Possibilities of osteopathic correction of somatic dysfunctions in children with chronic adenoiditis

Abstract

Introduction. Chronic adenoiditis is one of the most frequent ENT diseases. It is comparatively resistant, and in advanced cases, the pathological process is hardly reversible. Despite the big number of publications on chronic adenoiditis, in a high percentage of cases specialists still encounter frequent recurrence of the disease. That is why issues of standard treatment, especially conservative, the search for adequate and effective methods of medical rehabilitation of patients with chronic inflammatory diseases, including in frequently ill children, are timely and relevant. Osteopathic methods of correction can potentially improve blood circulation and the innervation of adenoids, which will increase the clinical effectiveness of conservative treatment, reduce medication period and achieve a longer remission. However, studies on the influence of osteopathic correction on the course of chronic adenoiditis have not been found in the literature available to us. That is why it was necessary to conduct this study. The goal of research — to justify the possibility of using osteopathic correction in the complex treatment of frequently ill children with chronic adenoiditis.Materials and methods. From January 2018 to March 2019, a prospective controlled randomized study was performed at the MEDSI Clinic (Moscow). Thirty patients with chronic adenoiditis at the age of 4 to 10 years were examined. Patients were divided by the method of simple randomization using a random number generator into two equal groups of 15 people: the main group and the control group. Children of the main group received osteopathic correction along with drug and irrigation therapy for 2 months. In total, 3 osteopathic sessions were conducted with a frequency of 1 time in 14 days. Children in the control group received only pharmacological and irrigation therapy. All patients before the start of treatment and 2 months after the start of treatment were examined by an otorhinolaryngologist with an endoscopic examination, and by an osteopath with the assessment of the main somatic dysfunctions. Otorhinolaryngological examination included history taking and collecting of complaints with fi lling out a special questionnaire, anterior and posterior rhinoscopy, as well as an endoscopic examination of the nasopharynx with the assessment of the revealed changes in points.Results. After the treatment, the number of complaints and the main symptoms of the disease, the number of changes in the nasopharynx and oropharynx, revealed by the results of endoscopic examination, decreased statistically significantly in patients of both groups. The study showed that regional biomechanical disorders are common for children with chronic adenoiditis. Dysfunctions of head region, neck region (visceral component), thoracic region (structural component) were the most frequent. Against the background of the treatment, patients of the main group presented a decrease in the number of regional somatic dysfunctions. Statistically significant differences were obtained in the frequency of occurrence of somatic dysfunctions: head region, neck region (visceral and structural components), thoracic region (visceral and structural components) (p<0,05). In patients of the control group, a statistically significant decrease in the number of somatic dysfunctions was detected only in the head region (p<0,05). A follow-up assessment of the results of the treatment showed that the inclusion of osteopathic correction in the complex therapy of children with chronic adenoiditis contributes to a longer remission (p<0,05).Conclusion. Based on the study, it can be concluded that the direct results of osteopathic correction in the complex treatment of frequently ill children with chronic adenoiditis are comparable with the results of isolated pharmacological and irrigation therapy (reduction in the number of complaints and positive changes in the results of endoscopic examination of the nasopharynx). However, the inclusion of osteopathic correction in the complex therapy of such children contributes to a longer remission, which is of great importance for this group of patients. The results of the research suggest a further study of the possibilities of osteopathic correction of somatic dysfunctions in frequently ill children with chronic adenoiditis.