Nasal Breathing Disorders Research Articles

Діагностична значимість методів визначення порушень носового дихання

In the diagnosis of nasal breathing disorders, the main instrumental diagnostic methods are optical endoscopy of the nose, X-ray computed spiral (or cone-beam) tomography of the nose and paranasal sinuses, as well as rhinomanometry. The statistics included 286 patients with nasal breathing disorders and a control group of 60 people. Patients were divided into two groups - with nasal breathing disorders of different nature and conditional norm (control group). The probability of error in detecting nasal breathing disorders is 0.27 (normalized Euclidean distance 1.82). Taking into account the addition of computed tomography data to the discrimination model, the diagnostic error decreases to 0.11 at a distance of 3.19. When rhinomanometry data are added to the model, the total normalized Euclidean distance increases to 3.96, and the probability of making a diagnostic decision, respectively, decreases to 0.05. Thus, rhinomanometric data make it possible to supplement the results of functional tests with information about changes in the architectonics of the nasal cavity by assessing the effect of anatomical structures on nasal aerodynamics and further reduce the likelihood of errors in diagnostic decisions when detecting disturbances in nasal breathing.

Treatment of acute nasopharyngitis in children

Acute nasopharyngitis in children is an inflammation of the nasopharyngeal mucosa. Recently, the use of saline solutions in the pathology of the nose and nasopharynx has become a leader in cleaning the mucous membrane. The main direction of modern pharmacotherapy of pathology of the nose and nasopharynx today is antiinflammatory therapy. There are a sufficient number of studies proving the effectiveness of mometasone furoate nasal spray in the treatment of inflammatory diseases of the nasopharynx in children. Our study examined the clinical efficacy of Etacid in the treatment of acute nasopharyngitis in children. Among the clinical symptoms were considered nasal breathing disorders, nasalness, snoring, cough during sleep. Endoscopy studied stagnant signs in the nasal cavity, nasopharyngeal discharge, enlargement of the pharyngeal tonsil. Proven sufficient clinical efficacy of the drug "Etacid" in the treatment of acute nasopharyngitis.

Клінічне значення біомікроскопії судин бульбарної кон’юнктиви у хворих при патології внутрішньоносових структур з порушенням носового дихання

Introduction. The clinical significance of biomicroscopy of bulbar conjunctival vessels in patients with pathology of intranasal structures and nasal breathing disorders was considered. The study of the clinical anatomy of the vascular system is very important in otorhinolaryngology. The conjunctiva of the eye, like the nasal cavity, is supplied with blood from the external and internal carotid arteries. Therefore, the assessment of biomicroscopy of the bulbar conjunctiva can be considered the only functional reflection of mi-crocirculation not only at the level of the body as a whole, but also the nasal cavity in particular. The study of the microcirculation of the bulbar conjunctiva allows us to assess the biomedical indicators of the state of trophic capabilities with more information than in the study of individual human organs and tissues. Aim. Evaluation of the clinical significance of bulbar conjunctiva microcirculation in patients with pathology of intranasal struc-tures and nasal breathing disorders. Results. Our study showed that in patients with changes in intranasal structures and nasal breathing disorders conjunctival bi-omicroscopy is characterized by the peculiarities of a number of morphostructural parameters of the microcirculatory tract, despite the nonspecificity of vascular disorders. With increasing magnitude of nasal resistance and duration of the disease, microcirculatory (MC) disorders from functional changes to the appearance of morphological disorders of both vascular and intravascular units of the MC channel intensified. An unfavorable manifestation of which was a decrease in the number of functioning capillaries and the ap-pearance of perivascular disorders. Conclusions. Our conclusions coincide with the data of other authors. It should be noted that biomicroscopy of the bulbar con-junctiva is absolutely justified and allows to assess the structures of microcirculation in terms of functional disorders. However, this method, against the background of obvious advantages, has disadvantages, such as complexity of image stabilization (because of the eyeball’s movements), the lack of assessment of the perivascular space, the inability to study the transitional capillary. The prospect of work is to conduct capillaroscopic studies directly in the mucous membrane of the nasal cavity to find direct correlations between microcirculation in the study area and peripheral areas. Key words: Microcirculation; Bulbar conjunctiva; Nasal breathing disorders; Intranasal structures.

