medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2020-17-132-140medsovet-5886Research ArticleАллергологияAllergologyАллергический ринит в период пандемии коронавирусной инфекции: сложности диагностики и особенности терапииAllergic rhinitis during a coronavirus pandemic: difficulties of diagnosis and features of therapyhttps://orcid.org/0000-0002-3508-9602СебекинаО. В.SebekinaO. V.

Себекина Оксана Владимировна, кандидат медицинских наук, ассистент кафедры аллергологии и иммунологии

125993, Москва, ул. Баррикадная, д. 2/1, стр. 1

Oksana V. Sebekina, Cand. of Sci. (Med.), Teaching Assistant, Department of Allergology and Immunology

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993

sebekin1@mail.ruhttps://orcid.org/0000-0002-3951-3810ПередковаЕ. В.PeredkovaE. V.

Передкова Елена Владимировна, кандидат медицинских наук, доцент кафедры аллергологии и иммунологии

125993, Москва, ул. Баррикадная, д. 2/1, стр. 1

Elena V. Peredkova, Cand. of Sci. (Med.), Associate Professor, Department of Allergology and Immunology

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993

НенашеваН. М.NenashevaN. M.

Ненашева Наталия Михайловна, доктор медицинских наук, профессор, заведующая кафедрой аллергологии и иммунологии

125993, Москва, ул. Баррикадная, д. 2/1, стр. 1

Natalia M. Nenasheva, Dr. of Sci. (Med.), Professor, Head of Department of Allergology and Immunology

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993

ГребенниковаЮ. В.GrebennikovaYu. V.

Гребенникова Юлия Владимировна, клинический ординатор кафедры аллергологии и иммунологии

125993, Москва, ул. Баррикадная, д. 2/1, стр. 1

Yuliya V. Grebennikova, Resident Physician, Department of Allergology and Immunology

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993

Российская медицинская академия непрерывного профессионального образованияРоссияRussian Medical Academy of Continuing Professional EducationRussian Federation202021112020017132140Copyright © Себекина О.В., Передкова Е.В., Ненашева Н.М., Гребенникова Ю.В., 20202020Себекина О.В., Передкова Е.В., Ненашева Н.М., Гребенникова Ю.В.Sebekina O.V., Peredkova E.V., Nenasheva N.M., Grebennikova Y.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/5886

Аллергический ринит встречается в практике врачей разных специальностей. В ряде случаев возникают сложности при проведении дифференциальной диагностики ринита, постановке правильного диагноза и назначении адекватной терапии. Эпидемия COVID-19 (Coronavirus Disease 2019) уже вошла в историю как чрезвычайная ситуация международного значения. За короткий период, с января 2020 г., уже накоплено достаточно сведений об этиологии, особенностях клинических проявлений этого заболевания, разработаны методы диагностики, продолжают отрабатываться клинические подходы и схемы лечения. Пандемия совпала с последовательными сезонами палинации деревьев, злаковых и сорных трав. В начале пыльцевого сезона врачи были обеспокоены возможной сложностью дифференциальной диагностики аллергического ринита, проявлениями коронавирусной и других вирусных инфекций. В процессе наблюдения за пациентами накапливалось все больше данных, свидетельствующих об особенностях клинических характеристик COVID-19, гриппа, острых респираторных инфекций, сезонного аллергического ринита (риноконъюнктивита). Терапия должна быть направлена на общий контроль симптомов АР. За последние десятилетия разработана концепция фенотипирования (определение заболевания по его клиническим проявлениям) и эндотипирования (исходя из патофизиологических механизмов заболевания). Принадлежность АР у конкретного пациента к определенному фенотипу играет ключевую роль в выборе максимально эффективной терапии и требует персонализированного подхода к лечению. В статье приводятся часто задаваемые вопросы, касающиеся лечения АР в период пандемии COVID-19. Обсуждается роль интраназальных ГКС, которые являются самыми эффективными препаратами в терапии АР, что обусловлено их выраженным противовоспалительным действием и влиянием на все этапы патогенеза болезни. Мометазона фуроат назальный спрей имеет самые широкие показания среди всех препаратов ИнГКС, зарегистрированных в нашей стране.

