N.A. Arefieva, L.F. Aznabaeva, E.R. Sharipova Bashkir State Medical University, Ufa The development of inflammation of the nasal mucosa and paranasal sinuses is facilitated by factors of the immune response, as well as processes leading to a violation of the drainage function of the sinus ostia. The aim of the study: to evaluate the influence of anatomical features of the nasal cavity and the production of endogenous IL-1? on the frequency of relapses of chronic purulent rhinosinusitis. Materials and methods: the examination was conducted on 57 patients aged 23 to 73 years, who were treated in the ENT department of the Republican Clinical Hospital of Ufa from 1998 to 2000 due to an exacerbation of chronic purulent rhinosinusitis. A specially developed questionnaire was offered to the examined patients. The causes and frequency of relapses of chronic purulent rhinosinusitis were studied. An examination of the ENT organs, endoscopy of the nasal cavity with a flexible Olympus endoscope, and radiation diagnostics - X-ray and/or computed tomography of the nose and paranasal sinuses in axial and coronal projections (as indicated) were also performed. The immune response was assessed once before treatment by determining the ability of blood cells to produce IL-1? when stimulated by phytohemagglutinin. Own observations: the results of the endoscopic examination showed that anatomical features of the intranasal structures were present in 29 patients (50.8%), in the form of: curvature of the nasal septum in 20 people (35.1%); changes in the area of ??the ostiomeatal complex in 9 people (15.8%); bilateral nasal polyposis - 6 people; a combination of curvature of the septum with bilateral nasal polyposis in 2 people; anomalies of the uncinate process - 1 person. Indicators of IL-1? production were as follows: in one group (20 people), instead of the expected increase, the IL-1? production rates corresponded to the data of practically healthy individuals (PHI) (505.17±15.4 pg/ml). 20 people were patients, the IL-1? production rates by blood cells of which were even lower than the level of practically healthy individuals (PHI) (247.5±12.16 pg/ml, p<0.05). Only 17 people had rates higher than the data of PHI (1435.2±21.3 pg/ml, p<0.05). In addition, 27 patients (47%) had a combination of anatomical changes in the nasal cavity with inadequate production of the proinflammatory cytokine - IL-1?, in the form of its decrease. An analysis of the recurrence rate of chronic purulent rhinosinusitis depending on the studied pathogenetic features showed that the greatest number of exacerbations occurred in patients with combined pathology. This was expressed in a combination of anatomical changes in the nasal cavity and a simultaneous decrease in IL-1? production indicators - 27 patients (47.4%). In the presence of only anatomical changes in the nasal cavity or only a decrease in IL-1? production, the frequency of relapses of chronic purulent rhinosinusitis occurred in an almost equal number of observations (26.3% and 21%, respectively). In the group of patients without anatomical abnormalities of the nasal cavity and with adequate IL-1? production, a relapse of the disease was noted in only one case (5.3%). Conclusions: 1. Relapses of chronic purulent rhinosinusitis suggest the need to select a treatment algorithm that ensures long-term remission or recovery of the patient. Based on the obtained results, the desired effect can be achieved only if the normal architecture of the nasal cavity is restored, ensuring good aeration of the paranasal sinuses. This problem can be addressed primarily through surgical treatment options. 2. A study of the immune response in patients with chronic purulent rhinosinusitis revealed that a significant number of patients have a reduced ability of blood cells to produce IL-1?, which may serve as an indication for cytokine replacement therapy.