Modern Diagnostic Studies in Rhinology: Necessary and Sufficient

The article provides the overview of the most modern diagnostics methods for diseases of the nasal cavity, paranasal sinuses and nasopharynx. The advisability of additional examinations for various pathologies has been provided. Methods of laboratory diagnostics and methods of material sampling for microbiological verification of pathogens are discussed. Methods of functional diagnostics of nasal breathing disorders are described.

Diseases of the upper respiratory tract in pregnant women

Inflammatory diseases of the upper respiratory tract are extremely common, 6-15% of healthy people get sick every year. Pregnant women, due to physiological changes in the upper respiratory tract and a special immune state, get sick even more often.The purpose of the article is to provide doctors with basic information about the features of the course and treatment of the most common diseases of the upper respiratory tract during pregnancy.Prerequisite for the development of nasal congestion syndrome during pregnancy is an imbalance in the autonomic regulation of vasoconstriction and vasodilation of the vessels of the nasal mucosa and secretion of the nasal glands, the predominance of parasympathetic influences. The most common nosological causes of nasal breathing disorders are allergic rhinitis, gestational (hormonal) rhinitis and acute rhinosinusitis.The pathogenetic mechanism of gestational rhinitis is estrogen-mediated inhibition of cholinesterase, resulting in cholinergic vasodilation and increased secretion of mucous glands. The increase in circulating plasma volume and extravasal transudation, which is also due to the effects of estrogen on the vascular wall, contribute to pregnancy. Treatment is symptomatic (local decongestants, herbal secretolytics, sea water).Allergic rhinitis is based on IgE-mediated inflammatory process of the mucous membrane of the nasal cavity and paranasal sinuses. The most common causative allergens are plant pollen, spores of lower fungi, insect particles, animal epidermis, house dust mites. Treatment includes topical and systemic agents (glucocorticosteroids with low bioavailability, H1-histamine receptor blockers).Acute rhinosinusitis is an inflammation of the nasal mucosa and paranasal sinuses that lasts up to 12 weeks. In pregnant women, the development of the disease and its prolonged course is facilitated by frequent swelling of the nasal mucosa. The main causative agent of GDS are viruses (approximately 80% of cases). Evidence-based treatment includes irrigation therapy (symptomatic treatment of all forms of GDS), modern phytonutrient therapy using standardized BNO 1016 extract (for viral and post-viral MS, safe during pregnancy), mometasone furoate (nasal spray), anesthesia . Antibacterial drugs are indicated only for the treatment of bacterial rhinosinusitis.Acute tonsillitis is an inflammation of the tonsils with clinical symptoms that occur suddenly. Specific manifestations are sore throat (without acute shortness of breath), redness and swelling of the tonsils, often with layers, regional lymphadenitis; non-specific – fever, general weakness, malaise and pain in the joints and lower back. The clinical picture in pregnant women does not differ significantly. The severity of the disease and the probability of bacterial etiology is assessed on a special scale. Be sure to determine the presence of β-hemolytic group A streptococcus in the throat, depending on which antibacterial treatment is prescribed.

The effects of nasal breathing on the development of snoring and apnea

Since the nose is the entrance gate of the upper airway, its stuffiness can contribute to sleep disturbance. The results of a number of case-control studies have shown that nasal congestion frequency associated with snoring and mild OSA. However, there is no strong correlation between the degree of nasal obstruction and the severity of OSA. Randomized controlled trials have shown that in patients with rhinitis, both allergic and non-allergic, the use of nasal steroids can improve sleep quality and may be useful for patients with mild OSA, but they themselves are not an adequate treatment. Surgical correction of nasal breathing disorders also reduces the apnea index and improves sleep quality.

