Topical therapy of acute viral rhinosinusitis in case of incomplete epithelialization of surgical wound during the long-term period of adenoid surgery

Abstract

Acute respiratory infection (ARI) of the upper respiratory tract with incomplete epithelialization of the nasopharynx after surgery of the pharyngeal tonsil using cold sodium plasma is a little-studied problem.Aim. To evaluate the clinical efficacy and adequacy of topical therapy of acute viral rhinosinusitis with 2% silver proteinate (Sialor® preparation, tablets for preparation of a solution for topical use, 200 mg, in a bottle with a spray nozzle) instead of using systemic and local antibiotic therapy in the period of incomplete epithelialization of an operating wound after surgical treatment of chronic adenoiditis associated with hypertrophy of the pharyngeal tonsil, by physical factors of destruction of lymphadenoid tissue.Materials and methods. We observed 64 patients who underwent surgical intervention in the site of the pharyngeal tonsil using different techniques. The epithelization status of the surgical wound in the nasopharynx was visualized using 2.4 mm flexible rhino-laryngo fiberscope examination of the nasopharynx performed on postoperative days 10, 20 and 30. We assessed the frequency rates of ARI during the first month follow-up period and the features of the clinical course of ARI according to the patient’s diary. The treatment included on-demand topical therapy with decongestants and Sialor (2% silver proteinate). Results and discussion. The duration of ARI and the severity of nasal symptoms are comparable to the course of mild to moderate ARI in children with preserved pharyngeal tonsil.Conclusion. Sialor topical therapy is an adequate choice instead of local and systemic antibiotic therapy to suppress the pathogenic microflora activity in ARI, to provide a local anti-inflammatory effect during the long-term period of pharyngeal tonsil surgery with incomplete epithelization. The incomplete epithelization of the nasopharynx is not an indication to administer systemic antibiotics in the presence of signs of ARI of the upper respiratory tract after pharyngeal tonsil surgery.