Priority areas of acute sinusitis therapy

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Abstract

Acute sinusitis (AS) is an inflammatory disease of the paranasal sinuses, accompanied by nasal congestion, difficulty in nasal breathing, mucopurulent discharge from the nose and the appearance of pain in the projection of the sinuses. The main cause of this pathology is impaired drainage due to blockage of the sinus ostia with edematous mucous membrane. The main etiological role in the development of AS belongs to respiratory viruses and only 0.5-2.0% to bacterial microbiota. In the pathogenesis of the disease, in addition to swelling of the mucous membrane of the nasal cavity and sinuses, a violation of the mucociliary clearance is of great importance, in particular a change in the composition of mucus and ciliary dysfunction, which results in the appearance of thick, viscous and difficult to separate pathological secretions. This circumstance negatively affects the course of inflammation, since it activates the adhesive properties of transient microorganisms and prolongs their presence on the mucous membrane of the upper respiratory tract and contributes to a long-term recurrent course of sinusitis and even its transition to a chronic form. In this regard, one of the most important areas of treatment for all forms of AS is mucoregulatory therapy, which is achieved through a variety of pharmacological properties of carbocysteine, such as improving the rheological properties of mucus, its qualitative and quantitative composition, regeneration of epithelial cells, and regulation of the number of goblet cells. The effects provided allow to recommend the use of carbocysteine in the complex therapy of acute sinusitis.

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About the authors

A. V. Gurov

Department of Otolaryngology named after academician B.S. Preobrazhensky, Institute of Surgery, Pirogov Russian National Research Medical University (Pirogov University); Sverzhevsky Research Clinical Institute of Otolaryngology

Author for correspondence.
Email: alex9999@inbox.ru
ORCID iD: 0000-0001-9811-8397

Dr. Sci. (Med.), Professor, Department of Otolaryngology n.a. Academician B.S. Preobrazhensky, Institute of Surgery, Department of Microbiology and Virology, Institute of Preventive Medicine, Pirogov Russian National Research Medical University; Senior Researcher, Sverzhevsky Research Clinical Institute of Otolaryngology

Russian Federation, Moscow; Moscow

M. A. Yushkina

Department of Otolaryngology named after academician B.S. Preobrazhensky, Institute of Surgery, Pirogov Russian National Research Medical University (Pirogov University); Sverzhevsky Research Clinical Institute of Otolaryngology

Email: alex9999@inbox.ru
ORCID iD: 0000-0002-9823-1047
Russian Federation, Moscow; Moscow

A. V. Muzhichkova

Department of Otolaryngology named after academician B.S. Preobrazhensky, Institute of Surgery, Pirogov Russian National Research Medical University (Pirogov University); Sverzhevsky Research Clinical Institute of Otolaryngology

Email: alex9999@inbox.ru
ORCID iD: 0000-0001-5940-9343
Russian Federation, Moscow; Moscow

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