Влияние курсового приёма цинка на эффективность эндоскопического хирургического лечения хронического риносинусита у детей и активность цилиарного аппарата слизистой оболочки носа

S. I. Alekseenko; A. V. Skalny; S. A. Karpischenko; S. A. Artyushkin; S. V. Barashkova; V. V. Dvoryanchikov; I. A. Anikin; A. A. Tinkov

S. I. Alekseenko Saint Petersburg Research Institute of Ear, Throat, Nose and Speech, St. Petersburg, Russia; I.I. Mechnikov North-Western State Medical University, St. Petersburg, Russia; K.A. Rauhfus Saint Petersburg Children’s Municipal Multi-specialty Clinical Center of High Medical Technology, St. Petersburg, Russia http://orcid.org/0000-0002-3377-8711
A. V. Skalny I.M. Sechenov First Moscow State Medical University, Moscow, Russia; Russian University of Peoples’ Friendship, Moscow, Russia http://orcid.org/0000-0001-7838-1366
S. A. Karpischenko K.A. Rauhfus Saint Petersburg Children’s Municipal Multi-specialty Clinical Center of High Medical Technology, St. Petersburg, Russia; I.P. Pavlov St. Petersburg First State Medical University, St. Petersburg, Russia http://orcid.org/0000-0003-1124-1937
S. A. Artyushkin I.I. Mechnikov North-Western State Medical University, St. Petersburg, Russia http://orcid.org/0000-0003-4482-6157
S. V. Barashkova K.A. Rauhfus Saint Petersburg Children’s Municipal Multi-specialty Clinical Center of High Medical Technology, St. Petersburg, Russia http://orcid.org/0000-0002-5618-4510
V. V. Dvoryanchikov Saint Petersburg Research Institute of Ear, Throat, Nose and Speech, St. Petersburg, Russia http://orcid.org/0000-0002-0925-7596
I. A. Anikin Saint Petersburg Research Institute of Ear, Throat, Nose and Speech, St. Petersburg, Russia; K.A. Rauhfus Saint Petersburg Children’s Municipal Multi-specialty Clinical Center of High Medical Technology, St. Petersburg, Russia http://orcid.org/0000-0003-2977-2656
A. A. Tinkov I.M. Sechenov First Moscow State Medical University, Moscow, Russia; Russian University of Peoples’ Friendship, Moscow, Russia http://orcid.org/0000-0003-0348-6192

Keywords: chronic rhinosinusitis, mucociliary clearance, zinc, inflammation, cilia

Abstract

Despite the presence of certain indications of the role of zinc in ciliated epithelium functioning, data on the potential effect of Zn supplementation in ciliary function in patients with chronic rhinosinusitis are absent. The aim of this study was to evaluate the efficiency of surgical treatment, ciliary activity, as well as local inflammation of nasal mucosa in children with chronic rhinosinusitis undergoing functional endoscopic surgery.
Methods. 192 pediatric patients with chronic rhinosinusitis were examined. 131 patients received standard postoperative prescriptions, whereas 61 children received 10 mg Zn daily for 90 days. Serum Zn concentrations were measured by inductively coupled plasma mass spectrometry. Ciliary function was evaluated by video cytomorphometry. Surgery efficiency was assessed with a SNOT-20 questionnaire, as well as with Lund-Kennedy and Lund-Mackay scales.
Results. Functional endoscopic sinus surgery resulted in a significant decrease in total SNOT-20, Lund-Kennedy, and Lund-Mackay scores independent of Zn supplementation. At the same time, Zn supplemented patients had a significantly lower risk of revision surgery. Zn also had a significant impact on ciliary function. Specifically, up to the 12^th mo postoperatively, Zn supplementation resulted in higher number of cells with motile cilia, ciliary beat frequency, ciliary length, and cell viability as compared to controls. Increased Zn status was also associated with a manyfold decrease in mucosal neutrophil and lymphocyte infiltration.
Conclusions. It is proposed that Zn enhances reparative processes in nasal mucosa and possesses anti-inflammatory activity.

The impact of zinc supplementation on the outcome of endoscopic sinus surgery and ciliary function of the nasal mucosa in children with chronic rhinosinusitis

Abstract