Adenoiditis In Children Research Articles

COMPLEX TREATMENT OF CHRONIC ADENOIDITIS IN CHILDREN

Background: Chronic adenoiditis in children is a prevalent condition that often leads to significant respiratory issues, including tubar dysfunction and snoring. Specific Background: The Bukhara Regional Children's Multidisciplinary Medical Center provides specialized ENT care, highlighting the need for effective treatment modalities in varying age groups. Knowledge Gap: Traditional therapeutic approaches exhibit limitations in their efficacy, particularly in rapidly alleviating symptoms and restoring normal respiratory function. Aims: This study aims to evaluate the effectiveness of photodynamic therapy (PDT) in comparison to conventional treatments for chronic adenoiditis among children aged 7 months to 11 years. Results: Analysis of 70 pediatric patients revealed that photodynamic therapy significantly improved nasal breathing, reducing snoring and tubar dysfunction five times faster than traditional methods. Additionally, it enhanced anterior active rhinomanometry outcomes, yielding a fourfold increase in total volume flow and a twentyfold reduction in total resistance. Novelty: This investigation is among the first to quantitatively assess the benefits of PDT in pediatric chronic adenoiditis, demonstrating its superior therapeutic efficacy. Implications: The findings suggest that incorporating photodynamic therapy into treatment protocols could offer significant advantages in managing chronic adenoiditis, warranting further exploration and potential integration into clinical practice to improve pediatric respiratory health outcomes.

TREATMENT OF CHRONIC ADENOIDITIS IN CHILDREN

The article describes various methods of removing adenoid hypertrophy, including aspiration diathermy, cold plasma surgery and a combined approach. The article analyzes in detail the combined approach, which is a more accurate, safe and effective method of removing adenoids, especially in children with palatine dysfunction. It describes how this method allows resecting lymphoid tissue with a cutter under clear visual endoscopic control, which avoids injury to the nasal septum, nasal conchs, posterior pharyngeal wall and tubal tonsils. The advantages of preserving the palatopharyngeal sphincter and controlling the depth of adenoid resection using this method are also discussed. In conclusion, it is noted that the combined approach based on the use of an endoscope is a promising method in the surgical treatment of adenoiditis in children with palatine dysfunction and can lead to improved results of surgery and reduced complications after it.

Non-drug technologies in the complex therapy of chronic adenoiditis

Introduction. In pediatric otorhinolaryngology, chronic adenoiditis is one of the most common diseases and leads to the search for effective methods of treatment. In this regard, it is of interest to study the use of additional physiotherapeutic methods of influence in complex therapy.Objective. To increase the effectiveness of the treatment of chronic adenoiditis in children using low-frequency ultrasonic cavitation in combination with photochromotherapy in complex therapy.Materials and methods. 104 patients with chronic adenoiditis aged 3 to 15 years were examined. By randomization by the envelope method, patients were divided into 3 groups depending on the treatment: the control group, the group with the use of only low-frequency ultrasonic cavitation as conventional therapy, and the group in combination with photochromotherapy, daily for seven days with a duration of one session of five minutes. Comparative evaluation of indicators was carried out before the start of therapy (day 0) and on the 7th day of treatment. The state of the nasopharynx was assessed using a flexible nasopharyngoscope, as well as the structure of the middle ear and auditory tube during acoustic impedancemetry.Results. There was a decrease in the size of the pharyngeal tonsil in patients with grade III adenoid hypertrophy by 46%, compared with the control group using only low-frequency ultrasonic cavitation, and by 54% in the group where photochromotherapy was added. Mucopurulent discharge from the surface of the pharyngeal tonsil decreased by 18% and 21%, purulent by 40% and 41%, respectively, compared with the control group. The positive effect in the second group was 3.3 times higher [CI 0.75; 14.6] compared with the control group, and in combination with photochromotherapy it was 3.6 times higher [CI 0.85; 15.5].Conclusions. The inclusion of low-frequency ultrasonic cavitation and photochromotherapy in the complex treatment of chronic adenoiditis makes it possible to achieve positive results earlier and reduce the number of adenotomies.