Rhinitis can be of various etiologies. More often it is an infectious process (bacterial, viral) or clinical manifestations of an immediate allergic reaction. Other factors that provoke the development of rhinitis, for example, irritating substances, a number of drugs, hormonal imbalance, neurovegetative dysfunction, viruses are known. Doctors of various specialties are familiar with allergic rhinitis (AR) in their practice. In a number of cases there can be some difficulties in the differential diagnosis of rhinitis, the correct diagnosis and the appointment of adequate therapy. The COVID-19 epidemic (“coronavirus disease 2019”) has already been imprinted in the global history as an emergency of international importance. Scientific medical communities continue to study the characteristics of this epidemic, which is regarded by WHO as a pandemic. In a short period (from January 2020), there has been accumulated enough information about the etiology, features of the clinical manifestations of this disease, diagnostic methods have been developed, and clinical approaches and treatment regimens continue to be developed. The pandemic coincided with successive pollen seasons of trees, grasses and weeds. At the beginning of the pollen season, doctors were concerned about the possible difficulty in differential diagnosis of allergic rhinitis, manifestations of coronavirus and other viral infections. In the process of monitoring patients, more and more data has been accumulated, indicating the features of the clinical characteristics of COVID-19, influenza, acute respiratory infections, seasonal allergic rhinitis (rhinoconjunctivitis). Undoubtedly, information is still being accumulating and enriching day by day. AR is not only the most common form of rhinitis, but one of the most common diseases in children and adults. It is known about the pronounced negative effect of AR symptoms on the patient’s quality of life: normal daily activity, cognitive functions, mood, sleep. The severity of AR symptoms varies from minimal clinical manifestations to severe. Therapy should be directed towards the general control of AR symptoms. Over the past decades, the concept of phenotyping (definition of a disease by its clinical manifestations) and endotyping (based on the pathobiological mechanisms of the disease) has been developed. The belonging of AR in a particular patient to a certain phenotype plays a key role in choosing the most effective therapy and requires a personalized approach to treatment. The article provides frequently asked questions regarding AR treatment during the COVID-19 pandemic. The role of intranasal corticosteroids (InHCS), which are the most effective drugs in AR therapy, is discussed, due to their pronounced anti-inflammatory effect and influence on all stages of the pathogenesis of the disease. Mometasone furoate nasal spray has the widest indications among all InHCS drugs registered in our country.

