A NOVEL APPROACH TO THE TREATMENT OF ATROPHIC RHINITIS

УДК 616.21

ABSTRACT

Atrophic rhinitis remains a significant challenge in modern otorhinolaryngology, particularly in pediatric practice, where the use of minimally invasive and effective therapies is essential. This study aimed to evaluate the clinical efficacy and safety of Deflu Silver as part of comprehensive therapy for atrophic rhinitis. A total of 24 pediatric patients were included. Treatment with Deflu Silver demonstrated high clinical effectiveness in reducing both local and systemic symptoms of the disease. No adverse effects were observed during the treatment period. The results indicate that Deflu Silver is a safe and effective component of comprehensive therapy for managing atrophic rhinitis in children.

АННОТАЦИЯ

Атрофический ринит остаётся значительной проблемой современной оториноларингологии, особенно в педиатрической практике, где применение минимально инвазивных и эффективных методов лечения имеет важное значение. Цель данного исследования заключалась в оценке клинической эффективности и безопасности препарата Deflu Silver в составе комплексной терапии атрофического ринита. В исследование были включены 24 пациента детского возраста. Лечение с использованием Deflu Silver продемонстрировало высокую клиническую эффективность в снижении как местных, так и системных симптомов заболевания. В ходе лечения побочных эффектов не наблюдалось. Полученные результаты свидетельствуют о том, что Deflu Silver является безопасным и эффективным компонентом комплексной терапии атрофического ринита у детей.

Keywords: Atrophic rhinitis, Deflu Silver, nasal dryness, comprehensive therapy, clinical efficacy.

Ключевые слова: атрофический ринит, Deflu Silver, сухость слизистой носа, комплексная терапия, клиническая эффективность.

Introduction. Atrophic rhinitis is a chronic and progressive disease characterized by atrophy of the nasal mucosa, leading to dryness, crust formation, and impaired nasal function [5]. It remains a significant challenge in modern otorhinolaryngology due to its impact on the respiratory system and the quality of life of affected individuals [2].

The prevalence of atrophic rhinitis varies across regions and is influenced by environmental, climatic, and genetic factors [3]. Air pollution, allergens, and infectious agents are considered major contributors to its development [8]. According to global data, atrophic rhinitis accounts for approximately 10-15% of all rhinitis cases.

In Central Asian countries, including Uzbekistan, the prevalence is relatively higher due to the dry climate, dusty air, and unfavorable ecological conditions. Epidemiological data indicate that the disease accounts for approximately 12-18% of all nasal pathologies, reaching up to 20% in industrial and arid regions [4].

The disease is more commonly observed in adults aged 30-60 years and is more frequent in women, possibly due to hormonal and anatomical factors. Occupational exposure, particularly in dust-prone industries such as construction, cement, metallurgy, and textile production, significantly increases the risk of developing atrophic changes in the nasal mucosa.

Urban residents are more affected due to air pollution and industrial exposure, while dry rural populations remain at risk. Atrophic changes impair secretion, promote microbial colonization, and may lead to nasal deformities in advanced stages.

Objective. To assess the clinical efficacy and safety of Deflu Silver in the comprehensive therapy of patients with atrophic rhinitis.

Materials and Methods. The study was conducted at the Department of Pediatric Otorhinolaryngology of Tashkent Pediatric Medical Institute, the ENT Department of Sirdaryo Regional Multidisciplinary Children’s Hospital, and Happy Life Medical Centre.

The study included 24 pediatric patients aged 3-18 years with a confirmed diagnosis of chronic atrophic rhinitis who received inpatient and outpatient treatment between 2022 and 2024. Additionally, a comparative group consisting of 30 conditionally healthy children was formed.

The patients were allocated into two groups:

• Control group (n=12): patients received standard complex therapy, including systemic antibacterial agents, topical anti-inflammatory drugs, antihistamines, daily nasal irrigation with iodized saline solution, and intranasal oil-based preparations containing vitamins A and E.
• Main group (n=12): in addition to standard therapy, patients received intranasal administration of Deflu Silver nasal spray (3-4 times daily) and topical application of povidone-iodine ointment (twice daily).

In both groups, adjunctive therapy included daily nasal irrigation with isotonic saline, a balanced vitamin-rich diet, topical lanolin ointment to prevent crust formation, and oral vitamins A and E twice daily. The treatment course lasted 12-14 days.

Therapeutic efficacy was evaluated based on clinical and instrumental criteria, including overall somatic condition, endorhinoscopic changes, restoration of nasal breathing, and prevention of disease-related complications.

Results. Treatment outcomes were evaluated using structured questionnaires, otomicroscopy, and endoscopic examination. All patients were clinically assessed before therapy and one month after completion of treatment. Both groups improved clinically, but the main group achieved significantly better outcomes, with complete mucosal restoration, reduced secretions, and uncomplicated healing (p < 0.001). As shown in Figure 1, the analysis of initial postoperative clinical signs in patients with chronic suppurative otitis media (CSOM) illustrates the comparative dynamics of symptoms between the main and control groups.

