CC BY
28
Ashurov Azimjon Mirzajanovich, Boymuradov Shukhrat Abdujalilovich, Khayruddinova Zulfiya Rafikovna Tashkent Institute of Advanced Medical Education, Tashkent Medical Academy E-mail: zulfiya1406@rambler.ru
Monitoring of frequency of sinusitis in diagrams
Abstract: In recent years more and more authors indicate an increase in frequency of sinusitis that take first place among ENT diseases. Approximately 5-15% of adults and 5% of children suffer from some forms of sinusitis. Approximately 10-15% of patients with rhinosinusitis, arising on a background of acute respiratory infection, take chronic forms. We analyzed the dynamics and frequency of sinusitis in last 5 years. Data are distributed by periods (years), forms of inflammation, the volume of the inflammatory process. A comparative analysis of the frequency of sinusitis for years, months was carried out. In terms of frequency as in acute as in chronic sinusitis the predominant lesion was in maxillary sinuses and the second place took ethmoid sinuses.
Keywords: sinusitis, dynamics, frequency.
In recent years more and more authors indicate an increase in frequency of sinusitis that take first place among ENT diseases. Nowadays the problem of inflammatory diseases of the paranasal sinuses (PNS) remains relevant and has social importance [3; 8]. According to various epidemiological studies conducted in more than 30 countries, the incidence of rhinosinusitis in recent decades has increased almost 3 times, and the proportion of hospitalized patients increases annually by an average of 1.5-2% [7; 9]. Approximately 5-15% of adults and 5% of children suffer from some form of sinusitis [4]. An increment of inflammatory diseases of PNS is largely due to serious environmental problems, in particular because ofsignificantly increased pollution of the air, growth of the number of respiratory infections, the quantity of inhaled allergens, reducing the reserve capacity of the mucosa ofthe upper respiratory tract, increasingly growing resistance of microflora as a result of a broad and irrational use of antibiotics [5]. It is believed that from about 0.5% to 2% of the cases of acute respiratory viral infections are complicated by bacterial infection of PNS [11; 12], but there are higher figures — more than 3% [6; 10; 14]. Acute rhinosinusitis characterized by an increasingly growing trend towards prolonged, subacute and recurrent course followed by chronicity of the pathological process of PNS, the spread of infection
300 ISO
= MlKilljfy liruiiitk
■ Frontitil
S3 i thmoidilk
■ $ptwnoi(iifii
■ Miiiluryfi Lthmcid smuihis
■ F rontcwth moiditiF.
a Ge n¡í niritiiS (ronpoerhmgiditií & I lemmnusLte
■ Pansinusitis
within the respiratory tract. Approximately 10-15% of patients with rhinosinusitis, arising on a background of acute respiratory infection, take chronic forms [4]. Despite the development of effective methods of treatment and new broad spectrum antibiotics chronicity of inflammatory process in paranasal sinuses is not reduced.
The aim of this study. Analysis of the dynamics and frequency of sinusitis in last 5 years.
Subject of study. The study included archival materials of ENT department of clinic hospital in Tashkent where patients were treated with various forms of sinusitis for the period from 2011 to 2015. The number of patients with sinusitis pathology is 1697. All patients passed general clinical and rhinological research methods to establish a final diagnosis. The clinic adheres to the classification of sinusitis by Piskunovs.
Results and discussion. Data are distributed by periods (years), forms of inflammation, the volume of the inflammatory process. A comparative analysis of the frequency of sinusitis for years, months was carried out. There was made an attempt to investigate the relationship between the frequency of sinusitis with weather conditions. According to our data sinusitis has not always ascending growth. This is clearly showed in Figure 1.
In 2011, the number of sinusitis had a tendency to decrease. Reducing of the frequency of sinusitis can be linked to some degree of weather factors. The weather in Central Asia changes often suddenly and this affects acceleration of acute respiratory infections of the upper respiratory tract and other comorbidities. With stable bottom temperature the occurrence of acute respiratory disease, acute respiratory viral infections, therefore, sinusitis decreases. Exactly in 2011 there was the least temperature fall in
Table 1. - The frequency of
autumn-spring periods in comparison to the last 10 years. Sinusitis except previously mentioned classification were assigned to monosinusitis (isolated inflammation of one sinus) and polysinusitis (an inflammation of two and more sinuses).
The number of patients with monosinusitis is 1216, representing 71.66% of the total number of sinusitis. The main part of monosinusitis forms an acute inflammation of the maxillary sinus, followed by frontal sinusitis, further ethmoiditis and sphenoiditis.
sinusitis in nosological forms.
Maxillary sinusitis Frontitis Ethmoiditis Spenoiditis Polysinusitis
Ac. Chr. Ac. Chr. Ac. Chr. Ac. Chr. Ac. Chr.
2012 144 36 24 1 6 21 - 1 80 14
2013 170 51 13 2 3 51 3 1 179 12
2014 124 75 27 3 3 52 1 6 84 13
2015 166 52 44 7 2 54 14 6 138 23
As can be seen from the Graph 2, as always, the maxillary sinus leads among the frequency of sinusitis inflammation. In chronic course this pattern persists as chronic maxillary sinusitis takes 20,48% (230 patients) among chronic monosinusitis. Comparatively few cases of isolated inflammation occur in frontal and sphenoid sinuses.