FEATURES OF CAPILLARY BLOOD FLOW IN PATIENTS WITH PATHOLOGY OF INTRANASAL STRUCTURES AND NASAL BREATHING DISORDERS

The investigation of the vascular microcirculation system is important for diagnosis, assessment of the severity and nature of pathological processes in human body, monitoring the effectiveness of treatment. Monitoring the state of microcirculation in impaired respiratory function of the nose helps to study the subtle mechanisms of regulation of vascular−tissue relations. To do this, there were used the biomicroscopic methods to study capillary blood flow, one of the most relevant and promising is optical capillaroscopy of the nail bed. This method makes it possible to identify at the evidence level the peculiarities of the functioning of the peripheral circulatory system by the state of the capillary system and to evaluate the effectiveness of treatment by the rheological properties of blood in hematological practice. There were examined 145 patients by means of computer capillaroscopy to study the rate of capillary circulation in the patients with pathology of intranasal structures and nasal breathing disorders. All patients underwent a complete clinical examination, routine instrumental examinations, and computer capillaroscopy using a video capillaroscope with a visual magnification of up to 550 times. The obtained images were stored and processed according to a special software. During the characterization of the capillaroscopic picture there were evaluated: pathological tortuosity, change in the caliber of arterioles and venules, disorganization of the capillary network, the number of functioning capillaries. Changes in the speed and nature of capillary blood flow (accelerated, slow, stasis) were observed. The optical capillaroscopy method allows not only to visually assess the condition of microvessels, but also to determine such an important parameter as blood circulation, actually, it can replace the study of laser Doppler. Such data will be important in the diagnosis of respiratory and olfactory disorders and the formation of adequate tactics for their treatment. Key words: microcirculation, microcirculatory tract, capillary circulation, nasal obstruction, nasal breathing disorders, pathology of intranasal structures, computer capillaroscopy.

This familiar diagnosis of “rhinitis”

The article highlights that rhinitis is the most common disease, it is divided into 3 main phenotypes: infectious (IR), allergic (AR) and non-infectious non-allergic (NAR). There are also combined forms. IR is a viral disease. Its clinical picture is described, the frequent failure of patients to consult a doctor for this disease is noted, which contributes to the development of complications and its chronization. The authors described the characteristic features of the AR clinic with “oral Allergy syndrome“. It is noted that NAR is a heterogeneous disease, which is divided into at least 6 subphenotypes: drug, taste, hormonal, atrophic, idiopathic and rhinitis of older people. The authors analyze the reasons for their occurrence. There is also a professional form of rhinitis. All these phenotypes are United by the symptom of difficult nasal breathing, which also occurs in chronic rhinosinusitis and “empty nose“ syndrome. Other causes of nasal breathing disorders are also mentioned. In the treatment of patients with almost any of the rhinitis phenotypes, the main ones are irrigation-elimination therapy and the appointment of topical decongestants (TD). An important role is played by avoiding the causes that activate the course of rhinitis, and educating the population to properly organize the individual treatment process. Topical vasoconstrictor drugs are the leading topical remedies that eliminate nasal breathing difficulties. They are sold in our country in the usual access and if used incorrectly can cause the development of medical rhinitis and many serious consequences. The methods of correct administration of the drug in the form of drops and spray, as well as its age-related dosages, are disclosed

Рarameters of spontaneous activation of basophils on dental materials with allergic rhinitis patients

Relevance. Тhe quality of dental care is greatly influenced by the biocompatibility of the materials used. This problem is particularly acute in patients with a high level of sensitization, such as allergic rhinitis. Currently, the CAST-test is used to diagnose allergies and sensitization of the body. The method has 100% specificity and significantly complements the definition of IgE antibodies.Purpose. To determine the individual tolerance of dental materials in patients with allergic rhinitis.Materials and methods. 47 patients with allergic rhinitis were examined. All patients were sent to determine the test of spontaneous activation of peripheral blood basophils on dental materials: cobalt-chromium alloy; zirconium dioxide; glass ionomer cement; composite material; plastic for the basis of the prosthesis (non-monomer).Results. The Average values of the activation coefficient of blood basophils in patients with nasal breathing disorders were revealed for a kobolto-chrome alloy – 1.29 ± 0.02, for zirconium dioxide – 1.04 ± 0.02, for glass ionomer cement – 1.11 ± 0.04, for composite dental light – curing material – 1.24 ± 0.03, for plastic for prostheses (non-monomer) – 1.19 ± 0.02.Conclusion. The study shows the need for special attention to the planning of dental treatment in patients with nasal breathing difficulties, especially with allergic rhinitis. The frequency of detection of the coefficient of spontaneous activation of basophils test showed a 100% positive result for composite light-curing material and non-motionless plastic, in 91.5% of cases-for a cobolto chrome alloy. 100% negative result for zirconium diaxide and 82.9% of cases for glass ionomer cement.

