=Paper=
{{Paper
|id=Vol-3302/paper13
|storemode=property
|title=Implementation of Uncertainty Calculation Elicited from Paranasal Sinuses Bones' Structural Parameters for Various Approaches to Treat Recurrent Poliposus
|pdfUrl=https://ceur-ws.org/Vol-3302/short7.pdf
|volume=Vol-3302
|authors=Viktor Reschetnik,Vadym Zherebkin,Galyna Semko,Andrii Lupyr,Victoriia Alekseeva,Rozana Nazaryan
|dblpUrl=https://dblp.org/rec/conf/iddm/ReshetnikZSLAN22
}}
==Implementation of Uncertainty Calculation Elicited from Paranasal Sinuses Bones' Structural Parameters for Various Approaches to Treat Recurrent Poliposus==
https://ceur-ws.org/Vol-3302/short7.pdf
Implementation of Uncertainty Calculation Elicited from
Paranasal Sinuses Bones' Structural Parameters for Various
Approaches to Treat Recurrent Poliposus
Viktor Reschetnika ,Vadym Zherebkinb, Galyna Semkoc, Andrii Lupyrd, Victoriia
Alekseevab,d and Rozana Nazaryand
a
Kharkiv National University of Radio Electronics, 14 Nauky Avenue, Kharkiv, 61116, Ukraine
b
Kharkiv International Medical University, 38 Molochna str., Kharkiv, 61001, Ukraine
c
SE Institute of Dermatology and Venerology of the NAMS of Ukraine, 7/9,Chernyshevska Street, Kharkiv,
61057, Ukraine
d
Kharkiv National Medical University, 4 Nauky Avenue, Kharkiv, 61000, Ukraine
Abstract
The problem of polyposus recurrent rhinosinusitis is extremely pressing today.
The aim of our study was to implement the uncertainty measurement of the bone structure
parameters of the paranasal sinuses for different ways of the treatment of the recurrent
polyposus rhinosinusitis.
Material and Methods. 400 people were included to the current study. 300 patients of the
study group were divided into three groups (100 patients in the each one), depending on the
treatment type they received.
Results. In the group of patients who underwent surgical treatment, vaccination both with the
prescription of the intranasal glucocorticosteroids, rather low density values were also
observed.
Conclusions. Uncertainty measurements were implemented to the calculation of the bone
density in different groups of patients. Obtained results provided strong evidence that patients
who had undergone that treatment were highly unlikely to develop complications and/or
recurrences.
Keywords 1
Recurrent poliposus rhinosinusitis, bone density, computed tomography, uncertainty
1. Introduction
Modern scientific approaches play an important role in a different branches of medicine and
science [1-3]. Recurrent poliposus rhinosinusitis (RPRS) accounts for significant overall burden of
chronic diseases of nasal cavity that puts it into limelight of modern otorhinolaryngology [4].
Recurrence of rhinosinusitis can ensue from various events that make direct or mediated impact on
different links of sophisticated chain weaving the pathogenesis of this disease. In particular driving
cause, presence or absence of comorbidities (for example bronchial asthma), morphological features
of nasopharynx and choice of treatment are the main contributors that predetermine the outcome. In
particular, etiology, the presence or absence of concomitant diseases (for example, bronchial asthma),
the morphological features of the nasopharynx or oropharynx [5-6], presence or absence of bad habits
[7-9] and the choice of the optimal method of treatment [10]. There are several conventional
approaches for treatment of RPRS. Although ample data have shed light on immune pathways giving
rise to RPRS, unfortunately surgical procedure remains as a mainstream intervention. However used
IDDM-2022: 5th International Conference on Informatics & Data-Driven Medicine, November 18–20, 2022, Lyon, France
EMAIL: alinanechyporenko@mail.com; viktor.reschetnik@nure.ua; vadimzh68@gmail.com; semkogalina@ukr.net; lupyr_ent@ukr.net;
vik13052130@i.ua
ORCID: 0000-0002-4501-7426; 0000-0002-8021-4310; 0000-0001-7025-9462; 0000–0002–9465–224X; 0000--0002-9896-163X; 0000-
0001-5272-8704
© 2020 Copyright for this paper by its authors.
Use permitted under Creative Commons License Attribution 4.0 International (CC BY 4.0).
CEUR Workshop Proceedings (CEUR-WS.org)
solely surgical management has high [11] odds to fail with respect to accomplished cure as well as
some postoperative disturbances experienced by majority of patients and therefore affected quality of
life, reduced timespan between relapses under condition of lingering causative drivers of RPRS.
