MODERN METHODS OF TREATMENT OF FRONTITIS (LITERATURE REVIEW)

Аннотация

INTRODUCTION the relatively small number of reports by foreign Chronic rhinosinusitis (CRS) is one of the most authors on the prevalence of the disease in significant clinical problems in global previous decades. The first multicenter study of the otolaryngology due to the high prevalence of the incidence of CRS in Europe, which included data disease, its significant impact on quality of life from more than 50 thousand respondents from 12 (QOL), and the difficulties in treatment, where countries, was conducted only in 2011. As a result conservative and surgical methods do not always of the questionnaire and examination, it was found allow achieving satisfactory and stable results [4]. that in the entire sample of respondents, 10.9% of Evaluation of the prevalence of CRS is quite respondents suffer from CRS, in accordance with complex, due to the variability of the disease the EPOS 2007 criteria [2]. In recent decades, the symptoms, the similarity of clinical manifestations incidence of CRS in the world has been steadily with acute rhinosinusitis, allergic and non-allergic increasing []. Kennedy D.W. in 1994 presented data rhinitis, as well as the lack of standards for according to which the number of patient visits to interpreting complaints and computed doctors regarding this disease increased from 8 to tomography (CT) data in this group of patients. 24 million from 1989 to 1992. In 1997, the For a long time, the importance of rhinosinusitis prevalence of CRS was 14% in the US population [`]. was underestimated, as evidenced, in particular, by According to the study by Blackwell D.L. et al. https://www.theamericanjournals.com/index.php/tajmspr 21 THE USA JOURNALS THE AMERICAN JOURNAL OF MEDICAL SCIENCES AND PHARMACEUTICAL RESEARCH (ISSN – 2689-1026) VOLUME 06 ISSUE08 (2014), 1 in 8 adult patients (12%) visit an the nose forward or flowing back, hyposmia or otolaryngologist annually for rhinosinusitis, which anosmia, an increase in body temperature [2]. In significantly exceeds the number of visits for 2003, these clinical criteria were supplemented by seasonal allergic rhinitis (7%), acute bronchitis the need to confirm the diagnosis with data from (4%) and chronic obstructive pulmonary disease objective research methods: rhinoscopy, (4%) and is comparable in level to the endoscopy of the nasal cavity and radiological corresponding indicator for bronchial asthma methods [10]. (13%). Also, CRS is in 5th place in the structure of To date, the diagnostic criteria for CRS have diseases for which antibiotics are used for remained virtually unchanged and, in accordance treatment. with EPOS 2020, include: the presence of two or Epidemiological studies have shown that the more symptoms, one of which is nasal congestion prevalence of CRS in the population of different (difficulty breathing through the nose) or nasal countries averages 10.9% [13]. This level varies discharge (forward or backward flow), in somewhat around the world, amounting to 5.5% in combination with other symptoms: pain/pressure Brazil [5], 8% in China [10], 12% in the USA [2], and in the projection area of the sinuses and/or 1.42% in Russia [3]. The differences in the above decreased or loss of smell, for at least 12 weeks. indicators are probably due to the variability of the These criteria are supplemented by data from nasal data collection methodology and the criteria for endoscopy and/or CT scan of the paranasal diagnosing CRS. The use of questionnaire methods sinuses, confirming the diagnosis of the disease for this purpose can lead to overdiagnosis of the [11]. The diagnostic criteria for CRS in disease, therefore, in real clinical practice, when international clinical guidelines are virtually the confirmed by objective diagnostic methods, the same: the documents emphasize that the diagnosis prevalence of CRS most likely ranges from 3 to of CRS should not be established solely on the basis 6.4% [6]. One of the first large medical and of clinical symptoms, but must be confirmed by sociological studies conducted by Gliklich R.E., objective diagnostic methods: rhinoscopy, nasal Metson R. (1995) showed that the impact of CRS on endoscopy or computed tomography of the QOL is comparable with other common chronic paranasal sinuses [4]. CRS is traditionally divided diseases: chronic obstructive pulmonary disease into two large groups: polypous rhinosinusitis (PR) (COPD), coronary heart disease (CHD) and chronic and CRS without polyps (CRSBP), the main back pain. Another study demonstrated that the distinguishing criterion for these forms of the impact of CRS on quality of life is comparable with disease is the presence or absence of polypous the corresponding indicators for cancer, bronchial lesions of the sinuses [12]. However, over time, it asthma (BA) and arthritis [4]. became clear that this classification does not fully reflect all variants of the disease, and therefore the To date, four fundamental international guidelines EPOS 2020 expert g