency of septoplasty Conclusion: The NOSE score can be used as a regular quality scoring system in analysing the outcomes of septoplasty.

Pediatric Inferior Turbinate Hypertrophy: Diagnosis and Management. A YO-IFOS Consensus Statement.

Pediatric inferior turbinate hypertrophy (PedTH) is a frequent and often overlooked cause or associated cause of nasal breathing difficulties. This clinical consensus statement (CCS) aims to provide a diagnosis and management framework covering the lack of specific guidelines for this condition and addressing the existing controversies. A clinical consensus statement (CCS) was developed by a panel of 20 contributors from 7 different European and North American countries using the modified Delphi method. The aim of the CCS was to offer a multidisciplinary reference framework for the management of PedTH on the basis of shared clinical experience and analysis of the strongest evidence currently available. A systematic literature review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria was performed. From the initial 96 items identified, 7 articles were selected based on higher-evidence items such as randomized-controlled trials, guidelines, and systematic reviews. A 34-statement survey was developed, and after three rounds of voting, 2 items reached strong consensus, 17 reached consensus or near consensus, and 15 had no consensus. Until further prospective data are available, our CCS should provide a useful reference for PedTH management. PedTH should be considered a nasal obstructive disease not necessarily related to an adult condition but frequently associated with other nasal or craniofacial disorders. Diagnosis requires clinical examination and endoscopy, whereas rhinomanometry, nasal cytology, and questionnaires have little clinical role. Treatment choice should consider the specific indications and features of the available options, with a preference for less invasive procedures. 5 Laryngoscope, 134:1437-1444, 2024.

A case of hyperplastic antrochoanal polyp in pediatric practice

A 14-year-old boy came to the children's ENT department with complaints of the absence of nasal breathing on the right side and sharp difficulty in nasal breathing on the opposite side. During pharyngoscopy, a neoplasm of pale pink colour was visible, elastic, without signs of bumpiness, which continued to the middle of the oropharynx. This clinical case shows that an antrochoanal polyp of this size is an exception in paediatric practice. During the surgical intervention, the part of the polyp that reached the nasopharynx and oropharynx was able to be removed with the help of Brunings forceps. Further operational tactic was standard.

Features of preoperative diagnosis of chronic lymphoproliferative syndrome of ENT organs in young children

Introduction. To determine the tactics of management of chronic lymphoproliferative syndrome in young children, a comprehensive examination is necessary. Herpesvirus infection (HVI) plays an important role in the etiology of hypertrophy of lymphoid formations of the pharynx.Purpose. To evaluate the results of preoperative diagnosis of chronic lymphoproliferative syndrome in children in early childhood.Materials and methods. In 96 patients aged 1 to 3 years 11 months with lymphoproliferative syndrome more than 3–6 months, endoscopy, otomicroscopy, impedance, ultrasound examination of abdominal organs, cervical and submandibular lymph nodes, serological and molecular genetic analyses of markers of EBV, CMV, HCV-6 in the blood; PCR in pharyngeal tonsil scrapings were performed.Results and discussion. The clinical picture in children with chronic lymphoproliferative syndrome of younger age was dominated by complaints of difficulty in nasal breathing, snoring in 42% of children, recurrent otitis in 58%, manifestations of asthenovegetative and intoxication syndromes and frequent acute respiratory viral infections in 70% of patients. A high degree of infection of children of the younger age group was revealed – HCV-6 in 87%, CMV in 63% of children, 46% – EBV. And high activity of the infectious process in 31% of patients for all three GVI, more often for EBV in 27%. A combination of two or three GVI was detected in 83% of patients. During instrumental examination, a high degree of hypertrophy of the nasopharyngeal tonsils (adenoid vegetations of 2–3 degrees – 67% and 3 degrees – 18%, combined with hypertrophy of the palatine tonsils in 27% of cases), an increase in neck lymph nodes of more than 16mm, including lymph node packs in 28% of younger children and reactive hepatosplenomegaly in 17.7% of patients.Conclusion. To determine the tactics of management of chronic lymphoproliferative syndrome in young children, it is important to assess the severity of lymphoproliferative syndrome according to the clinical picture and instrumental research methods (nasopharyngeal endoscopy, ultrasound examination of neck and abdominal lymph nodes) in combination with laboratory data and characteristics of the stage of activity of the infectious process of herpesvirus etiology.

