Acute rhinitis and acute rhinosinusitis (ARS) have viral etiology in the most of cases, and their therapy is aimed at alleviating clinical symptoms and preventing new episodes. The indications for antibiotic therapy are severe bacterial ARS, ARS with complications, and recurrent bacterial ARS. Such a categorical approach is due to the increase of antibiotic resistance, which leads to the popularization of efficient phytotherapy. Modern herbal medical products comply with general recommendation and standards of efficacy, safety and quality, and their effectiveness has been proven in clinical trials along with synthetic drugs. In acute upper respiratory tract infections, herbal medical drugs stimulate the immune system, relieve clinical symptoms, and improve the patient’s quality of life. A significant emphasis in phytotherapy is given to complex drugs synthesized on the basis of phytoneering. One of such remedies is the herbal medicinal product containing the different parts of 5 medicinal herbs: Gentian root (Gentianae radix), Primrose flowers (with calyx) (Primulae flos (cum calycibus)), Common sorrel herb (Rumicis herba), Elder flowers (Sambuci flos) and Vervain herb (Verbenae herba). This herbal medicinal product shows secretolytic, secretomotor, antiinflammatory, antiviral and mild antibacterial farmacological effects. The article provides an analysis of studies in vitro and in vivo proving the anti-inflammatory effect of Sinupret®, its potentiating effect on nasal mucosa mucociliary transport as well as efficacy and safety in patients with rhinosinusitis.

The article is devoted to the treatment of one of the most common diseases - the treatment of rhinosinusitis. According to statistics only 2% of the sinusitis in population are bacterial. At the same time administration of systemic antibiotic therapy reaches 95.5%. The problem of rational prescription of antibacterial drugs, including management of the rhinosinusitis, is very acute, especially considering the constant increase in the number of antibiotic-resistant microorganisms. Currently, the level of patients with prolonged post-viral rhinosinusitis after COVID-19 has increased. Most have a history of one or more courses of systemic antibiotics and, often, without indications. In article are listed indications for systemic and local antibacterial therapy in adults and children, based on national and European clinical guidelines. The data on complications during the use of systemic antibacterial drugs are presented. Authors give information about the advantages of the local use of antibiotics: the absence of general toxic complications, the creation of an optimal concentration directly in the focus of inflammation. The advantages of combining solutions of neomycin and polymyxin B for topical use, such as a pronounced bactericidal effect against gram-positive and gram-negative bacteria (Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Haemophilus influenzae, Pseudomonas aeruginosa), causing the development of infectious processes in the upper respiratory tract, are separately noted. The author describes his own experience of using the original nasal spray Polydex with phenylephrine, containing a fixed combination of neomycin, polymyxin B, dexamethasone sodium metasulfobenzoate and phenylephrine, in the treatment of patients with post-viral rhinosinusitis. As a result of the collection of literature data, as well as based on their own experience, the authors concluded that the use of this nasal spray in outpatient practice will significantly improve the effectiveness of treatment and reduce the frequency of prescribing systemic antibiotics.

Purulent-inflammatory diseases of the upper respiratory tract and ENT organs are an urgent problem of modern clinical medicine. The high prevalence of this pathology is due to the active effect of pathogenic microflora on the mucous membrane of the respiratory tract, the increasing role of opportunistic and atypical microorganisms in the genesis of infection of the upper respiratory tract, as well as disorders in the mucociliary clearance. Limitations in the mobility of cilia of ciliated cells, as well as their partial or complete absence, a change in the composition of mucous secretions and a slowdown in the speed of mucus movement are the mechanisms that determine the possibility of an acute inflammation focus on the mucous membrane of the upper respiratory tract, and also increase the risk of developing chronic inflammatory diseases of the ENT organs. The accumulated data on the peculiarities of the existence of microbial biocenoses in the human body, as well as the steady widespread growth of the problem of antibiotic resistance, dictate the need to search for new solutions in the treatment of purulent-inflammatory pathology of the ENT organs. A well-established principle of therapy for such conditions is the topical use of combined drugs that combine mucolytic and antibacterial components that actively affect the main links in the pathogenesis of acute and chronic inflammation of the upper respiratory tract. These tasks are most effectively solved by the drug, which contains the mucolytic N-acetylcysteine, which potentiates the effect of another component – the antibiotic thiamphenicol. An important aspect in favor of choosing this drug as a monotherapy or combination therapy for purulent-inflammatory diseases of the upper respiratory tract is a convenient form of release for aerosol administration.