аллергический риниткоронавирусдифференциальная диагностикамометазона фуроатCOVID-19allergic rhinitiscoronavirusdifferential diagnosismometasone furoateCOVID-19ReferencesCruz A.A., Camargos P.A., Urrutia-Pereira M., Stelmach R. Global Alliance against Chronic Respiratory Diseases (GARD) Brazil success case: overcoming barriers. J Thorac Dis. 2018;10(1):534–538. doi: 10.21037/jtd.2018.01.40.Cruz A.A., Camargos P.A., Urrutia-Pereira M., Stelmach R. Global Alliance against Chronic Respiratory Diseases (GARD) Brazil success case: overcoming barriers. J Thorac Dis. 2018;10(1):534–538. doi: 10.21037/jtd.2018.01.40.Bousquet J., Khaltaev N., Cruz A.A., Denburg J., Fokkens W.J., Togias A. et al. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA2 LEN and AllerGen). Allergy. 2008;63(Suppl. 86):8–160. doi: 10.1111/j.1398-9995.2007.01620.x.Bousquet J., Khaltaev N., Cruz A.A., Denburg J., Fokkens W.J., Togias A. et al. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA2 LEN and AllerGen). Allergy. 2008;63(Suppl. 86):8–160. doi: 10.1111/j.1398-9995.2007.01620.x.Blaiss M.S. Allergic rhinitis: Direct and indirect costs. Allergy Asthma Proc. 2010;31(5):375–380. doi: 10.2500/aap.2010.31.3329.Blaiss M.S. Allergic rhinitis: Direct and indirect costs. Allergy Asthma Proc. 2010;31(5):375–380. doi: 10.2500/aap.2010.31.3329.Bousquet J., Fokkens W., Burney P., Durham S.R., Bachert C., Akdis C.A. et al. Important research questions in allergy and related diseases: nonallergic rhinitis: a GA2 LEN paper. Allergy. 2008;63(7):842–853. doi: 10.1111/j.1398-9995.2008.01715.x.Bousquet J., Fokkens W., Burney P., Durham S.R., Bachert C., Akdis C.A. et al. Important research questions in allergy and related diseases: nonallergic rhinitis: a GA2 LEN paper. Allergy. 2008;63(7):842–853. doi: 10.1111/j.1398-9995.2008.01715.x.Brożek J.L., Bousquet J., Agache I., Agarwal A., Bachert C., Bosnic-Anticevich S. et al. Allergic Rhinitis and its Impact on Asthma (ARIA) Guidelines – 2016 Revision. J Allergy Clin Immunol. 2017;140(4):950–958. doi: 10.1016/j.jaci.2017.03.050.Brożek J.L., Bousquet J., Agache I., Agarwal A., Bachert C., Bosnic-Anticevich S. et al. Allergic Rhinitis and its Impact on Asthma (ARIA) Guidelines – 2016 Revision. J Allergy Clin Immunol. 2017;140(4):950–958. doi: 10.1016/j.jaci.2017.03.050.Hellings P.W., Klimek L., Cingi C., Agache I., Akdis C., Bachert C. et al. Nonallergic rhinitis: Position paper of the European Academy of Allergy and Clinical Immunology. Allergy. 2017;72(11):1657–1665. doi: 10.1111/all.13200.Hellings P.W., Klimek L., Cingi C., Agache I., Akdis C., Bachert C. et al. Nonallergic rhinitis: Position paper of the European Academy of Allergy and Clinical Immunology. Allergy. 2017;72(11):1657–1665. doi: 10.1111/all.13200.Akdis C.A., Hellings P.W., Agache I. (ed.). Global Atlas of Allergic Rhinitis and Chronic Rhinosinusitis. Published by the European Academy of Allergy and Clinical Immunology. Zurich, Switzerland: European Academy of Allergy and Clinical Immunology; 2015, pp. 232–233. Available at: https://www.zora.uzh.ch/id/eprint/140934/1/GlobalAtlasAllergy.pdf.Akdis C.A., Hellings P.W., Agache I. (ed.). Global Atlas of Allergic Rhinitis and Chronic Rhinosinusitis. Published by the European Academy of Allergy and Clinical Immunology. Zurich, Switzerland: European Academy of Allergy and Clinical Immunology; 2015, pp. 232–233. Available at: https://www.zora.uzh.ch/id/eprint/140934/1/GlobalAtlasAllergy.pdf.Papadopoulos N.G., Bernstein J.A., Demoly P., Dykewicz M., Fokkens W., Hellings P.W. et al. Phenotypes and endotypes of rhinitis and their impact on management: a PRACTALL report. Allergy. 2015;70(5):474–494. doi: 10.1111/all.12573.Papadopoulos N.G., Bernstein J.A., Demoly P., Dykewicz M., Fokkens W., Hellings P.W. et al. Phenotypes and endotypes of rhinitis and their impact on management: a PRACTALL report. Allergy. 