Combined nasal spray containing tuaminoheptane, acetylcysteine, and hyaluronic acid in the complex therapy for acute rhinosinusitis
Authors:   St. Petersburg Research Institute of Ear, Throat, Nose, and Speech, St. Petersburg, Russian Federation, Ryazantsev S.V. , Krivopalov A.A. ,   St. Petersburg Research Institute of Ear, Throat, Nose, and Speech, St. Petersburg, Russian Federation,   I.I. Mechnikov North-Western State Medical University, St. Petersburg, Russian Federation, Dvoryanchikov V.V. ,   St. Petersburg Research Institute of Ear, Throat, Nose, and Speech, St. Petersburg, Russian Federation, Alekseenko S. ,   St. Petersburg Research Institute of Ear, Throat, Nose, and Speech, St. Petersburg, Russian Federation,   I.I. Mechnikov North-Western State Medical University, St. Petersburg, Russian Federation,   K.A. Raukhfus Children City Multidisciplinary Clinical Center of High Medical Technologies, St. Petersburg, Russian Federation, Kuzovkov V.E. ,   St. Petersburg Research Institute of Ear, Throat, Nose, and Speech, St. Petersburg, Russian Federation, Barashkova S.V. ,   St. Petersburg Research Institute of Ear, Throat, Nose, and Speech, St. Petersburg, Russian Federation,   K.A. Raukhfus Children City Multidisciplinary Clinical Center of High Medical Technologies, St. Petersburg, Russian Federation, Tikhomirova E.K. ,   K.A. Raukhfus Children City Multidisciplinary Clinical Center of High Medical Technologies, St. Petersburg, Russian Federation
Published: October 2023

Aim: to assess the effect of hyaluronic acid on the clinical efficacy of a combination of tuaminoheptane and N-acetylcysteine and the functional activity of the nasal mucociliary apparatus in acute rhinosinusitis (ARS). Patients and Methods: 60 adults aged 17–65 and 60 children aged 6–16 diagnosed with moderate ARS were enrolled. The study group received Drug 1 (a dosed spray for topical use containing tuaminoheptane, acetylcysteine, and sodium hyaluronate). The comparison group received Drug 2 containing tuaminoheptane and acetylcysteine. In addition, all patients received standard antibacterial therapy. Patients were examined at three control points. Visit 1 is an initial referral for subjective assessment of the severity of complaints using a 10-point visual analogue scale/VAS), assessment of symptoms by a specialist (0-3 points), and evaluation of the morphological structure of the mucosa and functional activity of the nasal mucociliary apparatus using video histomorphometry. Visit 2 occurred 5–7 days after starting treatment with a similar set of examinations. Visit 3 occurred on days 10–14 after treatment, and examinations included assessment of the severity of complaints and ARS symptoms. Results: comparative analysis of changes in the severity of complaints and objective ARS signs in both age groups demonstrated that both drugs significantly reduced the severity of subjective complaints and ARS symptoms. However, Drug 1 demonstrated greater clinical efficacy. Both drugs were safe in both adults and children. Drug 1 containing hyaluronic acid had a positive effect on cell morphology and survival and on the activity of the nasal mucociliary apparatus. Conclusions: a combined nasal spray containing sodium hyaluronate, tuaminoheptane, and N-acetylcysteine demonstrated higher clinical efficacy because of a positive effect on the nasal mucociliary apparatus and morphological characteristics of the nasal ciliated epithelium. Therefore, this preparation is recommended for practical use in adults and children. KEYWORDS: acute rhinosinusitis, hyaluronic acid, tuaminoheptane, acetylcysteine, mucociliary clearance, ciliated epithelium, decongestants, mucoactive therapy. FOR CITATION: Ryazantsev S.V., Krivopalov A.A., Dvoryanchikov V.V., Alekseenko S., Kuzovkov V.E., Barashkova S.V., Tikhomirova E.K. Combined nasal spray containing tuaminoheptane, acetylcysteine, and hyaluronic acid in the complex therapy for acute rhinosinusitis. Russian Medical Inquiry. 2023;7(8):498–510 (in Russ.). DOI: 10.32364/2587-6821-2023-7-8-5.