Optimal treatment for infectious rhinosinusitis as a tool to prevent COPD exacerbations
DOI: 10.32364/2587-6821-2023-7-8-6
A.Yu. Ovchinnikov1, N.A. Miroshnichenko1, Yu.O. Nikolaeva1, A.A. Zaitsev2,3
1A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russian Federation
2N.N. Burdenko Main Military Clinical Hospital, Moscow, Russian Federation
3BIOTECH University, Moscow, Russian Federation
Background: many studies report on the association between upper and lower respiratory infections. Various theories explain this association. In particular, some evidence demonstrates that nasal symptoms in diseases of the nasal cavity and paranasal sinuses affect exacerbations of chronic obstructive pulmonary disease (COPD). Therefore, treatment for rhinosinusitis improves the overall health and quality of life of these patients.
Aim: to assess the clinical efficacy, tolerability, and safety of a combined antibacterial, anti-inflammatory, and vasoconstrictive drug in mild and moderate acute rhinosinusitis and concomitant COPD.
Patients and Methods: this study enrolled 50 male and female patients aged 41–65 years. The primary examination included complaints and history taking, examination, instrumental tests for ENT organs, and pulmonary consultation. All patients underwent digital diaphanoscopy during the first visit to rule out acute exudative rhinosinusitis. In addition, all patients filled out a subjective assessment questionnaire. Treatment continued for 10 days with an interim examination on day 5±1 after starting treatment. Study group patients received a combined drug Polydexa with phenylephrine (1 injection into each nostril 4 times daily for 10 days) and irrigation with isotonic saline. The control group patients received 2 doses of mometasone furoate twice daily into each nostril for 10 days and irrigation with isotonic saline. Topical vasoconstrictors were allowed to be used as needed.
Results: significant differences in the improvement of inflammatory symptoms between the groups were reported as early as by the second visit. The effect occurred earlier and was more significant at all treatment steps in the study group. A natural association between upper respiratory infection (acute rhinosinusitis), treatment strategy choice, and COPD exacerbation was revealed. Meanwhile, more COPD exacerbations were detected in the control group than in the study group (7 vs. 4).
Conclusion: in mild and moderate acute rhinosinusitis and concomitant COPD, the combined drug Polydexa with phenylephrine reduces the rate and severity of COPD exacerbations.
Keywords: rhinosinusitis, nasal symptoms, upper and lower respiratory tract inflammation, Haemophilus influenzae, chronic obstructive pulmonary disease, phenylephrine, neomycin sulfate, polymixin B.
For citation: Ovchinnikov A.Yu., Miroshnichenko N.A., Nikolaeva Yu.O., Zaitsev A.A. Optimal treatment for infectious rhinosinusitis as a tool to prevent COPD exacerbations. Russian Medical Inquiry. 2023;7(8):511–517 (in Russ.). DOI: 10.32364/2587-6821-2023-7-8-6.
About the authors:
Andrey Yu. Ovchinnikov — Dr. Sc. (Med.), Professor, Head of the Department of Otorhinolaryngology, A.I. Yevdokimov Moscow State University of Medicine and Dentistry; 20/1, Delegatskaya str., Moscow, 127473, Russian Federation; ORCID iD 0000-0002-7262-1151.
Nina A. Miroshnichenko — Dr. Sc. (Med.), Professor of the Department of Otorhinolaryngology, A.I. Yevdokimov Moscow State University of Medicine and Dentistry; 20/1, Delegatskaya str., Moscow, 127473, Russian Federation; ORCID iD 0000-0003-4213-6435.
Yulia O. Nikolaeva — Cand. Sc. (Med.), assistant of the Department of Otorhinolaryngology, A.I. Yevdokimov Moscow State University of Medicine and Dentistry; 20/1, Delegatskaya str., Moscow, 127473, Russian Federation; ORCID iD 0000-0001-7930-8259.
Andrey A. Zaitsev — Dr. Sc. (Med.), Professor, chief pulmonologist of the Ministry of Defense of Russian Federation, chief pulmonologist of the N.N. Burdenko Main Military Clinical Hospital; 3, Gospitalnaya sq., Moscow, 105094, Russian Federation; Head of the Department of Pulmonology (with Allergy Course), BIOTECH University; 11, Volokolamskoe road, Moscow, 125080, Russian Federation; ORCID iD 0000-0002-0934-7313.
Contact information: Yulia O. Nikolaeva, e-mail: yu.o.nikolaeva@gmail.com.
Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.
There is no conflict of interests.
Received 30.05.2023.
Revised 23.06.2023.
Accepted 18.07.2023.
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