M.E. Zulinskaya, V.S. Dergachev, Altai State Medical University, Barnaul. Inflammatory diseases of the paranasal sinuses are a major problem in otolaryngology, requiring enormous financial expenditures. According to estimates, 10 million people in Russia suffer from acute rhinosinusitis annually. It is believed that 9 out of 10 patients do not seek medical attention. Acute sinusitis is often a complication of a cold. The average duration of the illness is 8-12 days and requires broad-spectrum antibacterial agents, often several at once. Silver is a powerful antiseptic, has an oligodynamic effect, does not develop tolerance, and selectively affects only pathogenic microflora. Silver ions have bactericidal and bacteriostatic effects on virulent microflora, including those causing acute sinusitis. We observed 90 patients with acute maxillary sinusitis who sought medical attention for the first time. Research has shown that acute sinusitis most frequently (70%) occurs between the ages of 16 and 35. Men are 20% more likely to suffer from acute maxillary sinusitis than women. This can likely be explained by men's greater exposure to cold, less attentiveness to their condition, and a higher incidence of nasal pathology due to various injuries. During examination, patients most frequently complained of nasal congestion on the side of the inflammation, abnormal nasal discharge, weakness, general malaise, low-grade or febrile temperature, and headache, which is consistent with generally accepted opinion. Diagnostic punctures of the maxillary sinuses revealed obstructed sinus drainage in 12% of those examined. This is associated with dysfunction of the natural ostium, caused by swelling of the ostium mucosa, a deviated septum, and hypertrophy of the nasal turbinates. Purulent secretions are most commonly found in the sinuses, which is confirmed by bacteriological studies. According to our data, Streptococcus pneumoniae and Hacmophilus influenzae were the most common virulent bacteria, consistent with the generally accepted opinion of some authors. Despite the presence of active inflammation in the sinus, no microbial growth was observed in 16.7% of patients. All patients were divided into three groups of 30 patients, each based on treatment method. The patient groups were identical in terms of clinical and laboratory data, as well as examination methods. All patients were discharged with recovery. To determine the optimal treatment regimen for maxillary sinusitis, the following methods were used: treatment with an ionic silver solution alone, and combination therapy combining an ionic silver solution with topical antibiotics. An ionic silver solution at a concentration of 120 mg/L was used as an antimicrobial agent. All patients had a sterile catheter inserted into the maxillary sinus during the initial puncture, and medications were subsequently administered through it. The patients underwent daily nasal anesthesia with vasoconstrictors (naphthyzinum, saporin, and galazolin) and hyposensitizing therapy (suprastin, fexadine, and telfast). To reduce sinus secretions, patients were prescribed topical UHF and laser therapy. In the first group of patients (30 patients), a traditional treatment method was used, including sinus lavage through a catheter with antiseptic solutions and the introduction of antibiotics, initially selected empirically, and then taking into account the sensitivity to antibiotics. Solutions of drugs were introduced into the sinus - lincomycin, gentamicin, ciprofloxacin, metrogyl in combination with proteolytic enzymes (chymotrypsin, chymopsin) and corticosteroids (hydrocortisone, dxamstazone). Sinus lavage through a catheter was performed twice a day. In the second group, also 30 people with acute maxillary sinusitis, complex treatment was carried out. Initially, the treatment was traditional, as described above, and then the maxillary sinus was lavaged through a catheter with an ionic silver solution (120 mg / l) in an amount of 50-100 ml (per lavage) until the absence of pathological discharge from the sinus. The procedure was performed twice daily. The third group consisted of patients with acute sinusitis, whose maxillary sinus was irrigated through a catheter only with an ionic silver solution at a concentration of 120 mg/L, without the introduction of any other medicinal substances, until the absence of pathological discharge from the sinus. The manipulation was also performed twice a day. Treatment in all groups was carried out until the disappearance of clinical symptoms, restoration of nasal breathing, until the absence of pathological discharge from the sinuses, i.e. until recovery. Long-term treatment results were assessed after 6 months and 1 year of treatment. In the group of patients treated using the traditional method, the selected antibiotic with in vitro sensitivity was sometimes (27%) ineffective when used in vivo, or there was an allergic reaction to this drug. As a result of treatment, nasal breathing was restored or periodic mild nasal congestion persisted, there was no pathological discharge from the nose: the treatment period was within 8-10 days. In evaluating the long-term results of the study, a temporary treatment effect was observed in 6% of patients in this group, while disease relapse occurred in 3%. In the group of patients who received comprehensive treatment, patients reported complete restoration of nasal breathing, the absence of pathological nasal discharge, and an improvement in well-being at the end of treatment. The treatment period for this group was 6-8 days. No disease relapses were observed. In Group III, an ionic silver solution at a concentration of 120 mg/L was used for treatment for the first time. While using this drug, patients noted a significant improvement in well-being within 2-3 days, headaches disappeared, nasal congestion decreased, and nasal breathing was restored. The treatment period for this group of patients was 4-6 days. We did not observe a temporary therapeutic effect or relapses in this group of patients. In addition, patients noted a reduced susceptibility to travel-related infectious diseases in the long-term periods of treatment, and the absence of allergic reactions. Thus, we believe that the use of a 120 mg/L ionic silver solution in ionotherapy and combination therapy for the treatment of patients with acute maxillary sinusitis is more effective than traditional conservative treatment methods and reduces hospital stays. This treatment method is the treatment of choice for patients with allergic reactions to antibacterial drugs, patients with dysbacteriosis (children), and pregnant women.