Perioperative complications of pediatric otorhinolaryngological operations.

Background:The identification of risk factors for the development of perioperative complications is one of the most important problems of pediatric anesthesiology.Purpose:To identify risk factors for the development of perioperative complications in children undergoing ambulatory surgical interventions on ENT organs.Methods:Total of 141 patients were examined at the age from 7 to 17 years. Depending on the presence of complications all patients were divided into three groups: «No complications» (n = 64), «One complication» (n = 55) and «Two or more complications» (n = 22). The study was carried out in the following areas: Preoperative clinical status, intraoperative and postoperative complications. The severity of nasal breathing disorders was determined rhinomanometrically. 31 children underwent somnography. In the study of heart rate variability was evaluated. Intraoperative complications included: Cardiac arrhythmias, arterial hypertension and desaturation less than 90%. Postoperative complications included: Cardiorespiratory complications, pain, delirium, postoperative nausea and vomiting.Results:The most significant complication in the intraoperative period is desaturation below 90%, in the postoperative period they are pain, nausea and vomiting. Risk factors for the development of complications in the perioperative period are a decrease in the thyromental distance, hyperplasia of the tonsils of the third degree, Malampati score ≥ to 2 points, parents' bad habits, combined neurological and respiratory pathologies in a child, an assessment of the class «allergology» of the ASPOND scale is not less than 180 points and the prevalence of vagal influences.Conclusions:The obtained results indicate that the presence of risk factors for perioperative complications during operations on ENT organs in children are associated with the initial autonomic status and the predominance of the parasympathetic nervous system as well as with clinical markers.

Hypertrophy of palatine tonsils - possible treatment approaches

To evaluate the effectiveness of different approaches to the treatment of patients with hypertrophy of the palatine tonsils (HPT). 90 children with HPT of II-III degree and 20 healthy children (group 1) aged from 3 to 7 years were included in the study. Children with HPT were divided into three groups: group 2 - children who underwent tonsillotomy (n=30), group 3 - children who underwent conservative treatment, including only topical use of Polyoxidonium (n=30), group 4 - children who underwent complex treatment (tonsillotomy with subsequent local use of Polyoxidonium), (n=30). The severity of nasal breathing disturbances on a visual analogue scale, the average number of acute respiratory viral infections 6 months before and after treatment, the level of gene expression of antimicrobial peptides before and after treatment, the degree of hypertrophy of the palatine tonsils and spleen with an assessment of the echostructure and determination of the spleen mass coefficient using Ultrasound were evaluated in the study. In children receiving only Polyoxidonium, there was a decrease in the severity of nasal breathing disorders, a decrease in the frequency of acute respiratory viral infections, an increase in the expression of antimicrobial peptide genes compared to the initial level of these indicators. Comprehensive treatment of children with HPT (group 4) showed a significant decrease in the severity of nasal breathing disorders, a decrease in the average number of acute respiratory infections within 6 months, an increase in the expression of antimicrobial peptide genes compared to children who underwent only tonsillotomy (group 2) or only conservative therapy (group 3). It is proved that the use of Polyoxidonium in the complex treatment of HPT is clinically effective and safe.

Hypertrophy of adenoid vegetation: causes and methods of treatment

Topicality: Nasal congestion, nasal breathing disorders and nasal discharge are the most common complaints that parents of ill children refer to an otolaryngologist and pediatrician. The prevalence of allergic pathology in patients with adenoid vegetation hypertrophy (AН) varies from 22 to 73% according to various authors. Aim: To determine the prevalence of allergic rhinitis among patients with hypertrophy of adenoid vegetations, a prospective study was conducted. Materials and methods: 50 children with hypertrophy of adenoid vegetation aged 4 to 14 years were examined. A comprehensive screening study to detect specific IgE sensitization to the most common inhalation and food allergens. Results: Sensitization to inhaled allergens was detected in 48% of cases. In 8% of cases it coincided with food with food allergy. Only food allergy was detected in 1 child (2%). Timely etiopathogenetic therapy with topical nasal corticosteroids in patients with AN will avoid relapses after adenoidectomy and normalize nasal breathing, and in some cases, avoid surgery.