Acute infectious and inflammatory diseases of the upper respiratory tract today belong to the category of the most common pathological conditions. Most often they occur in the form of acute nasopharyngitis, acute rhinosinusitis and acute laryngitis, the clinical of which consists of such symptoms as general weakness, hyperthermia, nasal blockage and nasal discharge, dysosmia, pain and tickling in the throat, cough, dysphonia. The need to select a safe and effective mucoactive therapy justifies the use of the phytopreparation in this pathology, the main active ingredient of which is an extract of ivy leaves. Also in the composition of the drug includes anise oil, peppermint oil, eucalyptus oil and levomenthol. The mechanism of action of is associated with α-hederin contained in ivy leaves. This substance, binding to the beta-adrenoreceptors of the bronchi, causes relaxation of their smooth muscles. In addition, thanks to the saponins contained in the leaves of common ivy, a mucolytic and expectorant effect is achieved. Literature data show that ivy leaf preparations significantly reduce the severity of acute respiratory infections of the upper respiratory tract. Virtually none of the patients had severe side effects. Allergic reactions were recorded in less than 0.5% of cases, with no mention of a severe allergic reaction of the anaphylaxis type. Thus, the drug of plant origin in the form of drops can be successfully used in patients with symptoms of acute respiratory diseases.

Introduction. Today, there are lot of theories of pathogenesis of polypoid sinusitis. The contribution of Starchylocossus aureus (S. aureus) to the occurrence of this pathogenetic reaction is being actively discussed.

Objective: to improve the effectiveness of treatment of polypoid sinusitis using the results of the study of the effect of persistent staphylococcal infection on the onset and course of the disease.

Materials and methods. The authors examined 105 patients with recurrent polyposis sinusitis aged 20 to 65 years. All patients underwent FESS surgery for recurrent polypous sinusitis at the initial visit. In the postoperative period, all patients received treatment according to one of two schemes. The first scheme included antihistamines and topical steroids, the second additionally included clarithromycin. The patients underwent bacteriological examination of smears for flora and fungi from the cavity; cytological examination of smears-prints from the mucous membrane of the nasal cavity (we counted neutrophils, eosinophils and lymphocytes in the preparation); immunological and allergic examination (skin tests, serum specific IgE levels).

Results and discussion. It has been established that the presence of a carriage and sensitization to S. aureus in a patient, especially in combination with atopy, results in a more severe course of polyposis sinusitis severe nasal obstruction (91% versus 69.5%, respectively) and is characterized by more pronounced eosinophilic inflammation than Polypoid Sinusitis associated with infection with other microorganisms (the number of eosinophils in the blood: 7.5% and 4.3%, respectively; the level of eosinophils in smears from the nasal mucosa is 13 and 4.8%, respectively; the average ECP level is 17.6 and 8.1 ug / ml, respectively).

Conclusions. The use of topical GCS remains one of the leading methods for preventing recurrence of PS. However, in addition to the backbone therapy with topical GCS and antihistamines, it is advisable to complete a course of antibiotics during nasal colonization with S. aureus.

Acute and chronic infectious and inflammatory diseases of the upper respiratory tract occupy a leading position in the structure of the pathology of the world’s population and remain the most frequent reason for patients seeking medical care. The prevalence and frequency of this disease in this nosological group makes a decisive contribution to the structure of the causes of temporary disability, which entails significant negative social and economic consequences. In this aspect, the spread of resistance of pathogens to etiotropic drugs and the insufficient arsenal of pathogenetic drugs stimulate the medical community to search for alternative approaches to the treatment of patients with respiratory pathology. One of these therapeutic areas is the use of immunomodulators, the most commonly used group of which are bacterial lysates. In the modern literature, sufficiently convincing data have been accumulated on the effectiveness of the use of bacterial lysates of systemic action, as a result of which the immune cells of the gastrointestinal tract are activated, which in turn leads to the restoration of autoregulation of the immune response throughout the body, and a decrease in the frequency of infectious and allergic diseases. The latest developments of domestic pharmacologists are topical bacterial lysates, the principle of which is based on the local activation of mucosal immunity in the respiratory tract. The undoubted advantage is that bacterial lysates, with all their effectiveness, do not harm the human microbiome, practically do not cause side reactions, combine well with other drugs, and can also be used at any stage of the disease, including for prophylactic purposes.