2015;70(5):474–494. doi: 10.1111/all.12573.Sin B., Togias A. Pathophysiology of allergic and nonallergic rhinitis. Proc Am Thorac Soc. 2011;8(1):106–114. 10.1513/pats.201008-057RN.Sin B., Togias A. Pathophysiology of allergic and nonallergic rhinitis. Proc Am Thorac Soc. 2011;8(1):106–114. 10.1513/pats.201008-057RN.Wilson K.F., Spector M.E., Orlandi R.R. Types of rhinitis. Otolaryngol Clin North Am. 2011;44(3):549–559. doi: 10.1016/j.otc.2011.03.016.Wilson K.F., Spector M.E., Orlandi R.R. Types of rhinitis. Otolaryngol Clin North Am. 2011;44(3):549–559. doi: 10.1016/j.otc.2011.03.016.Rondón C., Doña I., López S., Campo P., Romero J.J., Torres M.J. et al. Seasonal idiopathic rhinitis with local inflammatory response and specific IgE in absence of systemic response. Allergy. 2008;63(10):1352–1358. doi: 10.1111/j.1398-9995.2008.01695.x.Rondón C., Doña I., López S., Campo P., Romero J.J., Torres M.J. et al. Seasonal idiopathic rhinitis with local inflammatory response and specific IgE in absence of systemic response. Allergy. 2008;63(10):1352–1358. doi: 10.1111/j.1398-9995.2008.01695.x.Rondón C., Romero J.J., López S., Antúnez C., Martín-Casañez E., Torres M.J. et al. Local IgE production and positive nasal provocation test in patients with persistent nonallergic rhinitis. J Allergy Clin Immunol. 2007;119(4):899–905. doi: 10.1016/j.jaci.2007.01.006.Rondón C., Romero J.J., López S., Antúnez C., Martín-Casañez E., Torres M.J. et al. Local IgE production and positive nasal provocation test in patients with persistent nonallergic rhinitis. J Allergy Clin Immunol. 2007;119(4):899–905. doi: 10.1016/j.jaci.2007.01.006.Powe D.G., Huskisson R.S., Carney A.S., Jenkins D., McEuen A.R., Walls A.F., Jones N.S. Mucosal T-cell phenotypes in persistent atopic and nonatopic rhinitis show an association with mast cells. Allergy. 2004;59(2):204–212. doi: 10.1046/j.1398-9995.2003.00315.x.Powe D.G., Huskisson R.S., Carney A.S., Jenkins D., McEuen A.R., Walls A.F., Jones N.S. Mucosal T-cell phenotypes in persistent atopic and nonatopic rhinitis show an association with mast cells. Allergy. 2004;59(2):204–212. doi: 10.1046/j.1398-9995.2003.00315.x.Астафьева Н.Г., Баранов А.А., Вишнева Е.А., Дайхес Н.А., Жестков А.В., Ильина Н.И. и др. Аллергический ринит: клинические рекомендации. M.; 2019. 84 с. Режим доступа: https://raaci.ru/education/clinic_recomendations/471.html.Astafeva N.G., Baranov A.A., Vishneva E.A., Daykhes N.A., Zhestkov A.V., Ilina N.I. et al. Allergic rhinitis: clinical guidelines. Moscow; 2019. 84 p. (In Russ.) Available at: https://raaci.ru/education/clinic_recomendations/471.html.Ревякина В.А., Дайхес Н.А., Геппе Н.А. РАДАР. Аллергический ринит у детей: рекомендации и алгоритм при детском аллергическом рините. М.: Оригинал-макет; 2015. 80 с. Режим доступа: https://mosgorzdrav.ru/uploads/imperavi/ru-RU/029_2015.pdf.Revyakina V.A., Daikhes N.A., Geppe N.A. RADAR. Allergic rhinitis in children: recommendations and algorithm for childhood allergic rhinitis. Moscow: Original-maket; 2015. 80 p. (In Russ.) Available at: https://mosgorzdrav.ru/uploads/imperavi/ru-RU/029_2015.pdf.Klompas M., Branson R., Eichenwald E.C., Greene L.R., Howell M.D., Lee G. et al. Strategies to prevent ventilator-associated pneumonia in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol. 2014;35(8):915–936. Available at: https://pubmed.ncbi.nlm.nih.gov/25026607.Klompas M., Branson R., Eichenwald E.C., Greene L.R., Howell M.D., Lee G. et al. Strategies to prevent ventilator-associated pneumonia in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol. 2014;35(8):915–936. Available at: https://pubmed.ncbi.nlm.nih.gov/25026607.Liu J., Zheng X., Tong Q., Li W., Wang B., Sutter K. et al. Overlapping and discrete aspects of the pathology and pathogenesis of the emerging human pathogenic coronaviruses SARS-CoV, MERS-CoV, and 2019-nCoV. J Med Virol. 