No1(2) 2019
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DOI 10.37219/2528-8253-2019-1-42 |
Arifov SS, Rasulov AB
Comparative analysis of some methods of surgical treatment of vasomotor
rhinitis
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Arifov Saifutdin S.
Tashkent institute of postgraduate medical education, Uzbekistan, Tashkent.
E-mail: sarifov@mail.ru
Rasulov Alexey B.
Tashkent institute of postgraduate medical education, Uzbekistan, Tashkent.
E-mail: rasulov.alexey@gmail.com |
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Abstract
Among chronic forms of rhinitis of great importance is vasomotor rhinitis,
which is the most common form of chronic non-allergic rhinitis and the
clinician has to deal with it constantly. Treatment of vasomotor rhinitis is
a complex and largely unresolved problem, which puts this disease among the
important problems of modern rhinology. The variety of methods used in the
treatment of patients with vasomotor rhinitis confirms the complexity of the
task of choosing the optimal method for clinicians and the difficulty of
obtaining a sustainable result from the chosen method. Surgical treatment of
patients with of patients with various forms of chronic rhinitis is
sometimes the only effective. Currently, the arsenal of methods and means of
surgical treatment of the nasal concha is quite wide and varied.
The purpose of this study – to study in a comparative aspect the functional
state of the nasal cavity after carrying out some methods of surgical
treatment ofvasomotor rhinitis.
Materials and Methods: The study was conducted in the clinic of the
Department of Otorhinolaryngology of the Tashkent institute of postgraduate
medical education on 43 patients with vasomotor rhinitis in age from 20 to
46 years, average age 28,0±1,3 years. All patients with BP included in our
study, after collecting complaints and anamnesis, underwent an endoscopic
examination of the nasal cavity and nasopharynx, a computerized tomogram of
the nose and paranasal sinuses, standard laboratory tests and microscopy of
a smear from the nasal cavity on eosinophils.Investigated the respiratory
(computer rhinopneumocotachometry), transport (saccharin test) functions of
the nasal mucosa, performed an adrenaline test and the Flour test
(determination of the consistency of inferior nasal concha and the response
to pushing with a push-button probe).
Results: Studies have shown the highest efficiency of laser
coagulation with vasomotor rhinitis. After laser surgery, a long-lasting and
sustained improvement in the functions of the nasal cavity was noted, while
there was no adverse effect on the mucous membrane of the nasal cavity,
which was reflected in the recovery rates of both nasal breathing and
mucociliary clearance. Given the well-tolerated laser coagulation, the lack
of the need for observation and care of the nasal cavity in the
postoperative period, the possibility of outpatient treatment, allows us to
recommend this type of exposure as the method of choice in the surgical
treatment of patients with vasomotor rhinitis.
The simplicity of submucosal vasotomy, the availability of instruments for
carrying out, the restoration of free nasal breathing and the positive
effect on the functional state of the nasal cavity, although slower than
laser coagulation, minimal side effects put it on a par with the laser
effect. The need to use tampons after surgery reduces the quality of life of
patients, hospital stays and the need to monitor patients in the early
postoperative period makes this operation strictly inpatient.
Electrocautery of inferior nasal concha demonstrated in our study a negative
effect on the function of the nasal cavity, although, of course, there was a
definite improvement in nasal breathing, but the severity and speed of
improvement was significantly less than during laser exposure and submucosal
vasotomy. The slowest and most incomplete restoration of the mucociliary
clearance of the nasal cavity once again underlines the disadvantage of this
method.
Conclusion: Evaluation of the long-term results of surgical treatment
based on the combination of effects on the respiratory and transport
functions of the nasal cavity, as well as on the clinical manifestations of
BP, makes it possible to recommend laser coagulation as the most optimal
method providing a long-lasting effect in treating patients with vasomotor
rhinitis. Alternatively, you can take a submucosal vasotomy of the inferior
nasal concha. |
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Keywords
vasomotor rhinitis, surgical methods of treatment, the functions of the
nasal cavity. |
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