rss_2.0Romanian Journal of Rhinology FeedSciendo RSS Feed for Romanian Journal of Rhinology Journal of Rhinology Feed The impact of tracheostomy on spoken language in children: a narrative review to make your sinus surgery more comfortable: our point of view<abstract> <title style='display:none'>Abstract</title> <p><bold>BACKGROUND.</bold> Endoscopic sinus surgery (ESS) has revolutionized the treatment of nasal and paranasal sinus conditions, offering minimally invasive techniques with improved patient outcomes. However, ESS can be challenging, lengthy, and physically demanding. This article presents a comprehensive overview of factors to consider before and during ESS to enhance surgical ease and patient comfort.</p> <p><bold>MATERIAL AND METHODS.</bold> The paper is a literature review sustaining a point of view on the factors influencing the outcome of endoscopic sinus surgery.</p> <p><bold>RESULTS.</bold> Preoperative considerations encompass a thorough assessment of surgical indications, weighing against medical alternatives as per guidelines. Attention to patient comorbidities, medication management and infection control are paramount. Intraoperatively, collaboration with anesthesiologists is crucial for optimizing patient stability and minimizing complications. Ergonomic considerations, patient positioning and surgical environment optimization contribute to surgeon comfort and procedural efficiency. The surgical procedure entails meticulous preparation of the nasal cavity, preservation of anatomical structures, and adherence to standardized techniques. The sphenoethmoidectomy is described as a sequential five-door procedure, emphasizing anatomical landmarks and meticulous dissection techniques. Hemostasis and the judicious use of powered shavers play pivotal roles in minimizing bleeding and optimizing tissue removal. Navigation systems offer additional support, particularly in complex cases or revision surgeries.</p> <p><bold>CONCLUSION.</bold> ESS requires meticulous planning, technical proficiency, and interdisciplinary collaboration to optimize outcomes. Anticipation and adherence to standardized protocols are paramount in navigating the challenges of ESS, ultimately enhancing surgical ease and patient comfort.</p> </abstract>ARTICLEtrue of the main factors involved in the auditory-verbal rehabilitation process in children with cochlear implants<abstract> <title style='display:none'>Abstract</title> <p><bold>BACKGROUND.</bold> Children’s communication with the family and the environmental surroundings begins immediately after birth and development continues throughout life. Impairment of hearing due to the presence of congenital hypoacusis results in severe language development disorders. The purpose of the study was to identify the main factors involved in the auditory-verbal rehabilitation process of children with hearing impairment.</p> <p><bold>MATERIAL AND METHODS.</bold> A descriptive, observational study was conducted on a group of 35 carers of hearing-impaired children proposed for auditory-verbal rehabilitation through cochlear implantation. The study carried out was based on the parents’ statements, analyzing the essential factors that can influence the quality of life of parents with hearing-impaired children: the child’s age at the time of the positive diagnosis, the child’s communication skills before implantation, the time elapsed from the intervention to implant activation, participation in auditory-verbal rehabilitation sessions with a speech therapist, parental commitment during the immediate pre- and post-implant period, the parent’s level of education.</p> <p><bold>RESULTS.</bold> The dominance of the female gender can be noted - 91.43%. 60% of adult participants were college graduates, 20% discontinued their education after completing high school, 17.14% graduated from a post-secondary school. 57.14% of the parents reported being employed in some form of work during the period before and immediately after the cochlear implantation of their children. 82.85% reported the diagnosis of their child’s hypoacusis in the pre-kindergarten group. Out of the total number of children, 68.57% were recipients of bilateral cochlear implants, 31.43% had unilateral implants. The periods during which children benefited from post-implantation speech therapy were between 1 and 6 months (5.71%), 1 and 2 years (2.86%), &gt;2 years (17.14%). In 71.43% of cases, families were in the rehabilitation phase with speech therapy at the time of filling out the form.</p> <p><bold>CONCLUSION.</bold> In the auditory-verbal rehabilitation process of a hearing-impaired child, there are a number of factors and conditions that must be considered in a specific manner for each individual patient.</p> </abstract>ARTICLEtrue cavity extramedullary plasmacytoma: literature review and clinical experience<abstract> <title style='display:none'>Abstract</title> <p><bold>BACKGROUND.