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Ozena: treatment
Last reviewed: 23.04.2024
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Currently, therapeutic measures are aimed at influencing the microbial factor, elimination of the main manifestations of the disease (peel, smell) and symptomatic therapy aimed at improving the functional state of the nose.
Indications for hospitalization
Hospitalization is indicated for moderate to severe forms of the disease, provided that there is no possibility of outpatient treatment.
Non-drug treatment
First of all, to remove the crusts, you can use nasal irrigation with 0.9% sodium chloride solution with the addition of iodine, sea node preparations, and nasal douche with the Dolphin device.
Drug treatment
For anti-Klebsiella pneumoniae ozaenae, various anti-microbial agents were used, but the aminoglycoside series of antibiotics deserve attention today: gentamicin, streptomycin, etc. Streptomycin, for example, injects intramuscularly 0.5 g 2 times a day, for a course of treatment up to 20 g.
Along with this, local treatment is necessary, including antimicrobials and drugs that improve trophism of the tissues of the nasal cavity, preventing the formation of crusts and odor. Streptomycin introduced into the drug mixture has an antimicrobial effect. There are no conditions for the formation of crusts, the feeling of dryness disappears, the smell disappears. To expand the blood vessels, you can enter into the composition of the medicinal mixture of xanthinol nicotinate.
Surgical treatment of ozena
All variants of the existing surgical treatment are aimed at artificial narrowing of the nasal cavity, for which autotransplants (bone, rib cartilage), allo-grafts, synthetic materials (polyurethane), etc. Are introduced into the submucosa of the side walls or nasal septum. Before the operation, it is necessary to conduct a preparatory course of conservative therapy for 12-14 days, aimed at cleaning the mucous membrane of the crusts and improving its trophism. Surgery is a palliative measure and does not always improve the condition of the patient.
Further management
Approximate periods of disability - 20-30 days at inpatient treatment. The patient must be under the constant supervision of an otorhinolaryngologist with the obligatory statement at the dispensary account with periodic check of the nasal microflora.
The patient’s attention should be paid to the observance of the rules of personal and general hygiene, since infection with Klebsiella pneumoniae ozaenae occurs through contact and through public goods, as evidenced by cases of familial ozone disease.
Forecast
Currently, in most cases, the prognosis is quite favorable for life, ability to work and communicate with others (with proper management of the patient).
Prevention
Considering the infectious nature of the disease, prophylaxis involves the observance of the personal hygiene rules of the patient with the allocation of individual care items. Strict observance of sanitary-hygienic measures in the family and the immediate environment is necessary.