Влияние назальной обструкции на газово-электролитный баланс организма

According to statistics, the most common complaint to an ENT doctor is difficulty in nasal breathing. The leading cause of such complaints is the curvature of the nasal septum, vasomotor and hypertrophic rhinitis. These conditions cause changes in the quality of life in the human body, and most importantly, the development of chronic diseases. The purpose of the study: to identify general patterns in patients with nasal obstruction, to develop recommendations for managing patients in the postoperative period. Patients and methods. In the period from 2018 to 2020, we examined 96 people aged 20 to 40 years: 72 of them were men, 24 were women with varying severity of nasal obstruction syndrome. The control group consisted of 16 people who did not complain of difficulty in nasal breathing. The patients were divided into two groups: those who received conservative treatment, and the group that was planned to undergo a surgical intervention aimed at eliminating nasal obstruction. Further, in patients of both groups, indicators of the acid-base state of venous blood were evaluated. Results. Indicators of the acid-base state of venous blood in patients of the group treated with a course of nasal decongestants and intranasal glucocorticosteroids remained practically unchanged after the treatment. Recovery of indicators of the acid-base state of venous blood in patients who underwent surgery is fully determined by the third month after the surgical treatment. Conclusions: The prevalence of diseases, including the hypoxic component, determines the need to study and understand the mechanisms of hypoxia, as well as the issues of eliminating oxygen deficiency, the process of adaptation to it.

A Case Study: Ayurvedic Management of Nasarshaw.s.r to Nasal Polyp

Nasais the most important organ ofUrdhwajatrugatabhagaand is the gateway for headas well as respiratory system. Nasarshas is one among the thirty-one Nasagata Rogasmentioned in our classics. Nasarshascan be correlated to nasal polyps. Nasal polyps are non-neoplastic masses of nasal or sinus mucosa. Prolonged use of antihistamines and antibiotics leads to drug resistance and decreases immunity, Fear of surgery, its complications and cost have restricted many patients from undergoing surgery and allopathic medicines. In this study a case of 31years male Patient presented with difficulty in nasal breathing, mouth breathing especially at night, sneezing, nasal discharge, headache since 9 months was taken for study. Present case study is taken to evaluate the efficacy of Ksharakarmain the management of Nasarshas w.s.r to Nasal Polyp along with internal medications for improve immunity and to reduce its recurrence. Ksharais an excellent medicine in the management of Arsha, as it has Lekhana,Tridoshaghna, Teekshna and Ushnaproperties. Shirovirechanabeing one of the Shodhana Karma,hence Nasyawith Apamarga Kshara Tailafollowed by Yava kshara prathisaranawas planned. Internally, Chitrakadi Vati,Triphala Gugguluand Haridra khanda, Hamsapadi Kashayawas prescribed. There was significant improvement in patient’s complaints and marked reduction in polypoidal mass.

Control of hormonal rhinitis symptoms in patients with hypothyrosis: pathogenetic and clinical aspects

One of the poorly studied sections of the pathology of ENT organs is chronic rhinitis in patients with hypothyroidism, the pathogenesis of which has not been fully understood, the diagnosis causes significant difficulties, and there are no recommendations for treatment. Despite receiving replacement therapy with levothyroxine, the symptoms of rhinitis persist. To study the effectiveness of the use of intranasal glucocorticosteroids in patients with chronic rhinitis and hypothyroidism. Patients with chronic rhinitis and hypothyroidism used mometasone nasal spray 100 mcg 1 time per day for a course of treatment of 2 months (n=60). To assess the symptoms of rhinitis, a visual analog scale (0-10 points), endoscopic examination of ENT organs, anterior active rhinomanometry were used. Evaluation of mucociliary transport was used a saccharin test. The concentration of transforming growth factor (TGF-β1) in nasal secretion and blood serum was studied by ELISA (Enzyme-Linked Immunosorbent Assay), the number of metabolites of NO - nitrites+nitrates (NOx) was recorded by colorimetric method. The use of mometasone nasal spray in patients with hypothyroidism helped to reduce complaints on a visual-analog scale (difficulty in nasal breathing, rhinorrhea) and improve nasal breathing according to anterior active rhinomanometry. The concentrations of TGF-β1 and NOx in nasal secretions before mometasone treatment were higher than after treatment, which probably indicates the contribution of these substances to the formation of edematous hypertrophic changes from the nose in patients with hypothyroidism.