</bold> Extramedullary plasmacytoma is an extremely rare solitary plasma cell neoplasm that occurs in locations other than bone, without involving the bone marrow. It is commonly located in the upper aerodigestive tract. In the head and neck region, the most frequent location is the sinonasal region.</p> <p><bold>MATERIAL AND METHODS.</bold> A systemic review in accordance with the PRISMA guidelines was done with research works in PubMed, Elsevier database, Cochrane library, Web of Science, Scopus, Crossref and Google Scholar. The search was carried out using the keywords “plasmacytoma and nose”, “extramedullary plasmacytoma”, “extramedullary plasmacytoma of nose”, “plasmacytoma and nasal cavity”, and “extramedullary plasmacytoma of nasal cavity”.</p> <p><bold>RESULTS.</bold> We analysed 27 research works with a total number of 32 cases. The most common presenting symptoms were nasal cavity bleeding. The disease showed a male preponderance (78.1%). Bone erosion was seen in 7 cases. The histopathological examination showed plasma cells arranged predominantly as a uniform population or sheet-like appearance. A common immunohistochemical marker was CD138 (11 cases). Treatment was primarily radiotherapy (43.7%). We are also reporting a case of a 53-year-old male with plasmacytoma of the middle turbinate managed by wide resection and postoperative radiotherapy.</p> <p><bold>CONCLUSION.</bold> Though a less common condition, in a case of polypoidal-like lesion with bleeding tendency, the clinician should keep in mind the possibility of extramedullary plasmacytoma. The diagnosis is made with histopathological examination and immunohisto-chemistry of the tissue involved. Treatment can be radiotherapy, surgery, or a combination of modalities.</p> </abstract>ARTICLEtrue levels of pulmonologists with geriatric patients during the COVID-19 pandemic<abstract> <title style='display:none'>Abstract</title> <p><bold>BACKGROUND.</bold> Patients were likely hesitant to communicate with physicians during the pandemic, when everyone saw others as potentially infectious. Every other was seen as the most likely to be infected as they were in close contact with infected persons. Likewise, physicians might have been wary of communicating with their patients, who might have been virus carriers. In our study, the communication between physicians (particularly pulmonologists) and geriatric patients was evaluated to develop recommendations for improvement if necessary.</p> <p><bold>MATERIAL AND METHODS.</bold> The study was conducted as an online evaluation questionnaire via e-mail or WhatsApp. The evaluation form, the Social Communication Skills Rating Scale, collected data regarding the respondents’ demographic characteristics, whose reliability and validity have been proven in previous studies. The volunteer pulmonologists completed the questionnaire.</p> <p><bold>RESULTS.</bold> The research comprised 200 doctors; 111 (55.5%) were women and 89 (44.5%) were men. Of the doctors who participated in the study, over 40% were in their forties. Pulmonologists’ communication skills with their geriatric patients were deemed adequate, and their interactions were evaluated as successful, despite the high risk of infection during the pandemic, the difficulty of examining patients while wearing protective clothing, and the typical communication difficulties of geriatric patients. This has been a crucial advantage for the senior patient group, as, throughout the COVID-19 pandemic, this group has communicated with pulmonologists predominantly owing to medical needs.</p> <p><bold>CONCLUSION.</bold> The pulmonologists’ effective communication with their geriatric patients could have made them feel good during the difficult time of the past pandemic period. It could have also been a source of pride for physicians.</p> </abstract>ARTICLEtrue considerations regarding the use of CAD-CAM systems in the metal substructure design of some metal-ceramic prosthetic restoration<abstract> <title style='display:none'>Abstract</title> <p>In this material, two clinical cases are described, regarding the use of CAD-CAM technology for producing the wax pattern of the metal substructure for a fixed prosthetic restoration. In fact, in these cases, it is about making a digital design and milling from a block of wax the patterns of future fixed metal-ceramic prosthetic restorations.</p> </abstract>ARTICLEtrue palatoplasty as a treatment for mild and moderate obstructive sleep apnea: our experience<abstract> <title style='display:none'>Abstract</title> <p><bold>BACKGROUND.</bold> Obstructive sleep apnea (OSA) is characterized by frequent episodes of breathing cessation during sleep, resulting in low oxygen and high carbon dioxide levels, leading to daytime sleepnes, cognitive issues, and increased cardiovascular risk. The objective of this study was to assess the effectiveness of the anterior palatoplasty (AP) procedure in the treatment of patients with mild and moderate obstructive sleep apnea.</p> <p><bold>MATERIAL AND METHODS.