Therapy of Nasal Breathing Disturbances in Acute Rhinosinusitis in Children with Hyperplasia of the Pharyngeal Lymphoid Ring

Introduction. The main place of pathogens accumulation and growth in childhood is the lymphoid tissue of the nasopharynx. Often, the development of rhinosinusitis begins with the adenoiditis. The most vulnerable in this situation are the children of preschool age with hyperplasia of the pharyngeal lymphoid ring. In this group, recurrent diseases of the upper respiratory tract are observed. Objective: optimization of the program for therapy of acute rhinosinusitis in children with pharyngeal lymphoid ring hyperplasia. Materials and methods. We observed 100 patients aged 2 to 6 years randomly divided into 2 groups of 50 children each. Regimen of 0.05% xylometazoline solution application: one injection into each nostril twice a day. Sodium chloride 0.9% was used in the form of nasal irrigation in the first group of children twice a day before xylometazoline administration. Clinical method consisted of the evaluation of anamnesis, clinical pattern, general clinical research methods. We took a smear for cytomorphological analysis of the nasal mucosa; performed staining with Giemsa’s diluted solution followed by microscopy, quantitative determination of the secretory IgA (sIgA) in saliva by enzyme immunoassay. The results were processed by the Mann-Whitney test, Fisher’s exact test. Results. Application of 0.05% xylometazoline in combination with a nasal irrigation by NaCl 0.9% has a statistically significant regenerating and sanation effect on the nasal mucosa. Use in xylometazoline with nasal irrigation by sodium chloride 0.9%, in contrast to xylometazoline administration without preparation of the nasal cavity, is not associated with a reduction of sIgA level in saliva, but leads to some increase of it. Conclusion. The use of 0.05% xylometazoline solution with nasal irrigation by sodium chloride 0.9% in the therapeutic regimen for acute rhinosinusitis in children with hyperplasia of the pharyngeal lymphoid ring has significant advantages over the xylometazoline administration without preparation of the nasal cavity