Treatment of chronic rhinosinusitis exacerbations

The developing resistance of microorganisms to the effects of antibacterial drugs creates difficulties in the treatment of purulent diseases. This is especially reasonable in the pandemic of a new coronavirus infection (COVID-19). The aggressive effect of new strains of the virus on the mucous membrane of the nasal cavity and nasopharynx contributes to the occurrence of complications such as acute purulent otitis media and exacerbation of chronic purulent otitis, both during coronavirus infection and in the postcovid period. Even before the start of the pandemic, antibiotic resistance was already one of the big problems in most countries of the world, this was due to the frequent unjustified appointment of systemic antibacterial agents for viral infection, as well as uncontrolled self-medication of the population with all available drugs. Due to the fear of people getting sick with COVID-19 and disagreements among doctors in treatment tactics, the use of systemic antibiotics and hormonal drugs increased already in the first months of the pandemic. In the future, the unjustifiability of this tactic was proved, but many doctors continued to prescribe several systemic antibacterial drugs to patients with uncomplicated viral infection. Under the current conditions, when there is evidence of bacterial infection, it is rational to use local antibacterial drugs, which allows you to quickly reach high concentrations in the focus of inflammation and avoid side effects of systemic antibiotics. Among the existing means in the complex therapy of perforated otitis, a special place belongs to the preparations of the group of quinoxaline derivatives, which include hydroxymethylquinoxalindioxide (Dioxidine). The advantage of the drug is its effectiveness against resistant microorganisms, as well as stimulation of marginal tissue regeneration. This property is especially important in the treatment of perforated otitis media.

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Topical antibiotic therapy for perforated otitis in the COVID-19 pandemic

Ryazantsev

Balatskaya

Tkachuk

et al. 2022

Medicinskij sovet

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Hydroxymethylquinoxalindioxide as levarage points for otorhinolaryngology

Eremeeva,

Nagovskaya,

Morozova

2023

Medicinskij sovet

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Hydroxymethylquinoxaline dioxide, better known as Dioxydin®, holds a special place among topical antimicrobials. The drug has the proven bactericidal action against a wide spectrum of aerobic and anaerobic bacteria, showed good results in otorhinolaryngology as a topical drug to treat bacterial diseases of upper respiratory tract and ear. The authors performed the search for publications among the sources of electronic libraries, such as National Electronic Library (NEB), eLIBRARY, Cyberleninka, Rucont, as well as electronic search engines Pubmed and Google Scholar for the period from 2015 to 2022. The literature analysis resulted in 9 domestic studies, including 6 prospective comparative (4 randomized) studies, two prospective non-comparative studies, and one retrospective descriptive study. The prospective studies involved 400 patients, and the retrospective study analysed the administration in 150 patients. In these studies, hydroxymethylquinoxaline dioxide (Dioxydin®) was used to treat culture-proven infections of upper respiratory tract and ear, both acute and exacerbations of chronic ones. In addition to 0.5% and 1% solutions, which are widely used in ENT practice and need to be prediluted, two new formulations of the drug, fully ready for use, also draws attention: Dioxydin® 2.5 mg/ml, ear drops, and Dioxydin® 0.25 mg/ml, sore throat gargle for topical use. A retrospective review of papers on the use of hydroxymethylquinoxaline dioxide (Dioxydin®) for the topical treatment of upper respiratory tract and ear diseases caused by bacterial agents shows high efficacy, safety and low risk of resistance development. It is promising to conduct studies demonstrating additional therapeutic activity of the Dioxydin®.

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Medical and psychological reasons for getting aesthetic rhinoplasty

et al. 2023

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The original desire of all people is the desire to look more attractive by improving their appearance and the most advanced direction, in achieving aesthetic superiority, cosmetic surgical interventions have been and remain. The leading place in the patient’s desires is occupied by aesthetic facial surgery, where the most popular and not always justified is the change in the shape of the external nose. To date, the techniques and techniques for performing aesthetic rhinoplasty have reached their perfection. But at the stage of selecting patients for aesthetic surgery on the external nose, doctors always face certain difficulties. The most common problems for plastic surgeons are created by patients with dysmorphophobia where, for example, the main motive for persons with dysmorphomania to make rhinoplasty is dissatisfaction with the size and shape of their own nose, which, in their opinion, prevents them from achieving success in their personal life, building a career, etc. Other patients with dysmorphophobic syndrome have low self-esteem, in their opinion, the ugly shape of the nose prevents marriage etc. In this context, an unsuccessful example of performing aesthetic rhinoplasty for a patient whose anamnesis was aggravated by polypous rhinosinusitis and bronchial asthma with an uncontrolled course is given. A brief review of the literature and presented clinical examples substantiate the need to address a number of important questions at the stages of selection and planning of aesthetic rhinoplasty: does the patient have mental disorders; what are the true reasons motivating the patient for surgery; whether there are any diseases of the upper respiratory tract, violations of the architectonics of the deep sections of the nasal cavity, preventing operations, etc.

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Treatment of chronic rhinosinusitis exacerbations

Cited by 4 publications

References 10 publications

Topical antibiotic therapy for perforated otitis in the COVID-19 pandemic

Topical antibiotic therapy for perforated otitis in the COVID-19 pandemic

Hydroxymethylquinoxalindioxide as levarage points for otorhinolaryngology

Medical and psychological reasons for getting aesthetic rhinoplasty

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