It has long been known, that nasal saline irrigation is a safe and effective method, which is routinely prescribed by otorhinolaryngologists to prevent and to treat a wide range of pathologies. There are a lot of publications on different irrigation techniques and methods. This literature review discusses the key parameters of nasal irrigation, including tonicity, pH, and the additional components, and explains how they affect the effectiveness of the procedure. The vast majority of available publications did not found any possible changes in the effectiveness of solutions with different pH close to neutral meaning. Whereas, the volume of the irrigated solution, increases the efficiency of the irrigation in direct proportion. Thus, the largest distribution area of the solute is noted when washing with a large volume of liquid. Nasal saline irrigation is an effective treatment option for patients with several acute and chronic diseases and for postoperative care after rhinosurgery. Moreover, nasal irrigation might be used as an effective non-specific method for prevention of acute upper respiratory tract infections. Irrigation of the nasal cavity reduces the mucus viscosity and promotes its faster elimination, along with pathogens fixed in it. Additionally, irrigation with isotonic saline solutions increases the hydration of the underlying water base, which enhances the frequency of ciliary beat and reduces the concentration of local inflammatory mediators. COVID-19 pandemic situation due to lack of any specific antiviral drugs dictates the necessity of an effective non-specific preventive option, which could be introduced worldwide. The so-called full volume lavage of the nasal cavity allows for better cleaning of the nasal cavity and effective moisturizing of the mucous membrane. It is the timely cleansing and moisturizing that are most important for maintaining the normal activity of the local protective mechanisms of the upper respiratory tract.

The article is devoted to the problem of chronic tonsillitis. The widespread prevalence of the disease, as well as the high risk of complications from vital organs, make this problem especially urgent. The article describes in detail the factors contributing to the formation of a focus of chronic inflammation in the amygdala. Special attention is paid to the microbiological aspects of the inflammatory process, anatomical, topographic and physiological features of the tonsils, as well as their immune function. The histological changes that form against the background of a long-term chronic inflammatory process in the tonsils are described. Changes in the parenchyma of the amygdala during inflammation can be expressed both by hyperplasia and by involution of follicles with the formation of infiltrates and the subsequent development of abscesses. In the final stages of an active inflammatory process, connective tissue grows, replacing lymphoid tissue. In the paratonsillar tissue and the capsule of the amygdala, an overgrowth of connective tissue is also observed, which is accompanied by the formation of nested infiltrates around small vessels, most pronounced at the upper pole of the amygdala. According to this classification, two clinical forms of chemotherapy are distinguished: simple and toxic-allergic of two degrees of severity. Further, in accordance with this classification, the basic principles of treatment are presented. Then the features of conservative therapy and the benefits of the herbal preparation are described. The composition of this drug includes marshmallow root, chamomile flowers, horsetail herb, walnut leaves, yarrow herb, oak bark and dandelion herb. The results of several clinical trials of the drug indicate its positive effect on the dynamics of both clinical and microbiological, immunological parameters in patients with chronic tonsillitis. All this allows us to recommend wider inclusion of this combined herbal medicinal product in the complex of treatment of chronic tonsillitis.