However many publications target is involvement of allergic disorders, but infectious immunity
contribution to sparkling of RPRS is often skipped by scrutiny. Considering immune response as the
pivotal protective measure against infectious agents, significance of search and development of new
means to modulate immune response can’t be overestimated.
Efficacy of treatment predetermines risk of recurrences. Nowadays there is no consolidated and
unified conception regarding pathogenesis of recurrent course of RPRS, however the mainstay of
modern view at this issue considers attrition of bone density stemmed from overwhelming
predominance of bone alteration and resorption fuelled by long-lasting inflammatory foci nestling in
the mucus lining of paranasal sinuses. Besides the other opinion claims that particularly bone density
rather than thickness of these bones plays the key role in recalcitrant course of RPRS and risk of
complications.
In the accordance to everything was mentioned above, the aim of our study was to implement the
calculation of uncertainty of the bone structure parameters of the paranasal sinuses for different ways
of the treatment of the recurrent polyposis rhinosinusitis.
2. Material and Methods
The study included 400 people who were divided into 4 groups. The control group were formed of
100 people without some signs of rhinosinusitis. The spiral computed tomography (SCT) examination
was carried out due to an unrelated pathology of the ENT organs (for example, a suspicion of a stroke,
which was not confirmed). The first study group included 100 people with signs of chronic polypous
rhinosinusitis , who underwent only surgical treatment of the disease. The second group was formed
from 100 people. The surgical treatment of patients of this group was supplemented by the
appointment of intranasal glucocorticosteroids. Finally, 100 patients of the third group underwent
surgical treatment were prescribed vaccination according to the author's method.
Autovaccine is a suspension of concentration of 101 macrocarganisms, which were taken from the
inflammatory source. A skin test by the prick test method was provided before the using of the
autovaccine. During the first stage (3–5 tests in the fallow period due to individual reactions), the
patient took 8 injections of autovaccines. Injections of the first stage of vaccine therapy were carried
out 1 time for 2-3 days, constantly increasing the dose (first injection - 0.1 ml, second - 0.2 ml, third -
0.3 ml, fourth - 0.4 ml, fifth - 0.5 ml, sixth - 0.6 ml, seventh - 0.8 ml, eighth - 1.0 ml). After the first
stage was complete, there was a break with a diapason of 3-4 days. After the interruption, another
stage of vaccine therapy was carried out/This stage consisted of seven injections of autovaccine,
which were carried out 1 time for 2-3 days, the skin dose was once increased by 0.2 ml (first injection
- 0.1 ml, the other - 0, 3 ml, third - 0.5 ml, fourth - 0.7 ml, fifth - 0.9 ml, sixth - 1.1 ml, seventh - 1.3
ml).
All groups were similar according to the anthropometric indicators and basic clinical parameters.
All the participants gave voluntary information to participate in the current study.
All patients underwent CT scan according to the EPOS recommendations. To provide CT
examination Toshiba Aquillion tomograph (Japan) was used. Subsequently, the obtained images were
processed by the RadiANT DICOM viewer program. In all groups, bone density indicators were
calculated using Hounsfield units, and afterwards the uncertainty of the density indicators of the upper
wall of the maxillary sinus was calculated. Attention was paid to the upper wall of the Maxillary sinus
as it is potentially dangerous for the development of intraorbital complications.
Uncertainty is an internationally accepted measurement.
All contributions of the uncertainties of the input quantities form the standard uncertainty of the
measured quantity u(Sn) (the total standard uncertainty uc, which is calculated according to the rule of
summation of variances.
On the first step of our study calculating the total standard uncertainty of measurement the density
was performed using the formula:
uc ( H H ) u 2A ( H Hi ) u B2 ( H Hi ) (1),
where uA(HHi) is the type A standard uncertainty, uB(HHi) is the type B standard uncertainty.
To calculate the standard uncertainty of type A, the following formula was used:
2
n n
u A ( H Hi ) ( H Hi H H )
n 1 i 1
(2),
where Hнi is the i-th value of the sample measurements, Hн is the mathematical expectation, n is a
number of measurements in the sample.
The calculation of the standard uncertainty of type B was calculated according to the formula:
H
uB (H H ) H H (3),
3 100
where H is the measurement error of the software, which does not exceed 0.0001% [&&&].
