V.I. Egorov, A.V. Kozarenko, E.Yu. Kazakova Central Military Clinical Hospital named after A.A. Vishnevsky, Moscow Chronic vasomotor (or year-round idiopathic) rhinitis, regardless of the cause and clinical development of its various forms, has a common pathogenetic mechanism for all its variants: hyperreactivity of the vascular and secretory systems of the nasal mucosa. In their treatment, it is advisable, on the one hand, to adhere to a consistent "step by step" tactic. On the other hand, if conservative measures are ineffective, do not delay surgical intervention, as a relationship has long been noted between the effectiveness of various surgical methods and the duration of the disease, due to changes in the mucosa itself, the development of a tendency to hyperplasia, and deterioration of mucociliary transport. The goal of surgical treatment of vasomotor rhinitis is to reduce nasal resistance to the inhaled air stream by reducing the volume of the inferior turbinates. Nasal breathing is assessed extemporo using a Gletzel mirror and documented using anterior active rhinopneumometry; mucociliary transport is assessed using the classic saccharin test. We employ the following surgical techniques in our practice. Ultrasonic disintegration of the inferior turbinates was proposed by L.L. Ferkelman in 1972; three submucosal tunnels are made using a disintegrator. This technique was primarily used in individuals under 16 and over 70 years of age (n=26). Surgical trauma is minimal (histologically confirmed by the depth of the coagulation necrosis zone) and is sufficient to improve nasal breathing during puberty until hormonal status stabilizes, and is better tolerated in old age. According to our data, mucociliary transport is quickly restored using the saccharin test, within 8-10 days. However, positive long-term results (up to 2-3 years) are no more than 70% (in a telephone survey of 20 respondents, after 5-7 years, improvement was maintained in half). Bleeding requiring posterior nasal packing was noted once (the posterior end of the inferior turbinate was punctured). Submucous osteal conchotomy is a very physiological surgical intervention, we use our own modification (n = 32). It preserves both the bone framework of the inferior turbinate and the ciliated epithelium covering it. Only the stroma of the turbinate with the cavernous tissue located within it is destroyed. The rate of mucociliary transport is restored by the end of the 2nd week in 80% and by the end of the 3rd in 20%. Normalization of nasal breathing is also by the end of the 3rd week. Retrospective analysis shows a lasting improvement of at least 75%. There were two episodes of bleeding from incisions along the anterior ends of the inferior turbinates (stopped by inserting a hemostatic sponge and pressing it from above with cotton swabs). Laser surgery is a reliable method for treating hypertrophic and vasomotor rhinitis. Inferior turbinates are destroyed with CO2 laser radiation by creating submucosal laser wound channels along the superior, medial, and inferior surfaces (5-6 watts of power were used). Postoperative bleeding was never observed, and fewer crusts formed in the nasal cavity (n=23). The rate of mucociliary transport normalizes by days 14-18. Improvement in nasal breathing is noted from days 7-10, with a sustained positive result (2-3 years) of approximately 75%. Argon plasma coagulation (APC) is a relatively new high-tech treatment method in otolaryngology. APC surgery is based on a monopolar high-frequency electric current transmitted via ionized argon gas from the applicator to the tissue surface. One advantage is limited penetration depth, as damage to adjacent tissue can be avoided. We have previously described this technique. No complications were observed with its use (n=48). The rate of mucociliary transport was reduced to 10-14 days. Significant improvement in nasal breathing begins at 10-12 days, stabilizing after three weeks. Positive long-term results are at least 80%. We have previously also used nitrogen monoxide plasma. However, due to the difficulty of delivering it (large diameter of the applicator tip) and, consequently, the difficulty of achieving dosed tissue exposure (n=20), we abandoned this method. Sometimes, after performing one of the above-mentioned surgeries, we observed insufficient localized reduction of the nasal turbinates at various points along their length, requiring, in our opinion, resection of the superior portion. Further analysis of the anamnestic data revealed that in all cases, the disease had been present for more than a year. Conclusions: 1. Surgical treatment of vasomotor rhinitis is advisable to begin when the disease has been present for up to a year (the stage of the well-known "minor" signs). 2. Submucosal argon plasma destruction of the inferior turbinates is well tolerated and yields better, more lasting functional results.