ENT

doi: 10.25005/2074-0581-2022-24-1-50-58
DYNAMICS OF RECOVERY OF FUNCTIONS OF THE NOSE IN PATIENTS WITH NASAL DEFORMITY COMBINED WITH NASAL CAVITY AND PARANASAL SINUSES DISORDERS IN THE POSTOPERATIVE PERIOD

M.I. Makhmudnazarov

Department of Otorhinolaryngology named after Yu.B. Iskhaki, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan

Objective: To study dynamical changes in the functional state of the nose in patients with nasal deformity (ND) in combination with diseases of the nasal cavity (DNC) and paranasal sinuses (PNS) before and after single-step surgical treatment.

Methods: The functional state of the nasal cavity was studied in 184 patients with ND in combination with DNC and PS in patients aged 16 to 45 years. The patients were divided into two groups of 92 people each. Group 1 consisted of patients with ND and nasal septum deformity (NSD) combined with DNC, and group 2 consisted of patients with ND and NSD combined with the DNC and PNS. The study included rhinoscopy, PNS CT scan, rhinomanometry, olfactometry, and analysis of the average duration of mucociliary transport (MCT). In addition, 184 septoplasties, 96 ultrasound turbinate reductions, 48 submucosal vasotomies, 17 nasal turbinate resections, 15 polypectomies/ethmoidectomies, 8 maxillotomies, and 184 rhinoplasties were carried out as a single-stage procedure.

Results: It was revealed that significant impairment of the nose's respiratory, olfactory, protective, and aesthetic functions occurs with ND combined with DNC and PNS. Six months after single-step surgical interventions, the restoration of nasal breathing was observed in 94.6% and 91.3% of patients in groups 1 and 2, respectively. At the same time, in 96.7% and 92.4% of patients in groups 1 and 2, respectively, the sense of smell returned to normal. In addition, normalisation of MCT duration was noted in 92.4% and 89.1% of patients in groups 1 and 2, respectively. Although there were no statistically significant differences in the parameters between the groups, the changes in all the studied dynamic parameters over the observation period in both groups were statistically significant (p<0.01).

Conclusion: The obtained results show the effectiveness of single-stage operations compared to multi-step procedures and the feasibility of their implementation in cases of ND in combination with DNC and PNS.

Keywords: Paranasal sinuses, nasal deformity, nasal septum deformity, turbinate hypertrophy, one-stage operations, mucociliary transport.