</bold> Sixteen patients diagnosed with mild and moderate OSA underwent AP in our clinic between 2021-2023. All patients were &gt; 18 years old, body mass index &lt; 30, with an apnea-hypopnea index (AHI) from 10 to 40 and disfunction of the velopharyngeal or of the retropalatal space. Patients underwent a one-night polysomnography examination prior to the surgical procedure, as well as six months after the procedure. Additionally, patients were asked to complete the Epworth Sleepiness Scale (ESS) both prior to and six months following the surgery. The procedure was done under general anaesthesia and involved AP surgery with or without reducing of the uvula.</p> <p><bold>RESULTS.</bold> The average of total AHI values decreased from 28.89 per hour prior to surgery to 11.14 per hour six months after surgery. The oxygen desaturation index decreased after surgery with 2.57%. ESS scores of patients also decreased from 10.40 to 7.80 and all patients felt less tired.</p> <p><bold>CONCLUSION.</bold> We believe that AP is an effective technique in the treatment of mild and moderate OSA caused by a disfunction of the velopharyngeal or retropalatal space. Additionally, we consider that AP is linked with a lower incidence of post-surgical complications compared to other surgical options.</p> </abstract>ARTICLEtrue associated with complications and mortality of deep neck abscesses in adults<abstract> <title style='display:none'>Abstract</title> <p>OBJECTIVE. Our objective was to evaluate the factors associated with complications and death in patients with abscesses of the deep spaces of the neck.</p> <p>MATERIAL AND METHODS. An observational, cross-sectional, analytical, retrospective study was conducted from 2017 to 2022. Demographic variables, comorbidities, affected spaces, management, need for tracheostomy, ICU care, presence and type of complications and death were collected. Descriptive statistics were applied as measures of central tenure and measures of dispersion, for inferential analysis; Pearson'’s Chi-square or Fisher'’s exact tests, odds ratio for risk analysis, binary logistic regression test to evaluate the predictor variables were used.</p> <p>RESULTS. We included 46 cases; mean age 44.41 ±13.84 years; 60.87% male patients. As comorbidities, we found diabetes alone and diabetes with hypertension as the most frequent. Three affected neck spaces were in 44% of patients. 46% needed a tracheostomy, this parameter being significantly associated with complications (p=0.037) and mortality (p=0.037). The need for intensive care and complications revealed a p=0.000 and with a p=0.005 for mortality; days of hospitalization ≥ 11 days was significantly associated with complications (p=0.005) and death (p=0.013). Hospital stay ≥11 days were risk factors for complications (OR=1.357, 95%CI 1.037-1.776) and death (OR=1.267, 95%CI 1.004-1.598); the need for ICU and complications had an OR=78.00 (95%CI 5.726 -1062.546), ICU and death had an OR=39.000 (95%CI 3.046-499.323). The variables ICU admission, tracheotomies and hospital stay ≥11 days were predictors of complications and death.</p> <p>CONCLUSION. The need for tracheostomy, ICU admission, hospitalizations ≥11 days are associated with complications and death in patients with deep neck abscesses. The same variables were risk factors and predictors of mortality and complications.</p> </abstract>ARTICLEtrue surgical management of the fronto-ethmoido-orbital mucopyocele: a case report and literature review<abstract> <title style='display:none'>Abstract</title> <p>Frontal sinus mucocele are benign, pseudocystic lesions that derive from the destruction of the sinus ostium, resulting in a continuous accumulation of mucus. The process of mucocele growth leads to a progressive enlargement of the sinus cavity, thickening and erosion of its bone walls until the invasion of surrounding tissues. Mucoceles are more common in the frontal sinuses, while involvement in the sphenoid, ethmoid and maxillary sinus is rare. The frontal sinus floor is divided by the upper orbital wall; thus, an early displacement of the orbit occurs in the growth of the frontal mucocele. This paper presents one of our experiences in endoscopic surgical management of frontal sinus mucopyocele with secondary orbital complications.</p> </abstract>ARTICLEtrue of obstructive sleep apnea on patients'’ quality of life<abstract> <title style='display:none'>Abstract</title> <p>Obstructive sleep apnea (OSA) is a very commonly spread disease, not only in Bulgaria, but all over the world. One of the reasons for this is that patients suffering from OSA find it difficult to share their problem with their treating doctor (sleep doctor or ENT specialist). Doctor-patient communication is extremely important when gaining the patient'’s trust, for the early detection and diagnosis of obstructive sleep apnea. Sleep disorders lead to a decrease in the quality of life, due to frequent anxiety, fatigue, depressive states, reduced cognitive and motor functions, lack of energy, headaches and sleepiness throughout the day. Improving the quality of life of patients is a primary goal of the health care system, which is conveyed in patient care aimed at reducing or eliminating the effects of diseases and their associated negative psychological and social effects. Prevention, screening and effective communication with the patient are extremely important for a successful diagnosis and treatment of sleep disorders.