V.N. Kim, Yu.V. Albrecht, N.I. Glinskaya Railway Hospital, Karaganda-Sorting Station, Kazakhstan The results of a long-term study of the prevalence of pathological inflammatory processes in the paranasal sinuses and the issues of rational and gentle treatment of these diseases remain relevant to this day. The development of new aspects of the technological process in otolaryngology suggest a new assessment of the issues of etiology and pathogenesis of diseases of the paranasal sinuses. [Palchun V.G. et al.; 1982] Sinusitis usually requires both general and local treatment. In the local treatment of exudative forms of inflammation of the maxillary sinuses, a well-proven method of repeated sinus lavage followed by the introduction of drugs is widely used. In most cases, this method leads to recovery of patients. However, treatment requires repeated punctures of the maxillary sinus, which are often poorly tolerated by patients, especially children and those with concomitant cardiovascular and nervous system diseases. Treatment of patients with punctures is favorably compared to methods of continuous drainage of the maxillary sinus through the inferior nasal passage. [Varvantsev G.N. 1986, Shevrygin B.V. 2002]. However, patients experience difficulties when inserting a tube into the sinus, (especially in children), associated with its large diameter and the narrowness of the inferior nasal passage. Complaints have been noted in adults and children caused by tight pressure of a rigid tube to the mucous membrane of the nasal septum, nosebleeds, a sensation of a foreign body in the nasal cavity, and the drainage tube itself, due to its location in the maxillary sinus, is a foreign body, an irritant. A puncture-free method of treating acute purulent sinusitis is partially justified. A study of the comparative effectiveness of puncture and non-puncture methods for treating acute purulent sinusitis has shown that recovery from acute purulent sinusitis occurs with the non-puncture method of treatment only with sufficient function of the maxillary sinus ostium and a full state of local immunity and properly selected antibacterial therapy. [Grigoryeva N.V. 2003]. The use of computed tomography and magnetic resonance imaging in examining patients, the development of microendosurgery of the nose and paranasal sinuses using endoscopes, the creation and introduction of the YAMIK sinus catheter into practice have marked a new stage in the sparing options for the treatment of acute and chronic purulent sinusitis. [Markov G.I., Kozlov V.S. [1984] Pathology of the lateral nasal wall, where the sinus ostia are located—the ostiomeatal complex (OMC)—plays a leading role in the development of inflammatory processes in the paranasal sinuses. Restoring normal function of the sinus secretion transport pathways and suppressing bacterial inflammation is a fundamental issue in the treatment of purulent sinusitis. When treating sinusitis, otolaryngologists typically encounter pathological processes in several sinuses simultaneously, so one of the key issues in the treatment of acute and chronic sinusitis is the shortest possible treatment period with minimal trauma to the patient. To address these issues, the ENT department of the railway hospital examined and treated 60 patients with acute and chronic purulent pathology of the maxillary sinuses, aged 12 to 50. All patients underwent radiographic examination and diagnostic endoscopy of the nasal cavity using rigid 0° and 30° endoscopes manufactured by Eleps. Bacteriological examination of flora for its sensitivity to antibiotics and adequate antibacterial therapy were performed. All patients complained of headaches, nasal congestion, and purulent discharge. In 8 patients, purulent discharge was absent, which was due to mucosal edema in the area of ??the ostiomeatal complex. During diagnostic endoscopy, edema, hyperemia of the nasal mucosa, and narrowing of the middle nasal meatus were noted in all patients. A significantly protruding uncinate process was detected in 10 patients, an enlarged bullous middle nasal turbinate was determined in 6 patients, and the semilunar fissure and the area of ??the ethmoid infundibulum were blocked by mucosal edema in 15 patients. Of the 60 patients with acute purulent maxillary sinus disease, 30 underwent punctures with a Kulikovsky needle, while 30 patients underwent YAMIK-2 sinus catheterization followed by the administration of antibiotic and hydrocortisone solutions. Patients whose sinus microflora was not isolated were administered a 1% dioxidine solution with hydrocortisone. Both groups of patients underwent the procedures every other day. The following results were obtained after the combined treatment: 20 patients who underwent maxillary sinus punctures until the lavage fluid was clear achieved clinical recovery within 8-9 days. Ten patients experienced clinical improvement due to a deviated nasal septum. Control radiographs of the paranasal sinuses revealed moderate thickening of the sinus mucosa. These patients complained of mild nasal congestion on the side with the deviated septum. These patients subsequently underwent surgical treatment for their deviated septa. Twenty-five patients who underwent YAMIK-2 sinus catheterization obtained pus during the first procedure. Five patients did not obtain pus despite complaints. According to the anamnesis, purulent sinusitis had been observed for 2-3 months. No medical attention was sought. Headaches disappeared or decreased in 23 patients after the first procedure. After the second procedure, purulent exudate was obtained in 12 patients, including those who did not obtain pus during the first procedure. Administration of an antibiotic solution with hydrocortisone caused liquefaction of the accumulated pus, which during the subsequent procedure contributed to the abundant discharge of liquid purulent exudate and a decrease in the swelling of the ostiomeatal complex. Moderate amounts of serous-mucous exudate were obtained in 9 patients. During the 3rd manipulation, purulent secretion was obtained in two patients, and a small amount of serous-mucous exudate (0.5-1.0) was obtained in 10 patients. No exudate was obtained in 18 patients. After the 4th manipulation, no secretion was obtained in the remaining 10 patients. Filling the paranasal sinuses with 10-12 ml of antibiotic solution indicated a clinically positive complete result of sinusitis treatment. Thus, after the 3rd - 4th sinus catheterization with YAMIK-2, all 30 patients showed clinical recovery or improvement. Research has shown that the YAMIK-2 sinus catheterization method promotes rapid relief of headaches (the main symptom of sinusitis), has a beneficial effect on the nasal mucosa and the ostiomeatal complex, evacuates purulent secretions from the paranasal sinuses and fills them with medications, and restores secretion transport from the sinuses, thereby eliminating obstructed nasal breathing and nasal discharge. Thus, of the possible gentle conservative treatments for acute and chronic sinusitis described above, the YAMIK sinus catheterization method is the most appropriate.