Level of Stress in Students with the Disturbance of Nasal Breathing and Comorbid Disorders

Background. The progressive increase of the number of schoolchildren with adaptation disorders and low level of health in recent years determines the need to assess the characteristics of the psychosomatic status in children and adolescents with various types of somatic pathology, including diseases of ENT organs, accompanied by nasal breathing disorders and hypoxia. It is also necessary to determine the severity of stress in children, for timely prevention and correction of these disorders.Aim: to assess the level of stress in schoolchildren with nasal breathing disorders against the background of nasal diseases and concomitant psychosomatic disorders.Materials and methods. 481 schoolchildren aged 12–17 (boys and girls) were examined. Nasal breathing disorders were assessed by a comprehensive ENT examination, including rhinoscopy, radiography of the sinuses, and olfactometry. The presence and severity of stress were determined by the questionnaire “Social factors and stress”.Results. We found that the high level of stress in children with nasal breathing disorders on the background of ENT pathology is more often associated with the high frequency and severity of psychosomatic symptoms: the presence of dorsalgia, asthenic syndrome, chronic headache and frequent episodes of abdominal pain. Moderately and significantly increased levels of stress associated with the presence of children with hypertension, asthenic syndrome, frequent abdominal pain, frequent pain in the cervical spine, panic disorders.Conclusions. Thus, the presence of certain psychosomatic complaints in children with nasal breathing disorders is directly related to the level of stress, which is important to take into account when planning preventive and corrective measures aimed at increasing the adaptive capacity and stress resistance of children. The studies illustrate the need to assess the psychosomatic status and the level of stress in schoolchildren with nasal breathing disorders taking into account their existing comorbid disorders of the psychosomatic spectrum.

Results of surgical treatment of skull-base primary malignant tumors with intracranial invasion

Analysis of factors affecting life expectancy at patients with primary malignant tumors of anterior and middle parts of the skull base with intracranial invasion. 139 patients (47 women and 92 men) with primary malignant tumors of the anterior and middle parts of the skull base with intracranial invasion (stage T4 according to TNM classification or stage C according to Kadish classification for estesioneuroblast ) were treated at the NMRCN Burdenko for the period from 2004 till 2018. The study was conducted by the method of total sampling. The observations are divided into 2 groups: primarily operated (group I) and repeatedly operated (group II). The average age in both groups was 50 years. In most (64.7%) cases, the tumor affected the medial sections of the base of anterior and middle cranial fossae, and in 35.3% of cases it was localized laterally. All tumors were classified to T4 stage according to TNM classification or (9 olfactory neuroblastomas) to stage C according to Kadish classification. The impact on life expectancy was largely provided by postoperative radiation therapy, the repeated nature of operation, and the presence of brain infiltration. In the total cohort of patients 5-year OS, 5-year RVS, 5-year-old IDF and 5-year LC were 50.7, 35, 54.2 and 36.4%, respectively. In group I, the medians OS and IDF were equal and amounted to 138.3 months. The median RVS was 43.8 months. 5-year OS equal to 63.6%, 5-year RVS - 40.8%, 5-year-IDF - 64.8%, 5-year LC was up to 65.7%. The survival rate in the analyzed cohort for 1, 2, 3 years was 81.4, 71.8 and 67.8%, respectively. In group II, the treatment results for the group of repeatedly treated patients were significantly worse. There were no cases of 5-year survival. The 1-, 2-, and 3-year survival rates were 59.3, 50.8 and 31.8%, respectively. The median OS was 27.1 months, IDF was 27.1 months, RVS was 18.2 months, and LC was 9.1 months. The results and analysis of literature justify the feasibility of surgical treatment of patients with malignant tumors of craniofacial localization at T4 stage. The purpose of surgical intervention should be: elimination of the immediate threat to the patient's life due to edema and dislocation of the brain; the maximum possible removal of tumor tissue (cytoreduction); if possible, the elimination of the most significant symptoms for the patient (pain, nasal breathing disorders, cosmetic defect). If there are special reserves, it is obligatory to include radiation and chemotherapy in the treatment process.