</p> </abstract>ARTICLEtrue use of social media and its influence on rhinoplasty decision<abstract> <title style='display:none'>Abstract</title> <p><bold>OBJECTIVES.</bold> We reviewed the use of social media and its influence on rhinoplasty decisions.</p> <p><bold>MATERIAL AND METHODS.</bold> The literature survey was performed in PubMed, EBSCO, UpToDate, and ProQuest Central databases of Kırıkkale University and Google and Google Scholar databases.</p> <p><bold>RESULTS.</bold> Networking features available through social media sites allow users to discover and share countless photos, videos and links from their desktops and mobile devices. In the United Kingdom, over 55% of facial plastic surgeons reported that their cosmetic patients were inspired to look better in selfies. 53.4% of respondents felt that TV shows promoting plastic surgery impacted the popularity of such procedures, and 65.0% of respondents believed that social media had a similar effect. Males reported being much less satisfied with surgery than females and were less specific about why they were unhappy. One-third of patients regularly looked for information about rhinoplasty on social media. Less than a third were affected by celebrities who had rhinoplasty for cosmetic reasons. However, over three percent believed the social media ads portraying rhinoplasty as a safe surgical procedure.</p> <p><bold>CONCLUSION.</bold> We concluded that social media platforms play a significant role for the decision to undergo rhinoplasty and postoperative patient satisfaction.</p> </abstract>ARTICLEtrue impact of a multidisciplinary approach on elderly patients hospitalized with SARS-CoV-2<abstract> <title style='display:none'>Abstract</title> <p><bold>BACKGROUND</bold>. The COVID-19 pandemic had a devastating impact in terms of both somatic and mental morbidity. The most vulnerable group of patients is represented by the elderly, due to their global fragility. During the COVID-19 pandemic, research have stated that age and related comorbidities are associated with the outcome and evolution of the coronavirus infection.</p> <p><bold>MATERIAL AND METHODS.</bold> We performed a prospective observational study by applying a specific unsystematized questionnaire containing 21 questions, including patients admitted between 01.10.2021-16.03.2022 in the Internal Medicine Clinic and the Infectious Diseases Clinic COVID-19. Two hundred patients were included in the study of which the most important group was represented by the elderly. The current study aimed to demonstrate the clinical complexity of the patients hospitalized with SARS-CoV-2 and the importance of a multidisciplinary approach.</p> <p><bold>RESULTS.</bold> Among those patients who complained of cardiovascular symptoms such as tachycardia, palpitations, chest pains, 59.6% had no cardiac pathology, therefore they required psychiatric examination and specific anxiolytic and/or antidepressant treatment. Despite the fact that alarmingly low rates of vaccination were observed, we noticed a statistically significant association between the presence of insomnia and vaccination status: half of the vaccinated stated that they sleep as well as usual, compared to only 22.8% of the unvaccinated. We also found a statistically significant association between the presence of insomnia and peripheric oxygen saturations below 93%.</p> <p><bold>CONCLUSION.</bold> The results of our study highlight the importance of a multidisciplinary management of the SARS-CoV-2 infection, especially targeting the elderly and fragile patients.</p> </abstract>ARTICLEtrue D3 deficiency and smell regions in adolescents: an MRI evaluation<abstract> <title style='display:none'>Abstract</title> <p><bold>OBJECTIVES.</bold> We investigated the effect of vitamin D3 deficiency on peripheral and central odor centres by using cranial magnetic resonance imaging (MRI).</p> <p><bold>MATERIAL AND METHODS.</bold> In this retrospective study, cranial MRI images of 23 adolescents with vitamin D3 deficiency and 18 adolescents with normal vitamin D3 levels (≥ 20 ng/ml) were evaluated. Blood tests for vitamin D3, B12, hemoglobin and calcium levels were also taken from the database of our hospital. Peripheral odor centers, olfactory bulb (OB) volume and olfactory sulcus (OS) depth, and also central odor centers, insular gyrus and corpus amygdala area were measured on cranial MRI.</p> <p><bold>RESULTS.