2020;92(5):491–494. doi: 10.1002/jmv.25709.Liu J., Zheng X., Tong Q., Li W., Wang B., Sutter K. et al. Overlapping and discrete aspects of the pathology and pathogenesis of the emerging human pathogenic coronaviruses SARS-CoV, MERS-CoV, and 2019-nCoV. J Med Virol. 2020;92(5):491–494. doi: 10.1002/jmv.25709.Никифоров В.В., Суранова Т.Г. Новая коронавирусная инфекция (COVID19): клинико-эпидемиологические аспекты. Архив внутренней медицины. 2020;(2):24–28. doi: 10.20514/2226-6704-2020-10-2-87-93.Nikiforov V.V., Suranova T.G., Chernobrovkina T.Yu., Yankovskaya Y.D., Burova S.V. New Coronavirus Infection (Covid-19): Clinical and Epidemiological Aspects. Arkhiv vnutrenney meditsiny = The Russian Archives of Internal Medicine. 2020;10(2):87–93. (In Russ.) doi: 10.20514/2226-6704-2020-10-2-87-93.Jackson D., Busse W., Bacharier L.B., Togias A., Gern J.E., Altman M.C. et al. Association of respiratory allergy, asthma, and expression of the SARSCoV-2 receptor ACE2. J Allergy Clin Immunol. 2020;146(1):203–206.e3. doi: 10.1016/j.jaci.2020.04.009.Jackson D., Busse W., Bacharier L.B., Togias A., Gern J.E., Altman M.C. et al. Association of respiratory allergy, asthma, and expression of the SARSCoV-2 receptor ACE2. J Allergy Clin Immunol. 2020;146(1):203–206.e3. doi: 10.1016/j.jaci.2020.04.009.Guan W.J., Ni Z.Y., Hu Y., Liang W.H., Ou C.Q., He J.X. et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;382:1708–1720. doi: 10.1056/NEJMoa2002032.Guan W.J., Ni Z.Y., Hu Y., Liang W.H., Ou C.Q., He J.X. et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;382:1708–1720. doi: 10.1056/NEJMoa2002032.Rochwerg B., Alhazzani W., Gibson A., Ribic C.M., Sindi A., Heels-Ansdell D. et al. Fluid type and the use of renal replace-ment therapy in sepsis: a systematic review and network meta-analysis. Intensive Care Med. 2015;41(9):1561–1571. doi: 10.1007/s00134-015-3794-1.Rochwerg B., Alhazzani W., Gibson A., Ribic C.M., Sindi A., Heels-Ansdell D. et al. Fluid type and the use of renal replace-ment therapy in sepsis: a systematic review and network meta-analysis. Intensive Care Med. 2015;41(9):1561–1571. doi: 10.1007/s00134-015-3794-1.Epidemiology Working Group for NCIP Epidemic Response, Chinese Center for Disease Control and Prevention. The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) in China. Zhonghua Liu Xing Bing Xue Za Zhi. 2020;41(2):145–151. doi: 10.3760/cma.j.issn.0254-6450.2020.02.003.Epidemiology Working Group for NCIP Epidemic Response, Chinese Center for Disease Control and Prevention. The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) in China. Zhonghua Liu Xing Bing Xue Za Zhi. 2020;41(2):145–151. doi: 10.3760/cma.j.issn.0254-6450.2020.02.003.Rochwerg B., Alhazzani W., Sindi A., Heels-Ansdell D., Thabane L., Fox-Robichaud A. et al. Fluid resuscitation in sepsis: a systematic review and network meta-analysis. Ann Intern Med. 2014;161(5):347–355. doi: 10.7326/M14-0178.Rochwerg B., Alhazzani W., Sindi A., Heels-Ansdell D., Thabane L., FoxRobichaud A. et al. Fluid resuscitation in sepsis: a systematic review and network meta-analysis. Ann Intern Med. 2014;161(5):347–355. doi: 10.7326/M14-0178.Yang J.M., Koh H.Y., Moon S.Y., Kim S.Y., Yon D.K. Allergic disorders and susceptibility to and severity of COVID-19: A nationwide cohort study J Allergy Clin Immunol. 2020;146(4):790–798. doi: 10.1016/j.jaci.2020.08.008.Yang J.M., Koh H.Y., Moon S.Y., Kim S.Y., Yon D.K. Allergic disorders and susceptibility to and severity of COVID-19: A nationwide cohort study J Allergy Clin Immunol. 