A pathological process in the nasal cavity and paranasal sinuses in chronic rhinosinusitis with nasal polyps (CRSwNP) is not limited by nasal obstruction and has a complex impact on the patient’s central regulatory mechanisms manifesting in cognitive and mnestic functions impairment.
OBJECTIVE
To conduct a comprehensive comparative analysis of clinical and functional indicators characterizing nasal manifestations in patients with CRSwNP, as well as the results of cognitive tests in the pre- and postoperative periods.
PATIENTS AND METHODS
A number of patients equal 45 with a long medical history of CRSwNP (M=117 months) without concomitant chronic pathology were examined. The age of patients was between 22 and 65 years (M=48.964 years). Clinical testing was carried out using the Sinonasal Outcome Test (SNOT-22), Lund—Mackey tests and active anterior rhinomanometry (ml/s). The changes in the X-ray examination (computed tomography of paranasal sinuses) were evaluated on the Lund—Kennedy scale. Cognitive abilities were assessed based on the MoCA test (in scores) with subsequent interpretation by a psychiatrist. The evaluation of indicators was carried out before the surgical treatment, after 1 and 6 months.
RESULTS
There has been a decrease in sinonasal symptoms on the SNOT-22 scale (from M=31.42 scores before surgery and to M=4.04 scores after 6 months); the Lund—Kennedy scales (from M=7.87 to M=0.38 respectively); the Lund—Mackey scales (from M=15.49 to M=0.47 scores respectively). The active anterior rhinomanometry indicators had a tendency to mean values increase from 399.04 ml/s to 856.60 ml/s after 6 months. Assessment of neurocognitive disorders on MoCA in patients preoperatively demonstrated mean values of 21.49 scores, which indicated the presence of disorders of mild severity. Mean values of 25.38 scores were obtained at further testing after 1 month, which were fixed after 6 months.
CONCLUSION
An interdisciplinary approach to the evaluation of clinical manifestations in patients with CRSwNP, based on the inclusion of neurocognitive disorders testing in the study, allows to more fully evaluate the impact of the pathological process on the patient’s body. The inclusion of the MoCA test in the complex of intra- and postoperative researches allows to form an individualized approach in the implementation of therapeutic and rehabilitation activities in this category of patients.