On the next step the interval uncertainty estimate, namely the expanded uncertainty U was calculated
according to the formula
U k UC (4),
where k is the coverage factor.
The coverage factor depends on the distribution of the measured value and the level of confidence p
which was chosen. For these samples, the hypothesis of a normal distribution is confirmed, therefore,
the coverage coefficient for a p = 0.95 is assumed to be 2.
3. Results
In the course of the study, the indicators of the structure of the upper wall of the maxillary sinus
were determined in all groups of patients and the results are present in the table 1
Table 1
Results of the values calculation of the total standard uncertainty for measurements of the upper
wall’s maxillary sinus density
Head 1 UA(HH) UB(HH) Uc U
Control group 197,67 -0,00003767 19,76 39,53
Patients of the 1st gr 119,12 0,00002858 11,91 23,82
nd
Patients of the 2 gr 139,36 0,00001980 13,94 27,87
Patients of the 3d gr 196,75 0,00000641 19,68 39,35
Thus, as can be seen from the table, the maximum value of bone density was typical for a group
of people under physiological conditions. In this case, the standard uncertainty for type A was
197,67 Hu, the standard uncertainty for type B was -0,00003767 Hu, the total standard uncertainty is ,
the expanded uncertainty was 39,53 Hu.
In the group of patients who underwent only surgical treatment, the worst result was obtained
according to the comparison with the rest of presented patients groups. In this group of patients, the
type A standard uncertainty was 119,12 Hu, the type B was 0,00002858 Hu, the standard uncertainty
was 11,91 Hu, the total standard uncertainty was 23,82 Hu.
In the group of patients who underwent combined treatment (surgical treatment both with the
prescription of intranasal glucocorticosteroids) the indicators were somewhat higher, although they
differed from the control group of individuals under physiological conditions. the standard uncertainty
for type A was 139,36 Hu, the standard uncertainty for type B was 0,00001980 Hu, the total standard
uncertainty was 13,94 Hu, the expanded uncertainty was 27,87 Hu.
In the group of patients who underwent surgical treatment, vaccination both with the prescription
of the intranasal glucocorticosteroids, rather low density values were also observed. The standard
uncertainty of the type A was 196,75 Hu, the standard uncertainty for type B is 0,00000641 Hu, the
total standard uncertainty was 19,68 Hu , the expanded uncertainty was 39,35 Hu (see table 1).
Control group
600
400
200
0
-500 -400 -300 -200 -100 0 100 200 300 400
-200
-400
-600
Group2
-800
Control group
400
200
0
-500 -400 -300 -200 -100 0 100 200 300 400
-200
-400
-600
-800
Group 3
-1000
Control group
400
200
0
-500 -400 -300 -200 -100 0 100 200 300 400
-200
-400
-600
-800
Group1
-1000
Figure 1: Results of the density calculation in the different groups of patients
4. Discussion
This study devoted to pressing concern of modern otorhinolaryngology, namely RPRS, came as
pioneering in the field, because it had put under the close scrutiny deranged immune response locked
into vicious circle, elicited pieces of evidence sufficient to develop approach with use of autovaccine
preceding surgical intervention confined to endoscopic polypectomy following by endonasal
corticosteroid spray use. Efficacy of different approaches for treatment that patients had undergone
according to allocated group was evaluated by bone density as a cornerstone for predicting the risk of
impending complications and fending them off.
600
400
200
0
Bone Density, Hu
0 10 20 30 40 50 60 70 80 90 100
-200
group1
-400 control
-600
-800
-1000
-1200 Measurements
600
400
200
0
Bone Density, Hu
0 10 20 30 40 50 60 70 80 90 100
-200
control
-400 Group3
-600
-800
-1000
-1200 Measurements
600
400
200
Bone Density, Hu
0
0 10 20 30 40 50 60 70 80 90 100
Group3
-200 Group2
-400
-600
-800 Measurements
600
400
200
Bone Density, Hu
0
0 10 20 30 40 50 60 70 80 90 100
Group1
-200 Group3
-400
-600
-800 Measurements
Figure 2: Comparison of the results of density calculation in the different groups of patients
Taking into consideration variability of targeted parameter and its challenging measurement we
introduced calculation of uncertainty as the leverage to manage this hurdle and neutralize inaccuracy
of calculus.
RPRS could be detected in many people with a lot of supportive diseases[12, 13] and requires
modern approaches to its diagnostics [14,15] and new approaches for the treatment [16].