Polypoid rhinosinusitis (PRS) is a form of chronic rhinosinusitis (CRS), which is a heterogeneous group of pathological conditions based on a chronic inflammatory process of the nasal cavity and paranasal sinuses (PNS), leading to polypoid tissue formation. In most cases, T2-inflammation underlies the pathogenetic mechanism of PRS. In the presence of T2-associated conditions, the course of PRS is usually severe. The main aim of PRS treatment is to control symptoms, prolong the recurrence-free period, and restore the aeration of the PNS. The basic therapy of PRS involves the use of intranasal glucocorticosteroids (InGCS), which have a nonspecific anti-inflammatory effect by acting on different points of the pathological inflammatory process. The level of evidence for the use of InGCS is Ia: the drugs are included in Russian and foreign clinical guidelines for the treatment of polypoid rhinosinusitis. InGCS have high topical activity at low steroid doses. Mometasone furoate has an important place among this group of drugs because of its high efficacy, long-lasting therapeutic effect and optimal safety profile. The drug is officially registered for the treatment of PRS. Long-term use of mometazone furoate has been clinically observed to cause almost no atrophic nasal mucosal changes. It can be administered as monotherapy and in combination therapy over long periods of time in all phases of the treatment of PRS.

Bacteriophages - viruses infecting bacteria are the largest known group of viruses, which in their structure mainly have doublestranded genomic DNA, but among them there are also groups with double-stranded RNA and single-stranded DNA and RNA. The total population is about 1031–1032 phages, they play an essential role in the regulation of the world’s number of bacteria. The rather complex and diverse interaction of these representatives of the microcosm continues throughout the history of their existence on our planet. The question of the use of bacteriophages in the treatment of patients with various bacterial infections still remains completely unexplored. The very idea of using these microorganisms for therapeutic purposes dates back to the First World War, when the French biologist and researcher Felix d’Hérelle discovered a special type of «bacteria-eating» viruses, on the basis of which he created drugs for the treatment of patients with dysentery. To date, a fairly large clinical experience has been accumulated in the use of phage preparations in the treatment of infectious and inflammatory diseases of the respiratory, gastrointestinal, urogenital tract, as well as in the therapy and prevention of purulent-septic processes and nosocomial infections. The mucous membrane of the upper respiratory tract is the first line of defense against various respiratory pathogens. The ability of bacteriophages to attach to the surface layer of mucus - mucin, forming an antibacterial protection of the mucous membrane and thus reducing the level of colonization of mucus by bacterial pathogens, determines their effective use in the treatment and prevention of inflammatory diseases of the upper respiratory tract. Due to certain unique properties of bacteriophages, peculiarities of vital activity and interaction with a bacterial cell, their use seems to be promising for the treatment of patients with infectious diseases of the upper respiratory tract.

In recent years, there has been a significant increase in the prevalence of diseases of the nose and paranasal sinuses. Inflammatory diseases of the mucous membrane nasal cavities (rhinitis) are most commonly characterized as a syndrome in which the patient experiences some combination of persistent nasal symptoms, including rhinorrhea, sneezing, nasal congestion, itching and burning in the nasal cavity. Among the chronic forms of rhinitis, allergic rhinitis occupies a large place along with vasomotor, infectious, hypertrophic, catarrhal and atrophic rhinitis. Allergic rhinitis is a significant social and medico-economic problem, since it significantly reduces the quality of life of patients and requires significant treatment costs. This nosology is found in the practice of doctors of all specialties, however, the correct diagnosis and the appointment of adequate therapy can take many months and years. Currently, the concept of “common airways” is widely discussed, which demonstrates the close relationship between allergic rhinitis and bronchial asthma and proves that the inflammatory response can be supported and enhanced by interrelated mechanisms. Therefore, patients with allergic rhinitis should be examined for the presence of bronchial asthma. In turn, patients with bronchial asthma need to diagnose allergic rhinitis, and treatment should be aimed at suppressing allergic inflammation in both the upper and lower respiratory tract. This article discusses modern diagnostic and therapeutic approaches to patients with these diseases, which make it possible to efficiently and timely identify allergic rhinitis and initiate appropriate adequate treatment. The article also discusses the feasibility of using combined therapy with levocetirizine and montelukast in the above nosologies.

