Introduction. Acute rhinosinusitis accounts for 40 % to 60 % of the morbidity in the structure of ENT pathology. COVID-19 pathogen, similarly to other respiratory viruses, can cause acute rhinosinusitis, which is the most relevant at the present time due to the ongoing pandemic. Viral etiology accounts for 90–98 % of all cases of acute rhinosinusitis. Accordingly, the choice of treatment tactics with antibacterial drugs in a number of cases is unreasonable and leads to the growth of antibiotic resistance. Local antiseptics containing sodium hypochlorite with a high safety profile that do not cause pathogen resistance are used to increase the effectiveness of therapy for acute rhinosinusitis.   Objective. To evaluate the effectiveness of nasal spray containing sodium hypochlorite on the duration of the course of exacerbation and severity of acute rhinosinusitis during the epidemiological season.   Materials and methods. The study involved 50 patients who were divided into 3 groups: 10 patients (group 1) with acute viral rhinosinusitis (therapy: sodium hypochlorite + decongestants); 20 patients (group 2) with acute bacterial rhinosinusitis (therapy: sodium hypochlorite + systemic antibacterial therapy); 20 patients (group 3) with acute bacterial rhinosinusitis (therapy: nasal lavage with isotonic sea salt solution + systemic antibacterial therapy).   Results and discussion. Pathogen eradication – the absence of the original pathogen at the locus of the inflammatory process during dynamic microbiological examination – was found in 14 (35 %) clinical cases: in Group 2 (sodium hypochlorite) – 10 (25 %) and in Group 3 (nasal irrigation with isotonic sea water solution) – 4 (10 %).   Conclusions. The results of microbiological studies showed effective antimicrobial properties of sodium hypochlorite when applied to the inflamed mucous membranes, expressed in a statistically significant reduction of bacterial semination of the nasal cavity epithelium.

Objective. To analyze the effect of concomitant deviated nasal septum in children with chronic rhinosinusitis (CRS) on the effectiveness of functional endoscopic sinus surgery (FESS), the state of the ciliary apparatus, and the morphology of the nasal mucosa in the postoperative period. Patients and methods. A comprehensive examination was performed in 124 patients with CRS without nasal septum deviation as well as 66 patients with CRS and concomitant nasal septum deviation who underwent FESS. Results. A statistically significant improvement in the condition of the subjects after surgery was found in both groups. At the same time, patients with CRS and nasal septum deviation had a higher number of complications and the need for revision surgery. The subjective evaluation of the results of FESS was significantly higher in the group of children with CRS without nasal septum deviation. According to the results of video cytomorphometry in children with CRS without deviated nasal septum, by 6 and 12 months of the postoperative period, there was a close to significant and significant increase in the survival of epithelial cells, the number of cells with mobile cilia, the length of cilia, and the frequency of cilia beating. A year after the operation, this group of subjects also showed a statistically significant decrease in epithelial dystrophy, the number of neutrophils and lymphocytes, and a tendency to arrange cells in layers. In contrast, in patients with CRS and nasal septum deviation, a significant increase in the length of cilia was noted only by 12 months after surgery, while other parameters only tended to normalize. Synchronicity of cilia beat increased significantly by 12 months in both groups. Thus, the obtained results indicate a delayed recovery of the ciliary apparatus and the morphology of the ciliated epithelium mucosa after FESS in children with CRS and concomitant nasal septum deviation, which may be associated with persistent inflammation, causing a less favorable course of the postoperative period.

Osteoma of the paranasal sinuses is a benign, slowly growing, most often solitary, formation. Detection of multiple osteomas of the paranasal sinuses is casuistic in nature. According to the literature, their occurrence is 0.13% in computed tomography of the paranasal sinuses. Clinically osteoma is asymptomatic. Multiple osteomas of the paranasal sinuses may be a manifestation of Gardner’s syndrome, which was first described in 1953 as a triad of symptoms: multiple colon polyps, multiple osteomas, and skin and subcutaneous soft tissue tumors. In addition, patients are also diagnosed with dental and skeletal anomalies, retinal pathology. Gardner’s syndrome is hereditary autosomal dominant. The article presents a clinical case of a patient with multiple osteomas of the paranasal sinuses. The practical interest of this observation is its rare occurrence and the need to discuss options for choosing a therapeutic, including surgical, tactic and further management (dynamic monitoring, additional examination) of the patient. The case of multiple osteomas seems to be a rare pathology, possibly hereditary. Despite the benign nature of osteomas of the paranasal sinuses, the patient should be informed about the need for further observation, should be included in the dynamic observation group, and additionally examined by related specialists (dermatologist, dentist, gastroenterologist, ophthalmologist).

One of the most frequent otorhinolaryngological pathologies is inflammatory diseases of the nose and paranasal sinuses. In Russia, according to the Ministry of Health and Social Development, 15% of adults and 5% of children suffer from chronic rhinosinusitis. According to analysis of medical records, indicators of ENT diseases do not decrease, and long-established treatment regimens prove to be ineffective, despite the large number of different medications. One of the hypotheses existing at the present stage attributes this tendency to the underestimation of the complexity of regulatory systems in the era of reductionism, when the organism is unable to fully adapt to the influence of the environment. In this connection, the concept of bioregulatory systems medicine (BrSM), developed by an international group of scientific experts and clinicians of different specialties, whose underlying principles are the perception of the human being as a complex and integrated system, acquires particular significance. The development of any process is carried out through multilevel interaction between the various systems of the body, the so-called intra-network interactions. According to the views accepted in BrSM, multipurpose therapy is justified to influence different links of pathogenesis. Thus, the bioregulatory approach is multitargeted, i.e., it involves the use of multicomponent drugs affecting the body as a single system. The purpose of this study is to consider treatment regimens for inflammatory diseases of the nose and paranasal sinuses from the perspective of bioregulatory systems medicine. It is concluded that bioregulatory nasal spray therapy is safe and well tolerated, has anti-inflammatory, antiviral, moisturizing effects, and stimulates mucosal regeneration, is combined with other medicines, and is an excellent alternative to traditional methods of treatment, has no side effects and limitations typical of them.