Topical administration of S. salivarius 24SMB-S. oralis 89a in children with adenoidal disease: a double-blind controlled trial

Chronic adenoiditis (CA) is generally sustained by some infectious foci mainly located within the nasopharynx or in the deep adenoidal pads and it is characterized by a complex interplay between bacterial species. The aim of this study was to assess the efficacy and safety of the topical nasal administration of a probiotic compound based on S. salivarius 24SMB and S. oralis 89a in children with CA in terms of reduction in: the number of acute adenoidal infections (primary outcome), and in the blockage of the nasopharynx space by hypertrophic adenoids (secondary outcome). A prospective, double-blind, 1:1 randomized controlled study was performed to test the effectiveness of a 90-day treatment with Rinogermina spray (DMD ITALIA s.r.l, Rome), 1 puff each nostril twice a day for 90 days, to nasal spray placebo in children with CA (in terms of number of acute exacerbations and blockage of nasopharynx space assessed after 90 days of treatment- T1, and 90 days later- T2). The final analysis was based on 152 children (males = 48.0%; mean age = 49.2 ± 14.1 months). Compared to the baseline, no significant differences in terms of number of acute exacerbations at T1 and T2 follow-up visits were detected in both groups. After treatment, a significant reduction in the blockage of nasopharynx space by hypertrophic adenoids (0.002 < p-value < 0.007) compared to the baseline was attested in the study group at T1 and T2, but not in the control group.Conclusions: Our findings document a positive effect of Rinogermina spray in achieving reduction in the blockage of nasopharynx space by hypertrophic adenoids, thus suggesting that its use into the integrated therapeutic management of children with CA could be of a certain utility.What is Known:• Chronic adenoiditis in children results from an imablance in baterial homeostasis at the nasophaynx, with impairment in respiratory microbiota.• The modulatory effect of target transnasal bacteriotheray by means of S. salivarius has been considered in children with chronic adenoiditis in children with recurrent acute otitis media with preliminary positive results.What is New:• This randomized controlled study, specifically designed on a cohrt of children with chronic adenoiditis, documents a certain effectiveness of the probiotic treatment in achieving a reduction in the grade of adenoidal hypertropy, compared to placebo.

Non-drug methods of influencing the pharyngeal tonsil and their clinical effectiveness in the complex therapy of chronic adenoiditis in children

Background. The importance of finding additional treatments for chronic adenoiditis is determined by its high prevalence.&#x0D; Aim. To evaluate the clinical effectiveness of low-frequency ultrasonic cavitation in combination with photochromotherapy in the complex therapy of chronic adenoiditis in children.&#x0D; Material and methods. Three groups were formed by randomization by the envelope method. Patients of the control group (the first group, 32 children) were not exposed to physical methods. One study group (the second group, 27 children) received low-frequency ultrasonic cavitation with photochromotherapy on the lymphoid tissue of the pharyngeal tonsil; another study group (third group, 25 children) low-frequency ultrasonic cavitation. The course of treatment was 7 days. Comparative evaluation of indicators was carried out before the start of therapy and on the 7th day. The dimensions of the pharyngeal tonsil were visualized, and the pathological discharge on the surface of the adenoid vegetations was assessed. For nominal data, absolute and relative frequency (%) were calculated, group comparison was performed using Pearson's 2 test.&#x0D; Results. After treatment in the second group, there was a decrease in the amount of purulent discharge on the surface of the pharyngeal tonsil by 35%, mucous by 20% (p=0.000), the number of children with grade 3 adenoid hypertrophy decreased by 55% compared with the period before the use of physical methods impact (p=0.000). In the third group, the same data were obtained a decrease by 35 and 20%, respectively, in the amount of purulent and mucous discharge (p=0.000), the proportion of children with grade 3 adenoid hypertrophy decreased by 44% (p=0.000). Low-frequency ultrasonic cavitation increases the effectiveness of conservative treatment by 2.08 times (confidence interval 1.02; 4.22), and in combination with photochromotherapy 2.37 times (confidence interval 1.21; 4.67) compared with the control group.&#x0D; Conclusion. Low-frequency ultrasonic cavitation with photochromotherapy is effective in the complex therapy of chronic adenoiditis in children.