Особенности нарушений носового дыхания у пациентов с назальной обструкцией

The objective of the study is to examine the specific features of the aerodynamic processes in the nasal cavity of patients with subjective nasal obstruction, and to make a differentiated analysis of the causes of its formation. Materials and methods: the authors examined 72 patients aged 18 to 64 years with subjective complaints of nasal breathing obstructions. Of these, 36 patients had not previously undergone surgical correction of external nose and intra-nasal structures. The other 36 patients have undergone septoplasty, rhinoplasty, turbinotomy or inferior nasal concha vasotomy over the period of 2.7±0.6 years. All subjects were surveyed, nasal obstruction was assessed using VAS scale, otorhinolaryngological examination and anterior active rhinomanometry with calculation of nasal resistance and volumetric nasal flow and acoustic rhinometry with the measurement of MCA 1 before and after α2-adrenomimetic test was performed. Results: in the patients with subjective nasal breathing obstructions, who had not previously undergone surgical correction of the external nose and intra-nasal structures, the most frequently identified causes of nasal obstruction are functional (38.9%) and structural (38.9%). The combined structural and functional changes in airflow circulation were found in 22.2% (8 patients). According to the modified VAS scale, 12 patients (32.6%) in this group had an underestimation of subjective degree of nasal obstruction, compared with objectively recorded aerodynamic respiratory function parameters. Among patients who had previously undergone surgical correction of intra-nasal structures, according to objective assessment of aerodynamic parameters, 11.1% have no nasal breathing disorders, in 47.2% of patients, the main cause of nasal obstruction is the nasal mucosa reactive edema, and 36.1% of patients have unsatisfactory functional results of surgical treatment due to incomplete correction of structural disorders. Conclusion: the anterior active rhinomanometry in combination with acoustic rhinometry should be conducted if the patients have subjective nasal breathing obstructions both at the stage of planning the surgical correction of intra-nasal structures and in the remote postoperative period for differentiated analysis of the nasal obstruction causes and provision of optimal functional result.

The effects of nasal decongestion on obstructive sleep apnoea

BackgroundMany studies have indicated associations between impaired nasal breathing and sleep disorders. However, the precise nature of the relationship between nasal patency and sleep remains unclear. PurposeWe analysed the effects of nasal patency on sleep architecture and breath in nasal obstruction-predominant obstructive sleep apnoea (NO-OSA) patients by applying nasal decongestant. Material and methodsA randomized, placebo-controlled double-blind crossover study was performed in OSA patients with chronic nasal obstruction and without obvious pharyngeal narrowing. All OSA patients (confirmed by polysomnography) were recruited and completed 2 overnight studies (randomly applying oxymetazoline or placebo). Data collected after oxymetazoline or placebo treatments were compared. The ClinicalTrials.gov identifier is NCT03506178. ResultsCompared with placebo, oxymetazoline resulted in significant increase in rapid eye movement sleep (p = 0.027) and reduction of stage 1 sleep (p = 0.004), as well as arousal index (p = 0.002). Moreover, great improvements in apnoea/hypopnea index (AHI) were observed (p < 0.001); AHI in the supine position was significantly reduced (p = 0.001). Oxygen saturation during sleep was increased significantly [mean oxygen saturation (p = 0.005) and lowest oxygen saturation (p = 0.024)]. Oxygen desaturation index was significantly reduced (p < 0.001). ConclusionsImproving nasal patency by decongestant could improve sleep quality, AHI, and oxygen saturation level during sleep.

Functional results of septoplasty conducted with the evaluation of aerodynamic characteristics and anatomical features of the nose region