</bold> The insular gyrus and corpus amygdala area were not different between the study group with vitamin D3 deficiency and the control group (p&gt;0.05). There was no difference between OB volume of the study and control groups (p&gt;0.05). Although the right insular area was lower in girls than males (p&lt;0.05), there was no correlation between OB volume and gender (p&gt;0.05). Higher hemoglobin levels were related to higher OB volume on the right side (p&lt;0.05).</p> <p><bold>CONCLUSION.</bold> In the group with vitamin D3 deficiency, olfactory bulb volume of the left side was asymmetrically larger than the one on the right side. Therefore, the measurements of vitamin D3 should be performed in adolescents, and the patients with the vitamin D3 levels of &lt; 20 ng/ml should be supplemented with medical treatment and reinforcing vitamin D synthesis by the exposure of sunlight more.</p> </abstract>ARTICLEtrue printing: From digital to real in modern personalized medicine of design and manufacturing of zirconium dioxide infrastructures for fixed prosthetic restoration<abstract> <title style='display:none'>Abstract</title> <p>In dental practice, CAD-CAM digital technologies are used for zirconium dioxide processing. Thus, in recent years, zirconium oxide has determined an extraordinary development of digital CAD-CAM technologies, a fact that determined the presentation in this material of several extremely interesting aspects, regarding the technological process of designing and manufacturing structures made of this material.</p> </abstract>ARTICLEtrue coccidioidomycosis in adults: systematic review of the literature and a case report<abstract> <title style='display:none'>Abstract</title> <p><bold>BACKGROUND.</bold> Coccidioidomycosis spp. is a dimorphic fungus endemic to the southwestern United States and northern Mexico. Incidences in high-risk locations have increased over the last years.</p> <p><bold>MATERIAL AND METHODS.</bold> A systematic review has been carried out following the PRISMA guidelines of the reports found in PubMed, Scopus, Google Scholar databases from 1953 to 2023. We included articles written in the English language, with the following keywords “laryngeal” and “coccidioidomycosis” and “adults”, "upper respiratory tract" and "coccidioidomycosis" and "adults".</p> <p><bold>RESULTS.</bold> In the review, we could access 8 publications with a total of 10 cases in which 7 men and 3 women were reported, with a mean age of 49.3 years. The ten reported cases were from the southern region of the United States, which borders our state of Sonora in the north. Also, we report the case of a 24-year-old male patient, who presented a chronic picture of more than 1 year with dysphonia, worsening in the last month. He underwent direct laryngoscopy with biopsy, resulting in the diagnosis of laryngeal coccidioidomycosis. Our patient had multiple comorbidities, among which chronic kidney disease in treatment with peritoneal dialysis, erythropoietin and prednisone, with a history of renal transplant in 2017, rejected in 2019.</p> <p><bold>CONCLUSION.</bold> Laryngeal coccidioidomycosis is a diagnostic challenge for the clinician, its characteristics may appear to be a malignant entity, up to the formation of abscesses and even present bone destruction. The geographical area in which we are located makes it necessary to always include coccidioidomycosis as a pathology to rule out in our patients.</p> </abstract>ARTICLEtrue between daytime sleepiness, arterial hypertension and the degree of apnea in patients with obstructive sleep apnea syndrome<abstract> <title style='display:none'>Abstract</title> <p><bold>BACKGROUND.</bold> Sleep-breathing disorders are increasingly common in the general population, affecting the quality of life from many points of view. Patients with sleep-disordered breathing have a series of comorbidities, including arterial hypertension, which affects the quality of life also through the collateral manifestations of daytime sleepiness.</p> <p><bold>MATERIAL AND METHODS.</bold> A descriptive study was conducted on a group of 134 patients who underwent investigations to determine the degree of obstructive sleep apnea syndrome (OSAS) by respiratory polygraphic and polysomnographic investigations. This group was also investigated from the point of view of blood pressure values as well as the degree of daytime sleepiness, an important element for the quality of life.</p> <p><bold>RESULTS.</bold> The average age of the evaluated patients was 42.18±12.70 years, and the body mass index was 31.20±5.74 kg/m<sup>2</sup>. The assessment of systemic blood pressure indicated an increased value above its standard normal value in most subjects: 58 patients (43.9%) were included in stage I hypertension, 9.8% in stage II, 1.5% of the subjects were diagnosed with stage III hypertension. To describe the relationship between OSAS and quality of life assessed by the degree of daytime sleepiness, we performed the regression and correlation analysis. The dependence between the values of the apnea-hypopnea index (AHI) and the ESS (the degree of daytime sleepiness) was positive; an increase in the AHI implies an increase in the ESS, thus a decrease in the quality of life.