Mucoactive therapy in the treatment of sinusitis in patients with post-Covid syndrome

Abstract

Rhinosinusitis, as in the pre-ovoid era, are still the most common diseases in the practice of an otorhinolaryngologist. According to the results of the analysis of medical documentation conducted at the clinic of the St. Petersburg Scientific Research Institute of Ear, Throat, Nose and Speech, more and more patients associate the diseases of the nasopharyngeal space that have appeared in them and the increase in the number of exacerbations of existing chronic diseases of this area with a coronavirus infection. In this regard, we decided to consider approaches to the treatment of rhinosinusitis by summarizing the available data and considering individual clinical cases of patients with sinusitis and COVID-19. Antibiotic resistance associated with uncontrolled administration of antibacterial drugs when infected with SARS-CoV-2 has also become one of the frequent problems at present. Therefore, our article considers the most relevant method in this case, based on the use of phytotherapy. According to the literature, the most effective phytopreparations are preparations containing standardized myrtol, which reduces the viscosity of the mucus of the paranasal sinuses and nasal cavity, increases the frequency of beating of the cilia of the ciliated epithelium, thereby contributing to an increase in the speed of mucociliary transport. Standardized myrtol also has an anti-inflammatory effect by reducing the concentration of leukotrienes and prostaglandin, neutralizing free OH radicals, inhibiting oxidation processes myrtol reduces toxic effects on the nasal mucosa and paranasal sinuses, and also acts on pathogenic flora as a bacteriostatic drug. Clinical recommendations of the Ministry of Health of the Russian Federation from 2021 according to the treatment of acute sinusitis and the European recommendations of the European Position Paper on Rhinosinusitis and Nasal polyps (EPOS 2020), based on the data of controlled studies presented in them, the use of phytopreparations in the treatment of acute and chronic sinusitis is confirmed both in combination with antibacterial therapy and without antibacterial drugs in combination with irrigation therapy and the use of topical decongestants.