Эпштейна — Барра вирус — ведущая причина гипертрофии глоточной миндалины у детей

The leading cause of tonsil hypertrophy in children is viruses, often in combination with bacterial flora. The purpose — to evaluate the role of the main viral-bacterial pathogens in pharyngeal tonsil hypertrophy (PTH) and adenoiditis in children. Material and methods. We observed 463 children with PTH and chronic adenoiditis. The patients were divided into groups depending on the PTH degree: 108 children with grade 1–2 adenoids, 355 children with PTH grade 3. EBV DNA, CMV and HHV-6 were determined in a smear from removed tissue of the pharyngeal tonsil or in a swab from the nasopharynx using the PCR method, and a bacteriological examination of a smear from the throat and nose was performed. The sIgA proteinase activity of the isolated S. aureus strains was determined. The content of sIgA in the patients’ saliva was determined. Statistical processing of data was carried out using Statistica 8.0 software. Results. DNA of herpes viruses in swabs from the nasopharynx was detected in 70.8% (328/463) of the examined: in 36.1% (39/108) of patients with grade 1–2 PTH and 81.4% (289/355) of grade 3, p &lt; 0.001. Epstein-Barr virus was isolated most often – in 53% (174/328). The results of a bacteriological study of 151 patients with PTH demonstrated the predominance of S. aureus (71.5%, 108/151) and S. pyogenes (55.6%, 84/151), p = 0.005 in nasopharyngeal swabs. 58.3% (63/108) of S. aureus strains had sIgA proteinase activity. In 45.3% (49/108) of cases, the isolation of such staphylococci was combined with the detection of EBV DNA. The level of sIgA in the saliva of patients with grade 3 tonsil hypertrophy (Me 43; IQR 34.4–76.6) was statistically significantly lower than the level of sIgA in the saliva of patients with grade 1–2 hypertrophy of the tonsils (Me 63.8; IQR 44.2–98,6), p = 0.023 and healthy children. Conclusions. Infection of the nasopharynx with EBV can be considered a leading risk factor for the development of tonsil hypertrophy and adenoiditis in children. This must be taken into account when monitoring such patients.

Особенности врожденного иммунитета у детей с хронической инфекцией носоглотки

The article presents the results of studies of α-defensin level in chronic adenoiditis in children. The purpose — to assess the state of innate mucosal immunity in chronic adenoiditis. Material and methods. We examined 151 patients with chronic adenoiditis aged 3 to 7 years. Concentration of α-defensin was determined using the HBT Human HNP 1-3 ELISA kit, designed for the quantification of neutrophil defensins in mixed saliva. Results. The analysis showed that in both groups of children with chronic adenoiditis there was a statistically significant (p &lt; 0.05) increase in the concentration of defensins in saliva compared to the age norm.

Конституциональные особенности состояния здоровья детей дошкольного возраста с рецидивирующей респираторной патологией

The purpose — to study the constitutional features of physical and neuropsychic development of 4–7 year old children of intro- and extravert types with chronic adenoiditis. Material and methods. The study included preschool children with a verified diagnosis of chronic adenoiditis. The control group consisted of conditionally healthy children without chronic diseases. All children were divided into introverts and extraverts. The features of somatometric and somatoscopic indicators of physical development, emotional, characterological and intellectual indicators of neuropsychic development and socialization were studied. Results. For introverted children with chronic adenoiditis, the disease onset occurred at the age of 3–4 years; obstructive sleep apnea syndrome in combination with snoring prevailed; the duration was about a year and a half; frequent acute purulent otitis media with a long monotonous course, the manifestation of excessive vagotonia and pronounced disorders of sound reproduction were observed. In extroverted children, chronic adenoiditis debuted at the age of 4–5 years, in the form of postnasal syndrome with night cough, excessive sympathicotonia and with earlier formation of exudative otitis and hearing loss; the duration of the disease was about six months. Introverts with chronic adenoiditis were three times more likely than healthy children of this type to have body mass deficiency and microsomia, lower indicators of social activity, abstract thinking, attention, fine motor skills and semantic memory. In extroverts with chronic adenoiditis, among the variants of physical development disorders, the frequency of excess body weight and macrosomia doubled, the level of impulsivity increased, discipline, large-motor giftedness, conceptual and visual-imaginative thinking decreased. Conclusion. Clinical and functional differences in the course of chronic adenoiditis in children of intro- and extravert types and the identified features of their physical and neuropsychic development can be the basis for creating differentiated programs for their medical and social support on an outpatient basis. The constitutional approach makes it possible to assess the psychophysiological features of individual qualities that make up the «ground» of the disease, both to make a reasonable choice of an effective combination of health disorders correction and prevention methods, and to ensure the fullest realization of a child’s physical and social potential.

