Abstract

Purpose of the study: to determine the main diagnostic criteria in patients with chronic rhinosinusitis with metabolic syndrome, the features of the course of chronic rhinosinusitis after COVID-19 before and after treatment in this category of patients, to determine the volume of surgical treatment in patients with chronic rhinosinusitis with metabolic syndrome according to diagnostic criteria, to evaluate the treatment in the long-term period.

Materials and methods: 80 patients with chronic rhinosinusitis, most of whom had a history of Covid-19, were divided into groups: of these, 50 patients were included in group I, in whom metabolic syndrome was observed. Patients with chronic rhinosinusitis without metabolic syndrome made up group II of 30 people. Diagnosis of metabolic syndrome was carried out according to the recommendations of the American Heart Association/National Heart, Lung and Blood Institute criteria. All patients in both groups underwent multispiral computed tomography (MSCT) of the paranasal sinuses with subsequent evaluation of CT studies according to the Lund-Mackay scale. All patients also underwent videoendoscopic examination of the nasal cavity and assessment of the condition of the nasal cavity according to the Lund-Kennedy scale. In order to study the assessment of the quality of life of patients, all patients with CRS underwent a survey according to SNOT-22. The survey according to SNOT-22 was performed before surgical treatment and after surgical treatment after 3, 6, 12 months.

Results: According to the Lund-Mackay scale, during CT examination of the condition of the nasal cavity and paranasal sinuses, the average value of the index in patients of group I was higher than in patients of group II. The average value of the Lund-Kennedy scale scores before surgical treatment in patients of group I was also higher than in patients of group II. The average number of points according to SNOT-22 at the initial examination in patients of group I was significantly higher than in patients of group II. The number of surgical interventions for CRS in group I was also greater than in patients without metabolic syndrome. Surgical treatment in the group of patients with metabolic syndrome consisted of the use of more extensive endoscopic interventions. In the surgical treatment of patients without metabolic syndrome, endoscopic surgery was performed more sparingly. In the postoperative period, endoscopic observation of the condition of the nasal cavity was carried out. According to the patient survey for SNOT-22, the average score in patients 3, 6 and 12 months after surgical treatment was significantly higher. In group I, most patients had Covid-19 (80%), of which 27 patients had a prolonged period of CRS (54%). In group II of patients without metabolic syndrome, 18 patients with CRS had COVID-19 (60%), 4 patients had a prolonged period of CRS (13.3%).

Conclusions: Patients with CRS with metabolic syndrome are older. When assessing the condition of the nasal cavity after surgical treatment for 3, 6 and 12 months, the manifestations of CRS were more pronounced in the group of patients with metabolic syndrome. The quality of life in patients of group I was restored significantly slower. The duration of the disease was longer in patients with CRS with metabolic syndrome. When assessing the rehabilitation period, it was found that a greater number of patients of group I with CRS who had COVID-19 had a significant prolongation of the postoperative period, compared to group II patients with CRS without metabolic syndrome.

Keywords: chronic rhinosinusitis (CRS), metabolic syndrome, COVID-19 infection.