卷 30, 编号 3 (2024)

The review article describes the literature data on the etiology and adverse factors of chronic atrophic rhinitis. Nasal mucosal changes in chronic atrophic rhinitis are reviewed. The main complications of chronic atrophic rhinitis, such as epistaxis, nasal septal perforation, facial pain, empty nose syndrome, and possible treatment options are discussed.

The problem of treatment of chronic tonsillitis is always relevant. The disruption of the protective mechanisms of palatal tonsils, pharyngeal mucosa and other immunocompetent organs contributes to the chronicity and exacerbation of inflammation. Tonsillectomy and antibacterial treatment involves the removal of palatal tonsils damaged by inflammation and alteration of microflora, but also reduces or suppresses the protective functions of the associated tissues. There are various initial etiopathogenetic factors of chronic inflammation of palatine tonsils, but the main one is persistent pharyngeal dysbiosis, which hinders the resolution of inflammation. Therefore, cleaning of the palatal tonsils should be supplemented by creating conditions for local and systematic restoration of the microbiocenosis. However, this issue is often overlooked and treatments to stabilize the microflora are not prescribed during antibiotic therapy. In recent years, several studies have evaluated the association between gastrointestinal disorders and palatal tonsil inflammation. Based on the general literature on intestinal disorders, microbiota and immunity, it was concluded that there may be direct correlation between the disruption of the protective functions of the intestine and palatal tonsils in patients with chronic tonsillitis with inflammatory and functional intestinal disorders, especially with intestinal dysbiosis.

This literature review describes the evolution of ideas about indications for tonsillectomy in children from the early 20th century to the present. Tonsillectomy has been used as a treatment option for more than 3,000 years and remains one of the most common surgical procedures today, but there is still no consensus on the indications for total tonsillectomy and criteria for outcome evaluation. In many countries, including the Russian Federation, the priority of protecting children’s health is one of the basic principles of healthcare, so the question of when to perform tonsillectomy in children is particularly relevant. Researchers believe that no other procedure was performed in children as frequently as tonsillectomy in the first half of the 20th century. During the polio epidemic of the 1950s and 1960s, the number of tonsillectomies performed declined due to a suspected link between the surgery and bulbar poliomyelitis. Later, the discovery of antibiotics and active immune system research changed the approach to tonsillectomy. The available foreign literature describes two main indications for tonsillectomy in children: obstructive sleep apnea and recurrent infection, with obstruction becoming a more important indication in younger children. However, many authors report that the number of tonsillar complications is currently rising, probably due to a shift away from predominantly surgical treatment of tonsillar disorders. Although the history of tonsillectomy goes back several thousand years, there are no consensus guidelines for the treatment of tonsillar disorders in children, so further research are required.

BACKGROUND: The number of iatrogenic complications, including dacryologic ones, inevitably increases with the active development of rhino-sinus surgery and the increase in the number of nasal procedures.

AIM: The aim was to evaluate the anatomical causes and the type of structural damage of the vertical part of the lacrimal ducts in cases of dacryocystitis after nasal and sinus surgery.

MATERIALS AND METHODS: The study included a retrospective analysis of 38 case reports of patients with chronic secondary dacryocystitis after nasal and sinus surgery.

RESULTS: Based on the data analysis, patients were divided into three comparable groups according to the level of lacrimal duct damage. Lacrimal duct obstruction was found at the level of the lacrimal sac in group 1 (7 cases), at the level of upper and middle part of nasolacrimal duct in group 2 (21 cases), at the level of lower third of the nasolacrimal duct in group 3 (10 cases). The relationship between the level of damage and the type of previous surgical procedure was evaluated. Retrograde dissection of the uncinate process during endoscopic middle meatal antrostomy was found to be the most common cause of lacrimal duct obstruction (12 cases, 31.58%). Persistent obstruction of the vertical part of the nasal passages was observed after anterior ethmoidectomy, maxillary sinus surgery with partial or total medial wall dissection, inferior turbinate plasty, inferior turbinate mucosal flap, and lateral osteotomy in rhinoplasty.

CONCLUSIONS: The results obtained require further study in a larger, more representative sample of patients.

This article reviews current treatment approaches for odontogenic maxillary sinusitis, one of the most common dental diseases. Special attention is paid to the pathogenesis of this disease and to the effects of dental infections on the development of sinusitis. Both non-surgical treatment options, such as antibacterial and anti-inflammatory therapy, and surgical procedures, including sinusotomy and drainage, are described. Clinical cases and treatment outcomes were analyzed to identify the most effective management strategies for this disease. Finally, the important role of a multidisciplinary approach in the diagnosis and treatment of odontogenic maxillary sinusitis is highlighted.