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References
  1. Kryukov AI, Tsarapkin GYu, Romanenko SG, Tovmasyan AS, Panasov SA. Rasprostranyonnost' i struktura zabolevaniy nosa i okolonosovykh pazukh sredi vzroslogo naseleniya megapolisa [The prevalence and pattern of diseases of the nose and paranasal sinuses among the adult population of a megalopolis]. Rossiyskaya rinologiya. 2017;25(1):3-6. Available from: https://doi.org/10.17116/ rosrino20172513-6
  2. Budkovaya MA, Artemyeva ES. Osobennosti narusheniy nosovogo dykhaniya u patsientov s nazal'noy obstruktsiey [The specific features of nasal breathing disorders in patients with nasal obstruction]. Rossiyskaya otorinolaringologiya. 2019;1:16-23. Available from: https://doi.org/10.18692/1810-4800-2019-1- 16-23
  3. Piskunov VS, Mezentseva OYu. Funktsional'nye i morfologicheskie izmeneniya slizistoy obolochki pri deformatsii peregorodki nosa [Functional and morphological changes in nasal mucosa in patients presenting with septal deformation]. Vestnik otorinolaringologii. 2011;1:13-5.
  4. Fokkens WJ, Lund VJ, Hopkins C, Hellings PW, Kern R, Reitsma S, et al. European position paper on rhinosinusitis and nasal polyps 2020. Rhinology. 2020;58(Suppl S29):1-464. Available from: https://doi.org/10.4193/Rhin20.600
  5. Gyusan AO. Vozmozhnosti simul'tannoy khirurgii v rinologii [The potential of simultaneous surgery in rhinology]. Vestnik otorinolaringologii. 2014;3:48-50.
  6. Baumann I. Quality of life before and after septoplasty and rhinoplasty. Laryngorhinootologie. 2010;Suppl 1:S35-45. Available from: https://doi. org/10.1055/s-0029-1246125
  7. Laberko EL, Talalaev AG, Bogomilskiy MR, Bullikh AV. Metodika ob"ektivnogo izucheniya sostoyaniya mukotsiliarnogo klirensa u detey [The method for the direct evaluation of the state of mucociliary clearance in the children]. Vestnik otorinolaringologii. 2015;80(2):40-4. Available from: https://doi. org/10.17116/otorino201580240-44
  8. Magomedov MM, Magomedov GM. Kislotno-shchyolochnoe ravnovesie i mukotsiliarnyy klirens v polosti nosa pri khronicheskom rinite i vospalitel'nykh zabolevaniyakh ONP [Acid-base equilibrium and mucociliary clearance in the nasal cavity in the patients with chronic rhinitis and inflammatory diseases of paranasal sinuses]. Vestnik otorinolaringologii. 2013;2:43-5.
  9. Polishenko TG, Piskunov GZ. Metody otsenki sostoyaniya slizistoy obolochki nosa i eyo funktsiy u bol'nykh s zabolevaniyami nosa i okolonosovykh pazukh do i posle khirurgicheskogo vmeshatel'stva [Methods for assessing the state of the nasal mucosa and its functions in patients with diseases of the nose and paranasal sinuses before and after surgery]. Rossiyskaya rinologiya. 2002;4:31- 4.
  10. Vasina LA. Vosstanovlenie struktury i funktsiy slizistoy obolochki polosti nosa v posleoperatsionnom periode u bol'nykh s iskrivleniem peregorodki nosa i khronicheskim gipertroficheskim rinitom [Structural and functional reconstruction of nasal mucosa during the postoperative period in patients with deflected nasal septum and chronic hypertrophic rhinitis]. Vestnik otorinolaringologii. 2009;2:33-5.
  11. Magomedov MM, Zeynalova DF, Andriyashkin DV, Magomedova NM, Starostina AE, Zvereva MV. Morfologicheskoe i funktsional'noe sostoyanie slizistoy obolochki polosti nosa i okolonosovykh pazukh posle khirurgicheskikh vmeshatel'stv [Morphological and functional state of the mucous membrane of the nasal cavity and paranasal sinuses after surgical interventions] Vestnik otorinolaringologii. 2016;5:54-6. Available from: https://doi.org/10.17116/ otorino201681554-56
  12. Vissarionov VA, Mustafaev MSh, Tarchokova EM, Gabuev IK, Mustafaeva SM. Osobennosti provedeniya rinoplasticheskikh operatsiy pri deformatsiyakh nosa posle travm i odnostoronney rinokheyloplastiki [Features of performing rhinoplasty operations in case of deformity of nose after traums and one-sided rhinocheiloplasty]. Vestnik poslediplomnogo obrazovaniya v sfere zdravookhraneniya. 2020;2:5-10.
  13. Shamsidinov BN, Shodiev NSh, Kurbanova FI. Effektivnost’ simu’ltannykh operatsiy khronicheskogo dakriotsistita v sochetanii s patologiey vnutrinosovykh struktur [Efficiency of simultaneous operations of chronic dacryocystitis in combination with pathology of intra-nasal structures]. Vestnik Akademii meditsinskikh nauk Tadzhikistana. 2020;10(1):56-61.
  14. Artykov KP, Azizov KN, Soliev OF, Mirzoev NM. Analiz prichin neudachnoy rinoplastiki [Analysis of the causes of unsuccessful rhinoplasty]. Zdravookhranenie Tadzhikistana. 2021;3:11-6.
  15. Yusupov ASh. Sovremennoe predstavlenie ob etiopatogeneze i khirurgicheskom lechenii deformatsii peregorodki nosa, sochetannoy s gipertrofiey glotochnoy mindaliny u detey [Modern concept of etiopathogenesis, and treatment of nasal septum deformation combined with phyalystonic tongue hyperplasia in children]. Zdravookhranenie Tadzhikistana. 2021;4:98-105.
  16. Budkovaya MA, Artemyeva ES. Ob"ektivnaya otsenka funktsii nosovogo dykhaniya u patsientov posle rinokhirurgicheskikh vmeshatel'stv [The objective evaluation of nasal breathing function in patients after rhinosurgical interventions]. Rossiyskaya otorinolaryngologiya. 2018;1:25-33.
  17. Pustovit OM. Posleoperatsionnaya reabilitatsiya struktur slizistoy obolochki nosa i okolonosovykh pazukh v rinokhirurgii [Postoperative rehabilitation of nasal mucosa structures and paranasal sinuses in rhinosurgery]. Rossiyskaya otorinolaringologiya. 2017;2:120-7. Available from: https://doi. org/10.18692/1810-4800-2017-2-120-127
  18. Khrustalyova EV, Pedder VV, Peskovackova EV, Shilkin NA. Otsenka protsessov zazhivleniya slizistoy obolochki polosti nosa posle simul'tannykh endonazal'nykh operatsiy u bol'nykh starshikh vozrastnykh grupp na osnovanii pokazateley MTST i sekretornogo immunoglobulina A [Assessment of the healing process of the nasal mucosa after simultaneous endonasal surgery in patients of older age groups based on measure of ITC and secretory immunoglobulin A]. Folia Otorhinolaryngologiae et Pathologiae Respiratoriae. 2016;22(1):53-7.
  19. Camacho M, Riaz M, Capasso R. The effect of nasal surgery on continuous positive airway pressure device use and therapeutic treatment pressures: A systematic review and meta-analysis. Sleep. 2015;38(2):279-86. Available from: https://doi.org/10.5665/4414

Authors informations:

Makhmudnazarov Makhmadamin Imomovich, Candidate of Medical Sciences, Associate Professor of the Department of Otorhinolaryngology named after Yu.B. Iskhaki, Avicenna Tajik State Medical University ORCID ID: 0000-0003-2048-5597 SPIN: 5239-4192 Author ID: 1079777 E-mail: mahmadamin@inbox.ru

Information about the source of support in the form of grants, equipment, and drugs

The research was carried out in accordance with the research plan of Avicenna Tajik State Medical University (state registration number – 0113ТJ00336). The author did not receive financial support from manufacturers of medicines and medical equipment

Conflict of interest: No conflict

Address for correspondence:

Makhmudnazarov Makhmadamin Imomovich
Candidate of Medical Sciences, Associate Professor of the Department of Otorhinolaryngology named after Yu.B. Iskhaki, Avicenna Tajik State Medical University

734003, Republic of Tajikistan, Dushanbe, Rudaki Ave., 139

Tel.: +992 (935) 067543

E-mail: mahmadamin@inbox.ru

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