Significant role of getting the required amount of air into the human body belongs to the breathing by the nose. The nasal cavity prepares the air for reciprocity with the lower respiratory tract owing to the complex structure of the mucous membrane. When nasal obstruction occurs, breathing is carried out mainly through the mouth, and there is a violation of the basic functions of the nose, as well as the ingress of unadapted aggressive air to the sensitive alveolar structures of the lungs. This leads first to functional, and then to morphological and structural changes. In addition, difficult nasal breathing leads to impaired aeration of the paranasal cavities, middle ear cavity and hypoxia of all organs of the body. Even short episodes of nasal obstruction affect the quality of life, and prolonged untreated or incorrectly treated acute viral rhinosinusitis can spill over into lingering bacterial diseases of the ENT organs. Decongestants are used to eliminate nasal congestion. Decongestants include a wide range of substances that are used topically or systemically, in the form of monotherapy or in combination with other substances. The most popular drugs in this group are topical decongestants, since they have the most pronounced effect. The main nasal decongestants can be divided into two groups: sympathomimetic amines: primary aliphatic; phenolic and non-phenolic compounds, as well as imidazoline derivatives. Among the modern vasoconstrictor drugs oxymetazoline. Using it strictly according to the instructions within 3–5 days guarantees the absence of the development of local and systemic complications.

Allergic rhinitis (AR) and chronic rhinosinusitis (CR) can be diagnosed as an independent or combined pathology, as well as a possible complication of each other. Allergic rhinitis is a disease characterized by IgE-mediated inflammation of the nasal mucosa and the presence of daily manifestations of more than one hour and at least two of the following symptoms: nasal obstruction, rhinorrhea, sneezing, nasal itching. The frequency of psychosomatic disorders is quite high and ranges in the population. Studying the mechanisms of disease development provides the basis for rational therapy, not just symptom relief. We have considered the use of elimination therapy for CR associated with AR. This type of treatment is available to all categories of patients, including children and pregnant women at any gestational age. On the basis of the Department of Otorhinolaryngology of A. I. Evdokimov Moscow State Medical University in 2019–2020, a clinical study was conducted, which showed that such a combination of isotonic saline solution and antiseptic leads to improvement of patients and accelerates the recovery. In the process of monitoring 36 patients: in 35 of them achieved clinical cure, 1 patient required the appointment of antibiotic therapy due to the development of symptoms of purulent sinusitis. The results indicate a pronounced advantage of treatment in combination with elimination drugs, which was expressed in a reduction of symptoms during the first week of treatment, their complete regression was noted on the 30th day of use of the drug. Thus, chronic rhinosinusitis and allergic rhinitis are an important medical and social problem, and treatment of such patients requires only an integrated approach with obligatory consideration of the pathogenesis of the disease.Allergic rhinitis (AR) and chronic rhinosinusitis (CR) can be diagnosed as an independent or combined pathology, as well as a possible complication of each other. Allergic rhinitis is a disease characterized by IgE-mediated inflammation of the nasal mucosa and the presence of daily manifestations of more than one hour and at least two of the following symptoms: nasal obstruction, rhinorrhea, sneezing, nasal itching. The frequency of psychosomatic disorders is quite high and ranges in the population. Studying the mechanisms of disease development provides the basis for rational therapy, not just symptom relief. We have considered the use of elimination therapy for CR associated with AR. This type of treatment is available to all categories of patients, including children and pregnant women at any gestational age. On the basis of the Department of Otorhinolaryngology of A. I. Evdokimov Moscow State Medical University in 2019–2020, a clinical study was conducted, which showed that such a combination of isotonic saline solution and antiseptic leads to improvement of patients and accelerates the recovery. In the process of monitoring 36 patients: in 35 of them achieved clinical cure, 1 patient required the appointment of antibiotic therapy due to the development of symptoms of purulent sinusitis. The results indicate a pronounced advantage of treatment in combination with elimination drugs, which was expressed in a reduction of symptoms during the first week of treatment, their complete regression was noted on the 30th day of use of the drug. Thus, chronic rhinosinusitis and allergic rhinitis are an important medical and social problem, and treatment of such patients requires only an integrated approach with obligatory consideration of the pathogenesis of the disease.

Increase in the number of acute and chronic diseases is a global trend. On the one hand, the emergence of new types of viruses, their active mutation, an increase in antibiotic-resistant bacterial strains, a high frequency of immunodeficiency and allergic diseases contribute to this. On the other hand is inadequate treatment of inflammatory diseases of the upper respiratory tract, widespread use of systemic antibiotics without indications. The use of bioregulatory medicines with proven efficacy in the complex treatment can reduce the drug load on the body, reduce the bacterial complications and side effects. Traumeel®S joins the physiological course of inflammation and activates pro-resolving mediators, contributes to its faster completion and tissue repair. The efficacy and safety of Traumeel®S has been confirmed in many randomized clinical trials. The drug has proven its value in almost any inflammatory pathology of the upper respiratory tract and ear. The drug Lymphomyosot®, a multicomponent agent with lymphatic drainage action, has proven itself perfectly in the complex therapy of chronic tonsillitis. In November 2019, the Council of Experts of the National Medical Association of Otorhinolaryngologists on the problems of pathology of the lympharyngeal ring was held. It is recommended to use the multicomponent bioregulatory preparation Traumeel®S to correct the inflammatory process, which has shown in studies a modulating effect on inflammatory mediators without suppressing COX-2 (prostaglandins). With exacerbation of chronic tonsillitis and lymphadenitis of nonspecific etiology, it is possible to use the multicomponent preparation Lymphomyosot®, which helps to improve the drainage and detoxification function of the lymphatic system.

The article is devoted to the treatment of one of the most common diseases - the treatment of rhinosinusitis. According to statistics only 2% of the sinusitis in population are bacterial. At the same time administration of systemic antibiotic therapy reaches 95.5%. The problem of rational prescription of antibacterial drugs, including management of the rhinosinusitis, is very acute, especially considering the constant increase in the number of antibiotic-resistant microorganisms. Currently, the level of patients with prolonged post-viral rhinosinusitis after COVID-19 has increased. Most have a history of one or more courses of systemic antibiotics and, often, without indications. In article are listed indications for systemic and local antibacterial therapy in adults and children, based on national and European clinical guidelines. The data on complications during the use of systemic antibacterial drugs are presented. Authors give information about the advantages of the local use of antibiotics: the absence of general toxic complications, the creation of an optimal concentration directly in the focus of inflammation. The advantages of combining solutions of neomycin and polymyxin B for topical use, such as a pronounced bactericidal effect against gram-positive and gram-negative bacteria (Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Haemophilus influenzae, Pseudomonas aeruginosa), causing the development of infectious processes in the upper respiratory tract, are separately noted. The author describes his own experience of using the original nasal spray Polydex with phenylephrine, containing a fixed combination of neomycin, polymyxin B, dexamethasone sodium metasulfobenzoate and phenylephrine, in the treatment of patients with post-viral rhinosinusitis. As a result of the collection of literature data, as well as based on their own experience, the authors concluded that the use of this nasal spray in outpatient practice will significantly improve the effectiveness of treatment and reduce the frequency of prescribing systemic antibiotics.