</p> <p><bold>CONCLUSION.</bold> We can conclude that the severity of OSAS is directly involved in establishing the degree of arterial hypertension. Moreover, early detection is essential in order to decrease the degree of daytime sleepiness and implicitly increase the quality of life.</p> </abstract>ARTICLEtrue of the 7 Congress of the Romanian Rhinologic Society, perceptions and knowledge regarding antibiotic use for respiratory illness and antibiotic resistance in Romania: an observational, questionnaire-based study results<abstract> <title style='display:none'>Abstract</title> <p><bold>BACKGROUND.</bold> Antibiotic resistance represents a public health threat worldwide, being a major cause of mortality due to resistant bacterial pathogens responsible for infections and colonisations. Worldwide, there is an inappropriate use of antibiotics in upper respiratory tract infections.</p> <p><bold>OBJECTIVE.</bold> To generate a quantitative snapshot of incidence of respiratory illnesses and symptoms, as well as behaviours and attitudes related to upper respiratory infections among Romanians; to understand the usage of antibiotics for respiratory symptoms and illnesses as well as sufferers’ attitudes and beliefs.</p> <p><bold>MATERIAL AND METHODS.</bold> An observational, descriptive, questionnaire-based global study was conducted in 2022. Adults from 12 countries who had experienced respiratory symptoms in the past 6 months were included (n=1000 per country). Data was collected on antibiotic use and attitudes towards antibiotics, respiratory symptom counselling and bacterial resistance. Herein, we focus on the results of Romanian respondents.</p> <p><bold>RESULTS.</bold> 40.2% took antibiotics for respiratory conditions in the past 6 months, 46.05% of them for cough symptoms and 44.4% for sore throat. 55.72% of the respondents took antibiotics for flu/cold; the most users in 55-64y group. 64.4% obtained the antibiotic from a doctor or nurse. Furthermore, 72.9% of the respondents who took antibiotics had undergone a diagnostic test prior to treatment. Unfortunately, 51.8% believed antibiotics kill viruses and 46% that antibiotics are efficient in cold/flu. Regarding the antibiotic resistance, only 16.5% were very well informed.</p> <p><bold>CONCLUSION.</bold> There is a great number of Romanians who use leftover antibiotics from previous prescriptions, the most frequent reasons being sore throat and common cold. In upper respiratory tract infections, the symptomatic treatment, such as multi-symptom cold/flu medication associated with sore throat medication, should be the first-line treatment. Further interventions are needed to increase awareness of antibiotic resistance.</p> </abstract>ARTICLEtrue with Cinnabsin in patients with acute and exacerbated chronic rhinosinusitis<abstract> <title style='display:none'>Abstract</title> <p><bold>BACKGROUND.</bold> Patients with rhinosinusitis account for about 30% of the total amount of otolaryngologic patients and their number is constantly growing. Currently, there is no ideal treatment for acute and especially chronic rhinosinusitis and various therapeutic approaches are still under debate.</p> <p><bold>OBJECTIVES.</bold> To evaluate the effectiveness and the safety of Cinnabsin® in acute and exacerbated chronic rhinosinusitis treatment.</p> <p><bold>MATERIAL AND METHODS.</bold> We included in our non-interventional, multicenter, prospective study 200 patients with acute and exacerbated chronic rhinosinusitis in order to evaluate the effectiveness and the safety of treatment with Cinnabsin® (while 20 out of 200 patients received additional therapy, only patients who did not receive additional therapy were taken into account in the statistical analysis; 180 patients have been treated with Cinnabsin® only and this is the basis of the statistical assessments performed). Changes in the total score of the typical symptoms of rhinosinusitis were assessed, and changes in edema, hyperemia and secretion were assessed by rhinoscopy.</p> <p><bold>RESULTS.</bold> The total score of the typical symptoms of rhinosinusitis showed a statistically significant difference between the first and final visits – v4 vs. v1 according to Pearson Chi-square (p = 0.0000) as well as in accordance with Risk Difference (RD), Relative Risk (RR), Odds Ratio (OR) ratios at the beginning and end of the treatment. The healthy status of the patients (major improvement, improvement, no complaints) was rated as 93.9% at the final visit. The efficacy of treatment (major improvement, improvement, no complaints) was rated as 93.9% at the final visit. Treatment tolerance was rated as very good in almost all patients (99.4%).</p> <p><bold>CONCLUSION.</bold> Cinnabsin® could be considered efficient in reducing the symptoms of acute rhinosinusitis, shows a very good safety profile, and could be recommended for outpatient treatment of patients with acute or exacerbated chronic rhinosinusitis, no matter the additional therapy.</p> </abstract>ARTICLEtrue