Индивидуализация подходов к реабилитации детей с хроническим аденоидитом с учетом их конституциональных различий

Abstract

The purpose — to reveal the features of the development, course and character of clinical manifestations of chronic adenoiditis in 4–7 y. o. children of various constitutional types. Material and methods. Children aged 4–7 years with a verified diagnosis of chronic adenoiditis were examined; they were divided into groups by constitutional types using the scale of mental activity orientation. The children with the expert assessment of mental activity orientation in the 1–3 interval were referred to the subgroup of «introverts», with 4–6 points — to the subgroup of «centroverts», and with 7–9 — to the subgroup of «extroverts». The sample of children was as follows: extroverts made up 35.9% of the total number of children, introverts — 34.1%, centroverts — 30%. The nature of clinical manifestations, development and course of chronic adenoiditis were assessed with the data from the child’s developmental history, additional parental questionnaire, and examination. Results. In introverts, the debut of chronic adenoiditis was at the age of 3–4 years, the disease duration by this age was about one and a half years, the diagnosis was made earlier than in extroverts, but with a later development of exudative otitis. In introverted children, complaints related to snoring and obstructive sleep apnea syndrome, as well as sound pronunciation disorders, came to the forefront. In extroverted children, chronic adenoiditis debuted at the age of 4–5 years, with the disease duration of about six months, with later diagnosis, but with early formation of exudative otitis. Clinical manifestations in extroverted children were associated with postnasal syndrome combined with nocturnal cough, formation of exudative otitis, frequent purulent otitis media and sharp hearing loss. Conclusion. Differences in the clinical and functional course of chronic adenoiditis in preschool children of various constitutional types should be taken into account in the organization of rehabilitation. This will improve the quality of life of these children, increase the bodily reactive capabilities and the levels of success and social adaptation in educational institutions.