Возможности противовоспалительной терапии в лечении пациентов с аденоидитом

The search for new ways to treat adenoiditis in children is relevant and in demand. Existing therapeutic options (eliminationirrigation therapy, topical antimicrobials, mucolytic drugs) in some cases (with a prolonged course of inflammation in the pharyngeal tonsil, in the presence of concomitant otorhinolaryngological or infectious pathology) have a limitation on the duration of course admission and require the search for new treatment regimens. Promising in this regard is the inclusion of antiinflammatory drugs in the treatment of patients with inflammation of the pharyngeal tonsil. Patients and methods. We observed 2 groups of patients (main (n = 52) and comparison (n = 20)) with signs of inflammation of the pharyngeal tonsil (adenoiditis). Patients of the main group were additionally prescribed ammonium glycyrrhizinate (Reglisam) in an age-appropriate dosage in accordance with the instructions for use for 30 days in the treatment regimen. On the 1st, 7th and 30th days of therapy, all patients underwent endoscopy of the nasal cavity and nasopharynx, assessment of complaints and symptoms on a 10-point visual analog scale (VAS), PCR-diagnosis of herpesvirus pathogens in a smear from the surface of the pharyngeal tonsil. Results. In patients of the main group after the course of treatment (on the 30th day of follow-up), the severity of the "snoring" symptom was 67% lower (p = 0.001) relative to the comparison group, the intensity of the symptoms of "nasal breathing difficulty" and "cough" was 20% and 50% less, respectively. Also in the main group, there was a decrease in the proportion of patients with grade 3 adenoid hypertrophy (from 54% to 33%, p = 0.029) and grade 2 (from 15% to 4%, p = 0.046), accompanied by a block of the pharyngeal mouths of the auditory tubes (no such positive dynamics was noted in the comparison group). Among initially EBV-positive patients, the virus eradication was 78% in the main group, in the comparison group it did not exceed 12% (p = 0.015). Conclusion. The inclusion of the anti-inflammatory drug Reglisam in the treatment regimen of adenoiditis contributed to a more effective reduction in the severity of the symptoms of the disease ("nasal congestion", "cough", "snoring") and the restoration of nasal breathing, which was associated not only with the absence of signs of inflammation, but also with a decrease in the size of the pharyngeal tonsil. The antiviral effect of Reglisam against Epstein–Barr virus (EBV) turned out to be interesting from a practical point of view (in 78% of cases, there was no virus among initially EBV-positive patients). Key words: adenoiditis, Epstein–Barr virus, ammonium glycyrrhizinate, glycyrrhizic acid

The use of SN-5 to differentiate chronic rhinosinusitis and chronic adenoiditis in children