2020;146(4):790–798. doi: 10.1016/j.jaci.2020.08.008.Peters M.C., Sajuthi S., Deford P., Christenson S., Rios C.L., Montgomery M.T. et al. COVID-19-related Genes in Sputum Cells in Asthma. Relationship to Demographic Features and Corticosteroids. Am J Respir Crit Care Med. 2020;202(1):83–90. doi: 10.1164/rccm.202003-0821OC.Peters M.C., Sajuthi S., Deford P., Christenson S., Rios C.L., Montgomery M.T. et al. COVID-19-related Genes in Sputum Cells in Asthma. Relationship to Demographic Features and Corticosteroids. Am J Respir Crit Care Med. 2020;202(1):83–90. doi: 10.1164/rccm.202003-0821OC.Рязанцев С.В., Артюшкин С.А., Будковая М.А., Артемьева Е.С. Место топических кортикостероидов в терапии аллергического ринита. Медицинский совет. 2018;(8):72–76. doi: 10.21518/2079-701X-2018-8-72-76.Ryazantsev S.V., Artuyshkin S.A., Budkovaya M.A., Artemyeva E.S. Place of topical corticosteroids in therapy of allergic rhinitis. Meditsinskiy sovet = Medical Council. 2018;(8):72–76. (In Russ.) doi: 10.21518/2079-701X-2018-8-72-76.Федоскова Т.Г., Носуля Е.В., Ненашева Н.М. Новое слово в лечении аллергического ринита. Эффективная фармакотерапия. 2017;(28):14–20. Режим доступа: https://umedp.ru/magazines/effektivnaya-farmakoterapiya-/.Fedoskova T.G., Nosulya E.V., Nenasheva N.M. A new word in the treatment of allergic rhinitis. Effektivnaya farmakoterapiya = Effective Pharmacotherapy. 2017;28:14–20. (In Russ.) Available at: https://umedp.ru/magazines/effektivnaya-farmakoterapiya-/.Rossi O., Massaro I., Caminati M., Quecchia C., Fassio F., Heffler E., Canonica G.W. Escaping the trap of allergic rhinitis. Clin Mol Allergy. 2015;13(1):17. doi: 10.1186/s12948-015-0023-y.Rossi O., Massaro I., Caminati M., Quecchia C., Fassio F., Heffler E., Canonica G.W. Escaping the trap of allergic rhinitis. Clin Mol Allergy. 2015;13(1):17. doi: 10.1186/s12948-015-0023-y.Рязанцев С.В., Будковая М.А., Артемьева Е.С., Хамгушкеева Н.Н. Полипозный риносинусит: основные аспекты противорецидивной терапии и восстановления носового дыхания. Медицинский совет. 2019;(20):13-18. doi: https://doi.org/10.17116/rosrino201725154-59.Ryazantsev S.V., Budkovaya M.A., Artemyeva E.S., Khamgushkeeva N.N. Rhinosinusitis with nasal polyps: main aspects of anti-relapse therapy and recovery of nasal breathing. Meditsinskiy sovet = Medical Council. 2019;(20):13-18. (In Russ.) doi: 10.17116/rosrino201725154-59.Савватеева Д.М., Кочетков П.А., Лопатин А.С. Влияние хирургического и медикаментозного лечения на обонятельную функцию у пациентов с полипозным риносинуситом. Вестник оториноларингологии. 2012;77(2):31–35. Режим доступа: https://www.mediasphera.ru/issues/vestnik-otorinolaringologii/2012/2/030042-4668201226.Savvateeva D.M., Kochetkov P.A., Lopatin A.S. The influence of the surgical and medicamental treatment on the olfactory function inpatients presenting with polypous rhinosinusitis. Vestnik otorinolaringologii = Bulletin of Otorhinolaryngology. 2012;77(2):31–35. (In Russ.) Available at: https://www.mediasphera.ru/issues/vestnik-otorinolaringologii/2012/2/030042-4668201226.Ушкалова Е.А., Зырянов С.К., Шварц Г.Я. Интраназальные глюкокортикостероиды в терапии риносинусита: фокус на мометазона фуроат. Вестник отоларингологии. 2016;81(5):59–66. doi: 10.17116/otorino201681559-66.Ushkalova E.A., Zyryanov S.K., Shvarts G.Ya. The use of intranasal glucocorticosteroids in the treatment of rhinosinusitis: Focus on mometasone furoate. Vestnik otorinolaringologii = Bulletin of Otorhinolaryngology. 2016;81(5):59–66. (In Russ.) doi: 10.17116/otorino201681559-66.Bielory L., Chun Y., Bielory B.P., Canonica G.W. Impact of mometasone furoate nasal spray on individual ocular symptoms of allergic rhinitis: a meta-analysis. Allergy. 2011;66(5):686–693. doi: 10.1111/j.1398-9995.2010.02543.x.Bielory L., Chun Y., Bielory B.P., Canonica G.W. Impact of mometasone furoate nasal spray on individual ocular symptoms of allergic rhinitis: a meta-analysis. Allergy. 2011;66(5):686–693. doi: 10.1111/j.1398-9995.2010.02543.x.

The authors declare that there are no conflicts of interest present.