Abstract:
PURPOSE: To perform a prospective comparative in
vitro study of the nasal mucociliary epithelium activity
in patients with fungus ball of the maxillary sinus for
adjustment of the diagnostic protocol, conservative
treatment and to establish the variety of infectious
agents involved in this clinical entity.
METHODS: Clinical prospective study. Study group I:
30 patients – surgical treatment and conservative treatment with dry extract BNO 1016 14 days preoperatively, nasal saline irrigations, topical vasoconstrictors.
Study group II: 30 patients – surgical treatment and
conservative treatment with nasal saline irrigations,
topical vasoconstrictors. Methods: patients were interviewed using the SNOT 22 test. Microbiological and
histopathological methods were used. Instrumental
methods (nasal endoscopy, CT, in vitro estimation of
vibrational activity of pituitary cells) were performed.
RESULTS: Fungus ball is a localized, non-invasive,
slightly aggressive, extramucosal fungal rhinosinusitis.
The importance of restoring the nasal mucosa function and the local immunity after a fungal process is
primary in improving the quality of life of our patients.
The mucociliary system is an important component of
the innate system of the respiratory tract protection
against the action of pollutants, allergens and pathogenic microorganisms. Mucociliary clearance is a natural process of airway cleaning. Failure of the nasal
mucociliary clearance and local immune-biochemical
indices is one of the basic links in the pathogenesis of
many rhinosinusal diseases. Statistic test applied:
Anova. In our study, the frequency of ciliary movements after the post-surgical conservative treatment was statistically significantly higher in patients of
group I compared to patients in group II (4.9±0.06 Hz
and 8.5±0.1 Hz, respectively, p<0.001), and subjects in
the control group (4.9±0.06 Hz and 11.9±0.3 Hz, respectively, p<0.001).
CONCLUSIONS: (1). The frequency of ciliary movements was statistically higher in patients in group I compared to those in group II. (2). This can be caused by
the use of dry extract BNO 1016 that has an anti-inflammatory and regenerative effect, facilitating the dissolution of mucous secretions and restoring the integrity of
the nasal mucosa and mucociliary epithelium. (3). Processes occurring in the mucociliary epithelium, including non-specific and specific immunity, require a more
detailed description, because they allow to understand
the physiopathological mechanisms of fungal rhinosinusitis and are potential therapeutic targets.