Allergic rhinitis (AR) and chronic rhinosinusitis (CR) can be diagnosed as an independent or combined pathology, as well as a possible complication of each other. Allergic rhinitis is a disease characterized by IgE-mediated inflammation of the nasal mucosa and the presence of daily manifestations of more than one hour and at least two of the following symptoms: nasal obstruction, rhinorrhea, sneezing, nasal itching. The frequency of psychosomatic disorders is quite high and ranges in the population. Studying the mechanisms of disease development provides the basis for rational therapy, not just symptom relief. We have considered the use of elimination therapy for CR associated with AR. This type of treatment is available to all categories of patients, including children and pregnant women at any gestational age. On the basis of the Department of Otorhinolaryngology of A. I. Evdokimov Moscow State Medical University in 2019–2020, a clinical study was conducted, which showed that such a combination of isotonic saline solution and antiseptic leads to improvement of patients and accelerates the recovery. In the process of monitoring 36 patients: in 35 of them achieved clinical cure, 1 patient required the appointment of antibiotic therapy due to the development of symptoms of purulent sinusitis. The results indicate a pronounced advantage of treatment in combination with elimination drugs, which was expressed in a reduction of symptoms during the first week of treatment, their complete regression was noted on the 30th day of use of the drug. Thus, chronic rhinosinusitis and allergic rhinitis are an important medical and social problem, and treatment of such patients requires only an integrated approach with obligatory consideration of the pathogenesis of the disease.

Allergic rhinitis (AR) and chronic rhinosinusitis (CR) can be diagnosed as an independent or combined pathology, as well as a possible complication of each other. Allergic rhinitis is a disease characterized by IgE-mediated inflammation of the nasal mucosa and the presence of daily manifestations of more than one hour and at least two of the following symptoms: nasal obstruction, rhinorrhea, sneezing, nasal itching. The frequency of psychosomatic disorders is quite high and ranges in the population. Studying the mechanisms of disease development provides the basis for rational therapy, not just symptom relief. We have considered the use of elimination therapy for CR associated with AR. This type of treatment is available to all categories of patients, including children and pregnant women at any gestational age. On the basis of the Department of Otorhinolaryngology of A. I. Evdokimov Moscow State Medical University in 2019–2020, a clinical study was conducted, which showed that such a combination of isotonic saline solution and antiseptic leads to improvement of patients and accelerates the recovery. In the process of monitoring 36 patients: in 35 of them achieved clinical cure, 1 patient required the appointment of antibiotic therapy due to the development of symptoms of purulent sinusitis. The results indicate a pronounced advantage of treatment in combination with elimination drugs, which was expressed in a reduction of symptoms during the first week of treatment, their complete regression was noted on the 30th day of use of the drug. Thus, chronic rhinosinusitis and allergic rhinitis are an important medical and social problem, and treatment of such patients requires only an integrated approach with obligatory consideration of the pathogenesis of the disease.

Introduction. Patients with nasal polyposis are predisposed to diffuse intraoperative bleeding, that could highly impair surgical field visualization. The absence of a universal technique of improving surgical field visualization became a reason for searching the specific hemostatic methods.

Objective: to evaluate the efficiency of sphenopalatine artery and/or its branches coagulation as a method of hemostasis in endoscopic surgery for nasal polyposis and to describe the surgical anatomy of sphenopalatine artery.

Materials and methods. Endoscopic coagulation of sphenopalatine artery and/or its branches was performed among 30 patients with nasal polyposis. Surgical field visualization was graded by Boezaart and Wormald scales before and after coagulation.

Results and discussion. Intraoperative attempts to achieve the hemostasis using warm (490С) saline irrigation and then application of xylometazoline (0.1%-10ml) and lidocaine (10%-4ml) were ineffective among 28 patients with initial grade 8 and among 2 patients with grade 9 according to Wormald scale. Sphenopalatine artery and/or its branches coagulation was effectively performed in these patients, obtaining the hemostasis in 100% of cases (р < 0,001). The initial surgical field grade improved to grade 5 by Wormald scale in 9 patients (30%), to grade 6 in 17 patients (56,7%) and to grade 7 in 4 patients (13,3%). Only one artery (trunk of sphenopalatine artery) was observed in 18 patients (60%), crossing the sphenopalatine foramen, and 2 arteries (posterior septal artery and posterior lateral nasal artery) – in 12 patients (40%). Endoscopic examination revealed no signs of mucosal atrophy in postoperative period.