BackgroundChronic adenoiditis (CA) and chronic rhinosinusitis (CRS) present with similar symptoms, but an accurate diagnosis is critical for optimal treatment. We aim to differentiate CRS and CA based on sinonasal symptoms using the Sinus and Nasal Quality of Life Survey (SN-5) in children. MethodsThis is a retrospective cohort study. Children (age 12 and younger) presenting with chronic sinonasal symptoms were divided into 2 groups based on CT scan sinus findings: CA group included patients with CT Lund-Mackay (LM) score <5 and CRS group included patients with CT LM score of 5 and more. SN-5 scores for each group were then compared, and both groups were compared to a control group. Other demographic data were also collected and analyzed. ResultsThere were 27 patients in the CA group, 42 patients in CRS group and 38 patients in the control group. Mean SN-5 scores were 2.03±0.71 for the control group, 3.49±1.00 for the CA group, and 4.53±0.77 for the CRS group (p < 0.0001); Statistical significance persisted when CA and CRS were compared in subset analysis (p < 0.0001). CT LM score was 2.70±2.07 for the CA group and 9.94±3.46 for the CRS group (p < 0.0001). Rates of asthma, allergic rhinitis, and smoke exposure differed between the three groups (p < 0.01), but they were not statistically different when CA and CRS were compared in subset analysis. ConclusionChildren with CRS have higher SN-5 score than children with CA. SN-5 score can be used to help otolaryngologists differentiate between these two clinical entities.

THE IMPORTANCE OF ALLERGIC FACTOR IN THE ETIOPATHOGENESIS OF CHRONIC ADENOIDITIS IN CHILDREN

The article presents the features of the course of chronic adenoiditis in children with allergic rhinitis. Allergic diseases of the upper respiratory tract and pathology of the pharyngeal tonsil today remain one of the most common diseases in pediatric practice and their pathogenetic mechanisms are often interrelated. The choice of treatment mode for this group of children is currently being actively discussed. The aim of the study is scientific-literary and practical consideration of the problem of the influence of an allergic factor on the pathogenesis of nasopharyngeal tonsil hypertrophy as a cause of chronic adenoiditis in children. The study examined 30 children with stage 2 adenoid hypertrophy, including 18 boys and 12 girls. A number of authors insist on the need to prioritize conservative management, while more and more evidence is emerging that there may often be indications for surgery. The prevalence of allergic diseases and adenoid vegetations in childhood has determined the relevance of studying the research problem. It is established that adenoids in allergic rhinitis become a kind of shock organ, on the surface of which inhaled allergens are delayed. It has been determined that in allergic rhinitis removal of adenoids has the ability to improve the general condition of the patient and relieve symptoms (including nasal congestion) and reduce the risk of various chronic pathologies (namely chronic otitis), and in obstructive sleep apnea — reduce the risk of suffocation. The algorithm of management of children with pathology of the pharyngeal tonsil in concomitant allergic diseases, where the first stage it is necessary to recommend treatment by an allergist, and only in the ineffectiveness of conservative therapy to perform surgery. It has been shown that most of the studied children (60–70%) with stage II nasopharyngeal tonsil hypertrophy showed allergic rhinitis and elevated levels of anti-inflammatory cytokines, which indicates the relationship of the disease with inflammatory diseases of the nasopharynx and immune system. It is determined that the problems of correct diagnosis of the causes of inflammation and hypertrophy of the nasopharyngeal tonsil and the strategy, tactics and correctness of their treatment deserve scientific attention.

Отдельные аспекты патогенетически обоснованного подхода в лечении хронического аденоидита с применением физических методов воздействия

Introduction. The relevance of using nondrug methods of influence on inflamed lymphoid tissue in the complex therapy of chronic adenoiditis in children is determined by the possibility of obtaining positive results in a shorter time. Objective. To study the effect of low-frequency ultrasonic cavitation in combination with photochromotherapy on the course of the inflammatory response in chronic adenoiditis in children. Patients and methods. There were 84 patients with chronic adenoiditis and adenoid hypertrophy of the second and the third grades with absolute indications for adenotomy in the prospective study. Adenotomy was used in every research. There were three groups for study clinical, morphological, and biochemical parameters in the tissues of adenoid vegetations under the influence of low-frequency ultrasonic cavitation in combination with photochromotherapy. The first group is the control group (n = 32). This group did not receive physical methods of exposure in the preoperative period. The second group (n = 27) received low-frequency ultrasonic cavitation irrigation of the nasopharynx in combination with photochromotherapy. The third group (n = 25) was not exposed to photochromotherapy. The course of the treatment lasted for 7 days. Results. Under the influence of a combination of low-frequency ultrasonic cavitation in combination with photochromotherapy, the content of the end products of lipid peroxidation – Schiff bases, which are a marker of irreversible dystrophic changes in the cell, decreases. An increase in the level of activity of the antioxidant catalase in the tissues was noted, which inhibits the processes of oxidative stress. Conclusion. Treatment of chronic adenoiditis with low-frequency ultrasonic cavitation with photochemotherapy reduces the inflammatory process in the tissues of adenoid vegetations, which greatly decreases the severity of illness and, as a result, surgery frequency.

