[Phage therapy in overcoming antibiotic resistance in chronic rhinosinusitis]. / Fagoterapiya v preodolenii antibiotikorezistentnosti pri khronicheskom rinosinusite.

The relevance of the study is due to the observed increase in antibiotic resistance of the main pathogens of chronic rhinosinusitis. OBJECTIVE: To evaluate the effectiveness of phage therapy in the complex treatment of exacerbations of chronic rhinosinusitis. MATERIAL AND METHODS: The study included 55 patients with a verified diagnosis of chronic rhinosinusitis and a history of periodic exacerbations throughout the year, hospitalized at the St. Petersburg State Budgetary Institution «Elizabeth Hospital¼ from January 2022 to February 2023.Depending on the antimicrobial treatment received, patients were divided into groups that received an antibiotic or a bacteriophage.All patients underwent puncture of the maxillary sinuses. All patients in the first group taking an antibiotic, underwent sinus rinse with saline, and in the second group, a bacteriophage sinus rinse was used. Material from the first puncture of the maxillary sinuses was used to determine sensitivity to antibiotics and bacteriophages. RESULTS AND DISCUSSION: The average duration of treatment to positive outcome in the group receiving antibiotic therapy was 8±1.59 days, whereas in the group receiving bacteriophage therapy 7.69±1.35 days (p=0.3008). There were no significant differences between groups in the average duration of treatment until a favorable outcome was achieved. CONCLUSION: The high efficiency of phage therapy, the absence of its effect on the growth of antibiotic resistance allows us to recommend the use of bacteriophages in the treatment of chronic rhinosinusitis.

[Clinical case of angiosarcoma of ethmoidal labyrinth and frontal sinus, issues of morphological verification of diagnosis]. / Klinicheskii sluchai angiosarkomy reshetchatogo labirinta i lobnoi pazukhi, voprosy morfologicheskoi verifikatsii diagnoza.

A clinical case of incorrect verification of the angiosarcoma of the ethmoidal labyrinth and frontal sinus in a 36-year-old man is presented. A feature of this case is the disregard of additional research methods without taking into account the unilateralism of the pathological process, which led to the wrong tactics of surgical treatment and the development of a relapse of the disease complicated by nasal liquorrhea. A thorough examination of the patient and an analysis of a series of computer tomograms of the paranasal sinuses suggested a diagnosis of malignancy. The patient underwent neoplasm removal with fistula plastic, and histological confirmation of the presumptive diagnosis was performed.