This approach also was engaged for the first time for assessment of patients with RPRS within
framework of our study. It is worth mentioning that although RPRS poses a substantional concern
from the point of view of promptitude and effectiveness of its treatment, this issue has received low
attention from evidence-based medicine. For example, one of the few studies published recently was
research of [17], the authors claimed advantage of combined macrolides and corticosteroids over the
solely use of antibiotics separately from intranasal corticosteroids. They also used SCT as the marker
of the treatment's efficacy, but the size and location of polyps were regarded of much more significant
value than SCT though. The structure of bones of maxillar sinuses wasn't evaluated at all. In our study
precisely morphological features of upper jaw's bone was the target of scrutiny, namely the density of
the top wall that was stipulated by its significance in averting intraorbital complications. As it can be
judge at the base of figure 2 the lowest bone density was revealed in patients who had undergone
solely endoscopic polypectomy.
This study could be perspective for the detection of the uncertainty parameters of the bone density
in different groups of patients, with different anthropometric data [18, 19], using new and informative
diagnostical methods [20-22].
The conclusion can be drawn that exactly this surgical procedure as the conventional management
of RPRS across the world might have been intimately related with intraoperative and long-term
postoperative complications. Furthermore particularly these patients were much more likely to
develop frequent recurrences. A bit better results of treatment were recognized among patients who
had undergone postoperative streak of intranasal corticosteroids (figure 2). However it turned out
those patients who had completed the full course including autovaccine, intranasal corticosteroids
together with adequate endoscopic polypectomy showed the best bone density of upper wall of
maxillary sinus (figure 2). Thus we can infer that holistic approach for treatment of RPRS was
associated with the highest effectivenes as it can have gotten reach of involved major causative
factors and by those means prevented from recurrences and complicated course of the disease.
5. Conclusions
Our study was the first to evaluate the bone density of maxillary sinus among patients with RPRS
with respect to the type of prescribed treatment. It turned out the best bone density was revealed in
patients who had completed combine treatment (autovaccine, intranasal corticosteroids followed by
endoscopic polypectomy). the maximum value of bone density was typical for a group of people
under physiological conditions. In this case, the standard uncertainty for type A was 197,67 Hu, the
standard uncertainty for type B was -0,00003767 Hu, the total standard uncertainty is , the expanded
uncertainty was 39,53 Hu. Obtained results provided strong evidence that patients who had undergone
that treatment were highly unlikely to develop complications and/or recurrences.
6. References
[1] W. S. A. Al Attar, “The Current Implementation of an Evidence-Based Hamstring Injury Prevention
Exercise (Nordic Hamstring Exercise) among Athletes Globally.” Physical Education Theory and
Methodology, vol. 21, no. 3, pp. 273-280, 2021, doi: 10.17309/tmfv.2021.3.11.
[2] Y. Polyvianna, D. Chumachenko and T. Chumachenko, "Computer Aided System of Time Series
Analysis Methods for Forecasting the Epidemics Outbreaks", 2019 IEEE 15th International
Conference on the Experience of Designing and Application of CAD Systems (CADSM), 2019. doi:
10.1109/cadsm.2019.8779344.
[3] C. Bales et al., "Can Machine Learning Be Used to Recognize and Diagnose Coughs?", 2020
International Conference on e-Health and Bioengineering (EHB), 2020. doi:
10.1109/ehb50910.2020.9280115.
[4] L. Yu, T. Hu. ‘[Research progress on internal classification and treatment response of chronic
rhinosinusitis]’. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi, 2020 Nov;34(11):1049-1052.
Chinese. doi: 10.13201/j.issn.2096-7993.2020.11.023. PMID: 33254332.
[5] V. Gargin, R. Radutny, G. Titova, D. Bibik, A. Kirichenko and O. Bazhenov, "Application of the
computer vision system for evaluation of pathomorphological images", 2020 IEEE 40th International
Conference on Electronics and Nanotechnology (ELNANO), 2020. doi:
10.1109/elnano50318.2020.9088898.
[6] A. E. Listyarini, “The Relations of Using Digital Media and Physical Activity with the Physical
Fitness of 4th and 5th Grade Primary School Students.” Physical Education Theory and Methodology,
vol. 21, no. 3, pp. 281-287, 2021, doi: 10.17309/tmfv.2021.3.12.
[7] R. Nazaryan, L. Kryvenko, Y. Zakut, O. Karnaukh, V. Gargin, “Application of estimated oral health
indices in adolescents with tobacco addiction”, Pol MerkurLekarski, 2020;48(287):327-330.