Микробиоценоз глоточной и небных миндалин при хронической воспалительной патологии глотки у детей

Chronic tonsillitis and adenoiditis in children is one of the unsolved problems in otorhinolaryngology. There are no specific pathogens of chronic adenotonsillitis, but there are still disputes about the viral, bacterial and fungal etiology of this disease. Chronic tonsillitis is a persistent chronic inflammation of the palatine tonsils, characterized in the vast majority of patients by recurrent exacerbations in the form of sore throats and a general toxic-allergic reaction, which is a frequently realized etiological factor of many local and general diseases and a catalyst for pathological processes in the body. Adenoid vegetations are pathological hypertrophy of the pharyngeal tonsil. Chronic adenoiditis is a chronic polyethological disease, which is based on a violation of the physiological immune processes of the pharyngeal tonsil. In children, it is impossible to talk about isolated inflammation of the pharyngeal tonsil, since as a result of exposure to antigens, an immune response occurs that involves all structures of the lymphoepithelial pharyngeal ring in the process, therefore some researchers use the term “adenotonsillitis”. With a pronounced violation of the microflora in the nasopharynx and oropharynx, the body's resistance to pathogenic microorganisms decreases, as a result, decay products and toxins lead to damage to the vascular endothelium, disrupt their permeability and, penetrating through the epithelial barrier, contribute to the development of chronic intoxication and sensitization of the body.

The effectiveness comparison of various conservative treatment options of nasopharyngeal inflammation in children

To compare the effectiveness of various schemes of conservative therapy of adenoiditis in children. 154 patients were divided into three groups: group I - standard therapy; group II - standard therapy + a specially developed homeopathic protocol; group III - a specially developed homeopathic protocol. At each of the visits (day 0th, 7th, 30th, and 90th), ENT-organs endoscopy and a 10-point visual assessment of symptoms were performed by analog score. The effectiveness of treatment (day 7th, 30th, and 90th) was evaluated by both doctors and patients. Analysis of the results showed that the symptoms of adenoiditis were stopped most quickly (day 7th) in patients of group I, but more pronounced and prolonged positive dynamics was noted in comparison groups II and III (only in these groups parents/legal representatives of patients rated the effectiveness as recovery in 25% and 35%, respectively). Conservative treatment of adenoiditis: has a positive effect (the severity and duration depends on the therapy regimen); avoids adenotomy, especially in patients who have taken homeopathic medications as a part of combined therapy. The use of a standardized homeopathic protocol is possible, both in combination with the use of other medications, and as monotherapy. Against the background of taking homeopathic medications, undesirable side effects may occur, which the parents of patients should be informed about in advance.

Prospects for the use of bacterial lysates in the complex therapy of chronic adenoiditis