Conclusion: The appropriate choice of hemostatic technique depends on grades of surgical field visualization. If there is a grade 8–9 by Wormald scale, endoscopic coagulation of sphenopalatine artery and/or its branches is an effective and safe method to improve surgical field visualization.

Introduction. In spite of the numerous studies devoted to the issues of chronic rhinosinusitis with nasal polyps, the urgency of this problem remains due to the high incidence of the disease. The relapsing course of chronic rhinosinusitis with nasal polyps determines the uncontrolled course of bronchial asthma by patients with combined pathology. The main goal of case management of patients with chronic rhinosinusitis with nasal polyps is to achieve control over the polyposis process. It has been shown, that a promising direction is the study of biological markers. Goal. Study of the concentration of serum periostin in combination with serum eosinophilia and the number of eosinophils of the nasal secretion to predict early recurrence of chronic rhinosinusitis with nasal polyps after surgical treatment.

Materials and methods. The study included 47 patients with a diagnosis of chronic rhinosinusitis with nasal polyps and chronic rhinosinusitis with nasal polyps in combination with bronchial asthma. All patients underwent bilateral endoscopic polysinusotomy followed by case follow-up for a year. The diagnosis of bronchial asthma was made based on the diagnostic criteria defined in the Global Strategy for the Treatment and Prevention of Bronchial Asthma and in the Federal Clinical Guidelines for the Diagnosis and Treatment of Bronchial Asthma. All patients were consulted by a pulmonologist. Control examinations of patients were carried out every 3 months. All patients underwent a study of the concentration of periostin in the blood serum. Blood probe samples were taken before the start of treatment and after 12 months.

Results and discussion. In the course of the study, was proved the relationship between a high concentration of serum periostin in combination with increased eosinophils of blood and nasal secretion with an early relapse of polyposis rhinosinusitis.

Conclusions. An increased concentration of serum periostin before surgical treatment is a prognostically unfavorable factor for early recurrence of chronic rhinosinusitis with nasal polyps.

Nasal congestion is one of the most common symptoms of common colds and rhinitis, due to an inflammatory reaction, vasodilation, increased nasal blood flow and vascular permeability. Nasal obstruction is often a multifactorial problem, in addition to infectious causes, it can be caused by a combination of anatomical aberrations, swelling of the nasal mucosa and enlargement of the turbinates. Anatomical and structural problems, such as nasal septum deviation and nasal valve collapse, are usually treated surgically. Drug therapy of nasal obstruction is aimed at reducing edema and inflammation of the nasal mucosa. Pharmacotherapy of nasal obstruction is aimed at reducing inflammation and/or swelling of the mucous membrane. Decongestants are widely prescribed to relieve symptoms. The drugs used have different mechanisms of action and include systemic and topical drugs. This article discusses decongestants as a treatment for nasal obstruction. When applied topically, the drugs of this group act directly on the α2 and α1-adrenergic receptors of the nasal cavity, causing vasoconstriction, a decrease in the volume of the nasal conch, an increase in nasal patency, and relieving the symptoms of obstruction. The existing risk of developing side effects, both systemic and local, is reduced with atopic exposure and proper dosing of the drug used. Preferably, the use of drugs with low bioavailability. The suppression of the ciliated epithelium can be caused not only by the pathological process, but also by the composition of drugs. The value is given to the acidity of the buffer system. The optimal pH value of intranasal agents is about 6 (neutral range). The combination with anticholinesterase substances reduces the production of pathological discharge. The use of multi-component medicines allows you to restore nasal breathing and suppress excessive nasal secretion. One of the effective and safe drugs of topical action is Xylometazoline, as a monocomponent agent or in combination with ipratropium bromide.

