Algorithms for the diagnosis and treatment of chronic tonsillitis

Abstract

Introduction. Features of the course of chronic tonsillitis may vary depending on the age of the patient, his comorbid status and the severity of the disease. One of the characteristic manifestations of the disease are local signs of chronic tonsillitis and manifestations of a systemic inflammatory response. The article considers the issue of increasing the effectiveness of treatment of patients with chronic tonsillitis at the stage of clinical examination by using bioregulatory therapy drugs in complex conservative treatment. Aim. Evaluation of the effectiveness of bioregulatory therapy (Traumeel ® S) in the dynamic monitoring of patients with chronic tonsillitis. Materials and methods. A randomized controlled trial was conducted in patients with newly established and confirmed diagnosis of chronic tonsillitis, decompensated form. The severity of subjective and objective symptoms was assessed using a visual analogue scale, as well as pharyngoscopy data, supplemented by the results of ultrasound examination of the palatine tonsils. Results. In the group of patients who took bioregulatory therapy, positive dynamics was observed already on the 2 nd day and related to the reduction of bad breath and sore throat. Comparative analysis in the groups made it possible to note a more significant and faster dynamics in relation to changes in the palatine arches, elasticity of the palatine tonsils and the phenomena of retromaxillary regional lymphadenitis. The monitoring of the condition of the treated patients over the course of 6 months made it possible to identify more rare recurrences of chronic tonsillitis among patients in the complex treatment of which the bioregulatory medicine was used, the frequency of which was 2.8 times lower compared to the control group. Discussion. The conducted study showed that the use of bioregulatory therapy has a positive effect on the symptoms of the inflammatory process. This is confirmed by an improvement in the general condition of patients in dynamics, a decrease in pain according to visual analogue scale, and an objective assessment of changes in the structure of the palatine tonsils using ultrasonography. Conclusions. Вioregulatory therapy as of a complex application (oral and parenteral forms) increases the effectiveness of treatment in patients of the dispensary group with a newly diagnosed chronic tonsillitis, decompensated form. Drug can significantly reduce the duration of therapy and reduce the number of relapses after complete recovery within 6 months.