No1(1) 2018
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DOI 10.37219/2528-8253-2018-1-26 |
Bezshapochny S, Loburets A, Loburets V
Optimization of postoperative management of patients undergoing functional
endoscopic sinus surgery
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Bezshapochny Sergey B.
Ukrainian Medical Dental Academy
Head of Department of Otolaryngology
Doctor of Medical Sciences, Professor.
Email: bezshapochny@ukr.net
Loburets Andrey V.
Ukrainian Medical Stomatological Academy
Department of Otolaryngology with Ophthalmology
PhD, Assistant of the department
E-mail: anjeyloburets@gmail.com
Orchid ID: http://orcid.org/0000-0003-4164-0816
Loburets Valery V.
Ukrainian Medical Stomatological Academy
Department of Otolaryngology with Ophthalmology
PhD, Docent
Email: umsalor@gmail.com
Orchid ID: http://orcid.org/0000-0001-8538-9649 |
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Abstract
Topicality: The result of surgical treatment depends largely on the
chosen method of management of the postoperative period, the main purpose of
which is to reduce the effects of surgical trauma. Despite the wide variety
of drugs for local and systemic use, the question of pharmacotherapy of the
operated sinus remains open to this day. The main properties that a modern
drug should possess are safety and high clinical efficacy.
Aim: to study the clinical efficacy of topical application of a
complex preparation based on a saline solution containing sodium hyaluronate
and dexpanthenol in patients with chronic sinusitis after functional
endoscopic sinus surgery (FESS).
Materials and Methods: Clinical and laboratory studies were conducted
on 47 patients with chronic rhinosinusitis who underwent surgery using the
FESS technique. Patients were divided into 2 groups according to the
principle of the postoperative period. Patients of research group (n=21),
except for traditional therapy, was used locally NASOMER (a preparation
based on a water-salt solution containing sodium hyaluronate and
dexpanthenol); to the control group (n=26) patients entered, in the
postoperative period received traditional therapy. Traditional therapy
included a toilet of the nasal cavity, the use of short-course topical
decongestants, irrigation of the nasal cavity with water-salt solutions.
Criteria of clinical effectiveness: data of endoscopy of the nasal cavity,
rhinomanometry, activity of the mucociliary transport system. The
effectiveness of functional research methods in the postoperative period was
determined on the 7th and 14th day of treatment.
Results: On the 3rd day of the study, an increase in the swelling of
the nasal cavity was observed in patients of both clinical groups,
correlated with difficulty in nasal breathing. On the 7th day, a decrease in
edema was observed in patients of both groups, but in the experimental
group, the index of nasal breathing, according to rhinomanometry, was
significantly (p<0.05) different from the control group, and was
respectively 1.54±0.14 and 2.04±0.19 kPa/l*s. On the 14th day of the study,
no significant difference was observed between these indicators.
When studying the activity of the ciliated epithelium of the mucous membrane
of the nasal cavity, it was proved that patients of the experimental group
on day 7 after surgery showed a statistically significant difference in this
indicator compared to the control group (17.8±1.0 and 22.7±2.1 min.
respectively).
Conclusions: The use of NASOMER after surgical intervention in
patients with chronic rhinosinusitis contributes to more effective treatment
compared with traditional therapy, as evidenced by the rapid recovery of the
main functional parameters according to active posterior rhinomanometry and
mucociliary clearance. Based on the results of the studies performed, the
use of NASOMER for pharmacotherapy in the postoperative period is
recommended for patients who have undergone rhinosurgical interventions with
the aim of reducing the period of postoperative rehabilitation as an
effective anti-inflammatory and wound-healing agent. |
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Keywords
sodium hyaluronate, dexpanthenol, nasomer. |
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