Allergic rhinitis remains one of the most pressing problems of modern otorhinolaryngology. Allergic rhinitis is an allergic inflammation of the nasal mucosa characterised by the following symptoms (one or more): stuffiness, rhinorrhoea, nasal itching, sneezing. In recent years the incidence of allergic rhinitis in the economically developed countries has been shown to be close to 40–50%. Allergic rhinitis is now characterised by an early onset, often continuously relapsing course and resistance to antiallergic therapy. Allergic rhinitis has a negative impact on a person’s social and daily activities, mental well-being and general health, regardless of age. Allergic rhinitis significantly reduces job performance, physical and mental activity, communication skills, causes snoring, anxiety, depression, sleep disorders and erectile dysfunction. Studying the mechanisms of the disease provides the basis for a rational therapy that addresses the complex inflammatory response rather than just the symptoms of allergy. Treatment is either in outpatient settings or inpatient – in specialised departments. A recent priority of pharmacotherapy is the use of intranasal corticosteroids, both as basic therapy for allergic rhinitis and as part of a combined regimen. The use of intranasal corticosteroids is considered to be the therapy of choice in allergic rhinitis. The paper demonstrates the efficacy and safety of topical corticosteroids for use in clinical practice. Intranasal corticosteroids have a wide range of reported indications, an extensive evidence base and can be recommended for the treatment of allergic rhinitis. For best result intranasal corticosteroids should be used at first signs of allergic rhinitis onset.

In modern otorhinolaryngology the use of herbal remedies, so-called clinical homeopathy, is widely used both as a basic and as part of complex therapy. A special place among this category belongs to medicines with secretolytic and mucolytic properties. This is due to the developed mucociliary system of the mucous membranes of the upper respiratory tract, which primarily suffers in acute and chronic inflammatory diseases. Most chemical mucoactive preparations have only one of the three mucosecretolytic effects and have a large number of contraindications. Herbal preparations, such as those containing Myrtol standardized, have secretolytic and mucolytic properties at the same time. Phytopreparations have deservedly occupied a leading place in the treatment of otorhinolaryngological diseases, as they have practically no contraindications and are successfully used in patients with comorbid pathology, children of all age groups and pregnant women. The efficacy of using preparations containing Myrtol standardized in the treatment of acute and chronic inflammatory diseases of the ENT organs and chronic atrophic diseases of the upper respiratory tract has been studied in a number of randomized clinical trials. The authors analysed 21 literature sources, reflecting the results of using mucosecretolytic drugs in otorhinolaryngology. In the complex treatment of acute rhinosinusitis and rhinopharyngitis the use of natural mucosecretolytic drugs significantly reduces the period of disability and avoids bacterial complications in both adult and paediatric practice. Mucolytic and antioxidant properties of preparations containing Myrtol allow for long-term effective therapy of subatrophic and atrophic processes of pharyngeal and laryngeal mucosa in elderly patients with comorbid pathology. An analysis of randomised trials has proven the efficacy of plant-based mucosecretolytics in the treatment of not only acute but also chronic upper respiratory tract diseases

 Introduction. The problem of chronic polypous rhinosinusitis today remains one of the most urgent in otorhinolaryngology. According to the analysis of medical documentation, diseases accompanied by this symptomatology are one of the most common reasons for contacting an otorhinolaryngologist. Despite the many proposed treatment regimens for polyposis rhinosinusitis, the recurrence rate of the disease remains high. Treatment of patients with polyposis rhinosinusitis is one of the most difficult problems of clinical rhinology. Studies of exocrine secretions of patients with chronic rhinosinusitis made it possible to clarify individual links in the pathogenesis of this disease, to identify differential diagnostic signs and pathogenetic similarities of various forms of rhinosinusitis, and to propose a new method of treatment.

The purpose of our present study was to assess the effectiveness of the correction of immunopathological conditions occurring in chronic ORS by using a herbal preparation containing in its composition Pelargonium sidophyta extract, which has antiinflammatory, immunomodulatory and antibacterial effects, in complex therapy.

Materials and methods. Clinical and laboratory examination and treatment of 54 patients with a diagnosis of chronic polyposis rhinosinusitis were carried out. Among them, 38 were patients with a disease duration of more than 10 years.

Results and discussion. It has been shown that the use of a phytopreparation containing in its composition an extract of pelargonium sieve in the complex treatment of patients with chronic polyposis rhinosinusitis allows achieving stable remission and reducing the number of recurrences of the polyposis process.

Conclusions. Our clinical experience allows us to recommend in order to prevent recurrences of chronic polypoid rhinosinusitis to carry out surgical intervention