Combined lesion of the paranasal sinuses — polysinusitis are the most common diseases of the paranasal sinuses and has a ten-
dency to growth not equally but unevenly. In the analysis of the frequency of unilateral or bilateral inflammation of the maxillary sinus we received the following data: acute maxillary sinusitis occurs most of all while chronic inflammation of the maxillary sinus is not frequent. This may be related to the use of rational therapy. According to our data chronicity of inflammation in the sinuses has a tendency to decrease.
Graph 2. The frequency and the form of maxillary sinusitis by periods
Earlier on the second place in frequency of sinusitis was sinusitis of cells of ethmoidal labyrinth, while the last time frontitis is more often revealed in practice. Acute frontitis diagnosed more as it related to the clinical course of frontal sinusitis. As it is known, frontal sinus-
itis occur with bright signs accompanied by pain syndrome. Patients are forced to seek medical advice in the early stages of the disease. A well-designed treatment strategy prevents the development of chronic process in the frontal sinus. It can be seen in Graph № 3.
Graph 3. The frequency and form of frontitis by periods
Unlike other sinusitis, chronic ethmoiditis markedly exceeds of ethmoidal labyrinth has a poor clinical presentation masked acute one. In our opinion this is due to the fact that acute eth- by clinic of acute respiratory viral infection, acute respiratory moiditis are not always diagnosed. Acute inflammation of the cells deseases.
Etmoiditis are often unnoticed and are a random finding on radiologic diagnostic of the paranasal sinuses, brain. Acute inflammation and allergic process untreated in time will undoubtedly lead to chronization and mucosal proliferation of ethmoidal labyrinth
cells. The heading "chronic ethmoiditis" includes also a polypoid inflammation of the cells of the labyrinth, and the percentage of this disease increases significantly (Graph 4).
Graph 4. The frequency and forms of etmoiditis by periods
Deep location ofbasic sinus does not excludes its inflammation, but in practice sphenoiditis considered a relatively rare disease. As noted by many authors, sphenoiditis has a polymorphic clinic reminding neurological, ophthalmological, neurosurgical diseases. The main methods of diagnosis of sphenoiditis are CT, MRI [1; 2]. Since the introduction of these techniques, the detection of sphenoiditis had
sharply increased. As the Graph № 6 shows the main part of sphenoiditis forms a chronic form of inflammation. This points again to the late diagnosis, frequent recurrence after conservative therapy. As a result, chronicity of inflammatory process in the basic sinus becomes more frequent. Our experience shows that it is needed to treat sphenoiditis surgically, i. e. by expansion of the natural anastomosis.
Graph 5. The frequency and forms of sphenoiditis by periods
According to our opinion, polisinusitis play an important role in increased frequency of sinusitis. The main share of sinusitis comes exactly to polisinusitis. In terms of frequency they ranked the second place after maxillary sinusitis. The modern methods
of investigation of the paranasal sinuses such as computed tomography, magnetic resonance tomography give an objective data of the status of all sinuses simultaneously, and the combined defeat of several paranasal sinuses often detected.
Graph 6. The frequency and forms of polisinusitis by periods
Sphenoethmoiditis and Antrosphenoethmoiditis were not Conclusion: The frequency of sinusitis is undoubtedly
revealed. growing in a large period (5-10 years). In a short period of time
the number of patients with sinusitis may decrease. In terms of frequency as in acute as in chronic sinusitis the predominant lesion was in maxillary sinuses and the second place took ethmoid
sinuses. An increased prevalence of disease of the paranasal sinuses is mainly due to the combined lesions of several cavities simultaneously.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Graph 7. The frequency and forms of hemisinusitis by periods
Graph 8. The frequency and forms of pansinusitis by periods References:
Kiselev A. S. Features of high-resolution computed tomography and visualization of anatomic structure of a ethmoidal labyrinth/A. S. Kiselev, D. V. Rudenko, I. F. Fedorova, etc.//Russian Rhinology. -1999. -№ 3. P. 10-15. Kozlov V. S., Shilenkova V. V., Shilenkov A. A. Consilium medicum. 2003; 53. Kozlov V. S. Russian Rhinology. 2003; 3: 20-4.
Lopatin A. S. Magnetic resonance imaging and examination of the nasal cavity and paranasal sinuses/A. S. Lopatin, M. V. Artsiba-sheva//Russian rhinology. - 1996. - № 5. - SZ-14. Lopatin A. S. Russian Medical Journal, 2000; 8 (5). Lyutova N. V., Piskunov G. Z. Russian Rhinology. 2008; 2: 17.
Morozov S. A., Kaznacheeva S. V., Novikova N. V., Kuznetsova O. N. Russian Rhinology. - 2002; 2: 105-8. Ovchinnikov A.Yu., Ponyakina M. A., Kolbanova I. G. Consilium medicum. - 2005; 7: 10. Piskunov G. Z. Clinical Rhinology - 2002, P. 225-233. Sakovich A. R., Perminov A. B. ARS medica. - 2009; 2: 48-49.
11. Stratchounski L. S., Kamanin E. I. Russian Medical Journal. - 1998; 6: 684-93.
12. Tarasov A. A., Kamanin E. I., Kryukov A. I., Stratchounski L. S. Bulletin of Otorhinolaryngology. - 2003; 2: 47-54.
13. Anand V. K. Annuals of Otolorhinolaryngology. Suppl. - 2004; (193): 3-5.
14. Durr D. G., Desrosiers, M. Y., Dassa, C. J Otolaryngol - 2001; 30 (2): 93-732.
