COMPLICATED POLYPOUS RHINOSINUSITIS

In the article, a case of severe recurrent polypous rhinosinusitis with the formation of thick mucin and destruction of bone tissue is presented, which required a special approach both in diagnosis and in treatment of the disease. Despite a short duration of the disease in the patient (2 years) and a complex surgical and medical treatment of polypous rhinosinusitis, as well as of concomitant bronchial asthma, the patient again turned to the otorhinolaryngologist for medical help. According to the visual analogue scale, the patient noted a pronounced impairment of the quality of life due to appearance of such symptoms as nasal congestion, anosmia and discharge from the nose – each estimated 10 points. The patient shortly needed the second operation on the paranasal sinuses (SNPs), since severe rhinogenic intracranial complications identified by computed tomography of the nose and SNPs, could threaten his life. The images showed signs of chronic inflammation in the sinuses in the form of hyperostosis of bone structures, high-density inclusions evidencing viscous, thick nasal discharge in the SNP, as well as areas of destruction of the sinus walls. Aggressiveness of the disease to the extent of evident neurological presentation could not be detected without computed tomography. Peculiarities of the course of the disease were identified by such research methods as histological examination of polypous tissue and of thick mucin, as well as by cytological examination of smear reprints from the nasal mucosa and SNP. In our opinion, to determine the nature of the inflammation, rhinocytological examinations should be conducted available in the practice of an otorhinolaryngologist, which will permit to choose the necessary drug therapy based on the pathogenesis of the disease.