The nasal breathing disorders is leading problem in otolaryngological practice. Despite the modern development of diagnostic methods of nasal breathing disorders and septum surgery, there are a number of patients who have violations of nasal breathing in the late period. The development of rhinomanometry methods and tomographic studies allow to improve the functional results of septoplasty. The aim of the study: Based on the data of anterior active rhinomanometry with a complex of functional samples, as well as data analysis of the anatomical correlation of the nasal cavity, to determine the main principles in planning and performing remodeling of the nasal septum, to evaluate their effectiveness. Materials and methods: In the results of a study of 64 patients who were previously questioned on the NOSE scale were examined in the article, they were examined rhinomanometrically (anterior active rhinomanometry in combination with functional samples) and an in-depth analysis of the correlation between the anatomical structures of the nasal cavity was carried out. Later, at the time of 2 months, 6 months and 12 months after surgical treatment, taking into account the survey data and the geometric analysis, they were re-examined. Results: In a primary rhinomanometric study, there are 38 (59.38%) patients with structural anatomical disorders accounted, 12 (18.75%) patients with edematous mucosal, 14 (21.88%) patients with a combination of structural and oedematous mucosal disorders accounted. A further study of rhinomanometric and anatomical correlation showed that, depending on the localization of the area of pathological nasal resistance, the front sections of the nasal cavity and the anterior nose valve region prevail making 37 (71.15%) people. Localization of pathological nasal resistance in the posterior sections of the nasal cavity 4 (7.69%), a combination of the anterior and posterior parts was noted in 11 (21.15%) people. At repeated examination at the time of 12 months, the number of unsatisfactory functional results was observed in 6.1% of cases. Conclusion: Anatomical correlation in the nasal cavity are key in ensuring normal aerodynamic processes in the nasal cavity. A comparative analysis of the indices of unsatisfactory functional results in terms of 12 months show, determined that after carrying out septoplasty, taking into account the rhinomanometry with functional tests in combination with the above analysis of the anatomical formations of the nasal cavity, this indicator is 6.1% and 8% if in the planning stage of surgery the results of these studies are not taken into account

Remote functional results of septoplasty performed taking into account the aerodynamic analysis of the nasal cavity

The problem of nasal breathing disorders occupies a leading place in otolaryngology. In modern conditions, insurance and evidence-based medicine is acquiring the urgency of searching for objective methods of investigating the function of nasal breathing at the stages of preoperative planning. The development of rhinomanometric methods of investigation makes it possible to increase the functional efficiency of septoplasty. Purposes: To develop a procedure for preoperative aerodynamic analysis of the nasal cavity on the basis of PARM and CT analysis and to evaluate the remote functional results of septoplasty performed taking into account the obtained data. Materials and methods: The article presents the results of a study of 160 patients who underwent septoplasty within 3 years. In the main group, a survey was carried out on the NOSE scale, rhinomanometric studies with a complex of functional samples and analysis of computer tomograms. Based on the data obtained, their surgical treatment was performed (84 patients). Further, the functional results of septoplasty in the main group were compared with the results in the group of patients who underwent septoplasty without taking into account aerodynamic and tomographic analysis (76 patients). Results: According to the results of a comparative analysis of the data of the state of the nasal breathing function, it is established that the above procedure allows more accurate estimation of the aerodynamic features of the nasal cavity and to determine the localization of pathological nasal resistance in the nasal breathing structure. In turn, this allows objectively to plan and conduct septoplasty, which positively affects its functional efficiency and reduces the risk of development of unsatisfactory results in the long term after the operation. Conclusion: When performing surgical interventions on the nose wall, taking into account the data of the anterior active rhinomatometry with the complex of functional tests and tomographic analysis, the total indicator for 3 years after the operation of unsatisfactory functional results was 3.57%, with a similar index of 13.16% in the course of operations without taking into account the above indicators (level of reliability р=0.0133&lt;0,05).

Nasal schwannoma with skull base destruction in a child (a case report and literature review)

Schwannomas (neurinomas) are benign, encapsulated, and slow-growing neoplasms developing from any peripheral, cranial, or vegetative nerve that has the Schwann sheath. Schwannomas of the nasal cavity and paranasal sinuses in adults occur rarely, less than 4% of cases. The world literature lacks similar data for the pediatric age group because these tumors in children are unique and extremely rare. The most common clinical symptoms of sinonasal schwannoma are nasal breathing disorders, hyposmia or anosmia, and snoring at night. Other symptoms are associated with intranasal schwannoma invasion of neighboring organs and tissues and include exophthalmos, epiphora (lacrimation), headaches, and anesthesia in the facial area. In this article, we describe a rare case of diagnosis and successful surgical treatment of a child with intranasal schwannoma destructing the skull base.

Nasal Obstruction and Sleep-related Breathing Disorders

Nasal Obstruction and Sleep-related Breathing Disorders