[8] D. Fesenko, O. Glazunov, O.Nakonechna, R. Nazaryan, V. Gargin, “Consequences of
microsequences of microcirculatory distrurbances of oral mucosa in modeling of rheumatoid
arthritis”, Georgian Med News, 2019;(295):137-140.
[9] O. Denga, T. Pyndus, V. Gargin, S. Schneider, “Influence of metabolic syndrome on condition of
microcirculatory bed of oral cavity”, Georgian Med News, 2017;(273):99-104.
[10] A. Schenström, S. Rönnberg, O. Bodlund, “Mindfulness-Based Cognitive Attitude Training for
Primary Care Staff: A Pilot Study”, Complement Health Pract Rev, 2006;11(3):144-152.
[11] C. Bachert, et al. “Biologics for chronic rhinosinusitis with nasal polyps.” The Journal of allergy and
clinical immunology, 2020(145)3: 725-739. doi:10.1016/j.jaci.2020.01.020
[12] S.M. Kolupayev, J.J. Yaroslavska, N.M. Mikhailenko, V.V. Gargin°, V.M. Lisovyi,
“Etiopathogenesis of stone formation of combined localization”, Azerbaijan Med J, 2021(4):50-56.
[13] V. Gargin et al., "Effect of Electronic Cigarettes on Oral Microbial Flora", Journal of Pharmacy and
Nutrition Sciences, vol. 11, pp. 54-64, 2021. doi: 10.29169/1927-5951.2021.11.08.
[14] D. Chumachenko, V. Dobriak, M. Mazorchuk, I. Meniailov and K. Bazilevych, "On agent-based
approach to influenza and acute respiratory virus infection simulation", 2018 14th International
Conference on Advanced Trends in Radioelecrtronics, Telecommunications and Computer
Engineering (TCSET), 2018. doi: 10.1109/tcset.2018.8336184.
[15] D. Chumachenko, "On Intelligent Multiagent Approach to Viral Hepatitis B Epidemic Processes
Simulation", 2018 IEEE Second International Conference on Data Stream Mining & Processing
(DSMP), 2018. doi: 10.1109/dsmp.2018.8478602.
[16] C. Bachert, “Current and future treatment options for adult chronic rhinosinusitis: Focus on nasal
polyposis.” The Journal of allergy and clinical immunology ,2015,136:1431-1440.
doi:10.1016/j.jaci.2015.10.010
[17] F. Tetik, "Comparison of Oral Steroids, Macrolides and Combination Therapy in Nasal Polyposis
Patients", SiSli Etfal Hastanesi Tip Bulteni / The Medical Bulletin of Sisli Hospital, 2018. doi:
10.14744/semb.2018.40316
[18] V. Kovtun, I. Izonin and M. Gregus, "Formalization of the metric of parameters for quality evaluation
of the subject-system interaction session in the 5G-IoT ecosystem", Alexandria Engineering Journal,
vol. 61, no. 10, pp. 7941-7952, 2022. doi: 10.1016/j.aej.2022.01.054.
[19] Nechyporenko, A. S., Alekseeva, V. V., Sychova, L. V., Cheverda, V. M., Yurevych, N. O., Gargin,
V.V. (2020). anatomical prerequisites for the development of rhinosinusitis. Lekarsky Obzor, 6(10),
334-338.
[20] I. Izonin, R. Tkachenko, Z. Duriagina, N. Shakhovska, V. Kovtun and N. Lotoshynska, "Smart Web
Service of Ti-Based Alloy’s Quality Evaluation for Medical Implants Manufacturing", Applied
Sciences, vol. 12, no. 10, p. 5238, 2022. doi: 10.3390/app12105238.
[21] R. Radutniy, A. Nechyporenko, V. Alekseeva, G. Titova, D. Bibik and V. Gargin, "Automated
Measurement of Bone Thickness on SCT Sections and Other Images", 2020 IEEE Third International
Conference on Data Stream Mining & Processing (DSMP), 2020. Available:
10.1109/dsmp47368.2020.9204289.
[22] A. Nechyporenko et al., "Comparative Characteristics of the Anatomical Structures of the Ostiomeatal
Complex Obtained by 3D Modeling", 2020 IEEE International Conference on Problems of
Infocommunications. Science and Technology (PIC S&T), 2020. Available:
10.1109/picst51311.2020.9468111 [Accessed 1 October 2022].