Figure 1. Comparative analysis of initial postoperative clinical signs in patients with chronic suppurative otitis media (CSOM)

Although these processes were less frequent in patients receiving conventional treatment, some pathological conditions and local clinical manifestations persisted. Figure 1 shows a comparative analysis of clinical symptoms of atrophic rhinitis in the study groups before and after treatment. Nasal crust formation was the most common symptom, observed in 88.4% of patients prior to therapy; after treatment, it decreased to 32.5% in the main group and 55.4% in the control group. Purulent nasal discharge was present in 74.2% of patients before therapy, and post-treatment was observed in 17.2% of the main group and 48.1% of the control group (p < 0.001).

Difficulty in nasal breathing was reported in 74.2% of patients before treatment, decreasing to 32.6% in the control group and 15.2% in the main group. Mucosal dryness, the most common symptom, was present in 88.4% of patients prior to treatment and decreased to 41.3% in the control group and 22.5% in the main group (p < 0.05).

Foul nasal odor was observed in 45.2% of patients before treatment, decreasing to 21.2% in the control group and 14.6% in the main group. Epistaxis occurred in 34.4% of patients prior to therapy, reducing to 17.3% in the control group and 9.5% in the main group. Nasal itching and sneezing were reported in 35.4% of patients before treatment and decreased to 25.3% in the control group and 14.4% in the main group (p < 0.05). Hyperemia of the nasal mucosa was documented in 36.5% of patients prior to treatment, 9.4% in the control group, and 5.2% in the main group.

Overall, analysis of these data indicates that all clinical manifestations were highly prevalent prior to treatment, with significant reductions observed in the main group following therapy. These findings demonstrate the superior effectiveness of the proposed treatment regimen.

Early diagnosis and timely intervention in atrophic rhinitis are essential to prevent severe complications. Modern diagnostic methods combined with comprehensive therapeutic strategies provide an effective approach for managing this condition. Therefore, both prevention and appropriate treatment remain critical.

Conclusion. The proposed treatment protocol, combining conventional therapy with Deflu Silver nasal spray and povidone-iodine ointment, demonstrated high clinical efficacy in pediatric patients with atrophic rhinitis. In the main group, nasal crust formation decreased from 88.4% to 32.5%, purulent nasal discharge from 74.2% to 17.2%, and mucosal dryness from 88.4% to 22.5% after treatment (p < 0.05). Other clinical signs, including difficulty in nasal breathing, epistaxis, nasal itching, and mucosal hyperemia, also showed significant reductions compared with the control group. Mucosal regeneration was achieved without complications, and primary healing was observed in the majority of patients.

• The prevalence of atrophic rhinitis depends on multiple factors, including arid climate, polluted urban environments, and occupational exposures, remaining a significant challenge in contemporary medicine.
• The inclusion of povidone-iodine in the treatment regimen significantly improved the dynamics of clinical symptoms in the main group, reducing pathological nasal discharge, edema, and local signs of atrophic rhinitis.
• Application of Deflu Silver nasal spray promoted epithelialization and mucosal recovery, achieving superior clinical efficacy compared with conventional therapy alone.

References:

1. Abdullaev, Kh., Khasanov, S., Khasanov, M., & Rasulova, N. (2010). The role of membranodestruction in the pathogenesis of adenoid vegetations. Stomatologiya, 1(1-2), 228-232.
2. Alimova, D., Amonov, A., & Amonov, Sh. (2023). Morphological characteristics of the mucosa in polypoid rhinosinusitis. Pediatriya, 1(1), 158-165.
3. Amonov, Sh. E., & Saidov, S. Kh. (2011). Effectiveness of surgical correction of nasal and nasopharyngeal pathology in the complex therapy of subatrophic rhinitis in children. Vrach-Aspirant, 47(4), 79-82.
4. Rajabov, A. Kh., & Amonov, Sh. E. (2020). Diagnosis and treatment of nasal bleeding in children with chronic hepatitis B. Otorhinolaryngology, (4), 1-4.
5. Rajabov, A. Kh., & Olimov, Zh. A. (2020). Surgical treatment of nasal bleeding in patients with chronic hepatitis B. Pediatriya. Scientific-Practical Journal, 4, 42-45.
6. Rajabov, A. Kh., Omonov, Sh. E., Inoyatova, F. I., & Omonov, A. Sh. (2009). ENT organ status in children with chronic hepatitis B. Vrach-Aspirant, 31(4), 323-327.
7. Salomov, K., & Jabbarova, D. (2023). Dysphonia as a symptom of laryngeal diseases. Pediatriya, 1(1), 164-167.
8. Dilmuratovna, S. D. (2014). The role of immunologic values in the pathogenesis of chronic rhinosinusitis in children. European Science Review, (3-4), 64-66.
9. Razhabov, A. Kh. (2020). Features of the clinic and blood parameters in patients with chronic hepatitis on the background of rhinosinusitis. World Journal of Pharmaceutical and Medical Research (WJPMR), 6(3), 132-134.
10. Shodiyeva, M. B., & Nurov, U. I. (2024). Diagnosis and treatment of chronic rhinosinusitis in school-age children. Eurasian Journal of Otorhinolaryngology-Head and Neck Surgery, 3, 57-61.