ROLE OF NASOPHARYNGEAL STATUS IN THE TREATMENT OF TYPE 2 PRIMARY DIFFUSE CHRONIC RHINOSINUSITIS IN ADULT PATIENTS

Authors:

Abstract:

The study was devoted to evaluating the role of the nasopharyngeal zone in the course and treatment of type 2 primary diffuse chronic rhinosinusitis in adults. A total of 339 patients were examined, of whom 68 (20.06 %) had concomitant chronic nasopharyngitis. At the second stage, 58 patients with chronic nasopharyngitis and 91 patients without it received standard therapy supplemented with the mucosal bacterial vaccine Lantigen B, whereas 36 control patients received standard treatment alone. Clinical, videoendoscopic, functional, microbiological, and immunological assessments were performed. Patients with chronic nasopharyngitis more frequently demonstrated grade I adenoid vegetations, greater clinical severity, pronounced nasopharyngeal dysbiosis, and middle-ear involvement. The addition of Lantigen B resulted in a significantly greater reduction in symptoms, normalization of the nasopharyngeal microbiome and secretory IgA levels in oropharyngeal secretions, and a lower incidence of acute otitis media and otitis media with effusion, particularly in patients with concomitant chronic nasopharyngitis.

Keywords:

chronic rhinosinusitis chronic nasopharyngitis otitis media allergy pharyngeal tonsil bacterial complications microbiome dysbiosis immunocorrection mucosal vaccine

References:

1. Holubovska OA, editor. Infektsiini khvoroby: pidruchnyk. 2nd ed. Kyiv: VSV «Medytsyna»; 2018. 688 p. [in Ukrainian].
2. Zabolotny DI, Melnikov OF, Tymchenko SV, Zabolotna DD, Faraon IV, Vakhnina HP, et al. Patofiziolohichni osnovy pidvyshchennia protyinfektsiinoi rezystentnosti slyzovoi obolonky dykhalnykh shliakhiv. Zhurnal vushnykh, nosovykh i horlovykh khvorob. 2018;(5-S):34. [in Ukrainian].
3. Kosakivska IA. Trudnoshchi diahnostyky adenoidnykh vehetatsii u ditei. Sovremennaya pediatriya. 2018;5(93):11–13. DOI: 10.15574/SP.2018.93.11. [in Ukrainian].
4. Naumenko OM, Krynychko LR, Motailo OV. Rol mikrobiomu nosovoi porozhnyny u patohenezi khronichnoho rynosynusytu: systematychnyi ohliad ta metaanaliz. Otorinolarynholohiia. 2025;1–2(8):52–76. DOI: 10.37219/2528-8253-2025-1-2-42. [in Ukrainian].
5. Popovych VI, Koshel IV. Infektsiia ta alerhiia: yak rozirvaty zamknene kolo. Zdorovia Ukrainy. Tematychnyi nomer «Pediatriia». 2023;2(68):12–13. [in Ukrainian].
6. Bidaye R, Desarda K, Thakkar J, William CS. Adenoid hypertrophy in adults. JSM Head Face Med. 2018;3(1):1007.
7. Braido F, Melioli G, Nicolini G, Canonica GW. Prevention of recurrent respiratory tract infections: a literature review of the activity of the bacterial lysate Lantigen B. Eur Rev Med Pharmacol Sci. 2023;27(16):7756–7767. DOI: 10.26355/eurrev_202308_33430.
8. de Bonnecaze G, Chaput B, Dupret-Bories A, Vergez S, Serrano E. Functional outcome after long-term low-dose trimethoprim/sulfamethoxazole in chronic rhinosinusitis with purulence: a prospective study. J Laryngol Otol. 2018;132(7):600–604. DOI: 10.1017/S0022215118000452.
9. Hauser LJ, Ir D, Kingdom TT, Robertson CE, Frank DN, Ramakrishnan VR. Investigation of bacterial repopulation after sinus surgery and perioperative antibiotics. Int Forum Allergy Rhinol. 2016;6(1):34–40. DOI: 10.1002/alr.21630.
10. Ikramova FS. Treatment of chronic adenoiditis in children. Int J Integr Mod Med. 2023;1(2):61–65.
11. Koutsourelakis I, Halderman A, Khalil S, Hittle LE, Mongodin EF, Lane AP. Temporal instability of the post-surgical maxillary sinus microbiota. BMC Infect Dis. 2018;18(1):441. DOI: 10.1186/s12879-018-3272-9.
12. Pu K, Zhang Z, Li L. Associations between gut microbiota and chronic sinusitis: a bidirectional Mendelian randomization study. Immun Inflamm Dis. 2024;12(7):e1328. DOI: 10.1002/iid3.1328.
13. Purnell PR, Ramadan JH, Ramadan HH. Can symptoms differentiate between chronic adenoiditis and chronic rhinosinusitis in pediatric patients? Ear Nose Throat J. 2019;98(5):279–282. DOI: 10.1177/0145561319840133.
14. Smith SS, Kim R, Douglas R. Is there a role for antibiotics in the treatment of chronic rhinosinusitis? J Allergy Clin Immunol. 2022;149(5):1504–1512. DOI: 10.1016/j.jaci.2022.02.004.
15. Weinstock J, Chen XX, Nino G, Koumbourlis A, Rastogi D. The interplay between airway epithelium and the immune system – a primer for the respiratory clinician. Paediatr Respir Rev. 2021;38:2–8. DOI: 10.1016/j.prrv.2021.03.002.

Publication:

«World of Medicine and Biology» Vol. 22 No. 96 (2026) , с. 111-116
УДК 616.321-002:616-092

DOI:

https://doi.org/10.26724/2079-8334-2026-2-96-111-116