Introduction. Adenotomy is a common surgical procedure in childhood. In children with recurrent infections of the respiratory tract, hypertrophy of the pharyngeal tonsil, a sign of lymphoproliferative syndrome of a secondary immunodeficiency state, is characterized by reduced adaptive abilities of mucosal immunity with impaired biocenosis in chronic inflammation. Pharyngeal tonsil surgery is considered stressful in frequently ill children and therefore requires preoperative preparation. In this context, it is relevant to study the nature of changes in the factors of mucosal immunity in terms of cell destruction in the nasal secretion in the complex treatment of children with hypertrophy of the pharyngeal tonsil and chronic adenoiditis, as prevention of complications in the postoperative period of adenotomy.Aim. To increase the effectiveness of the treatment of chronic adenoiditis in children with recurrent infections of the respiratory tract using the combined effect of low-frequency ultrasonic cavitation with monochromatic unpolarized light and bacterial lysates.Materials and methods. In order to test the hypothesis about the possibility of canceling adenotomy in 77 children aged 3-6 years with hypertrophy of the pharyngeal tonsil, accompanied by chronic inflammation. The effectiveness of the complex treatment was assessed by the functional and metabolic status of nonspecific resistance factors in the nasal lavage.Results and discussion. The combined effect of low-frequency ultrasonic cavitation with photochromotherapy and bacterial lysates leads to the normalization of pathophysiological changes on the surface of the mucous membrane, leading to a balance of the qualitative and quantitative composition of the functional-metabolic status of NG, which makes it possible to postpone adenotomy. The best clinical result is observed when bacterial lysates are used in complex therapy in combination with physiotherapy in children with chronic adenoiditis and, to a certain extent, substantiate the advisability of a combined effect as a non-invasive and effective method.Conclusions. Topical bacteriolysate in a complex treatment regimen for children with recurrent infections of the respiratory tract against a background of chronic inflammation eliminates bacterial antigens and enhances the intrinsic defenses of the mucous membrane of the pharyngeal tonsil.

Prospects for using herbal preparation in combination with physical methods in complex therapy of chronic adenoiditis

Introduction. Importance of the search effective methods of treating chronic adenoiditis in children is associated with a high incidence and risk of developing complications. Treatment of chronic adenoiditis are described in the literature, but the advantages of any of them are inconclusive, which leads to the search for additional more progressive methods.Objective. To increase the effectiveness of the treatment of chronic adenoiditis using complex therapy of non-drug methods in combination with the herbal preparation Tonsilgon N.Materials and methods. Biochemical changes in lymphoid tissue were studied on biopsy material in 111 children with chronic adenoiditis, grade 3 adenoid hypertrophy, directed to planned surgical treatment. In the preoperative period, patients were divided into 4 groups: Group 1-control group, patients who received conventional methods of treatment; 2-study group, patients who additionally used low-frequency ultrasound irrigation of the nasal cavity and nasopharynx with photochromotherapy; The third group, patients who received the herbal preparation tonsilgon N (drops) as preoperative therapy; The fourth group study underwent low-frequency ultrasound irrigation of the nasal cavity and nasopharynx in combination with photochromotherapy and took the drug Tonsilgon N in an age-related dosage.Results and discussion. When comparing the results of biochemical studies, an increase in the products of lipid peroxidation was noted in patients of the first group, which was regarded as a factor in the protracted course of the disease. The use of targeted phytoniring drugs in combination with low-frequency ultrasonic cavitation and photochromotherapy in complex therapy significantly modulates the processes of lipid peroxidation and can potentiate the antioxidant protection of cells.Conclusion. Objective data were obtained for the first time on biochemical changes in lymphoid tissue for various methods of therapy indicate the prospects of using non-drug methods in combination with a herbal preparation in the complex therapy of chronic adenoiditis.

BACTERIAL BIOFILM IN CHILDREN WITH CHRONIC RHINOSINUSITIS AND CHRONIC ADENOIDITIS

Chronic rhinosinusitis with chronic adenoiditis in children represents a global public health issue, seriously affecting the quality of parents and children life, because of its irritating symptoms like intermittent snoring, mouth breathing, dry mouth, nasal obstruction, headaches increased irritability and focus disorders on children. Bacterial biofilms are highly associated with the chronic infectious processes in children. Correct therapeutical management of this diagnostic combination is mandatory to improve the quality of one’s life. Objectives. The aim of the study is: to observe the ratio of adenoid mucosa covered with bacterial biofilm extracted from the nasopharynx of 50 paediatric patients suffering of chronic rhinosinusitis (RSC) and chronic adenoiditis (CA); and to point the fact that the adenoids contaminated with bacterial biofilm are a generator for chronic upper airway infections in children. Material and methods. We have measured using an image analysis program the bacterial biofilm covering the entire surface of the extracted adenoids mases, from 28 girls and 22 boys aged between 5 and 12 years diagnosed with CRS and CA. Control visits were performed to verify symptom improvement at 1, 3 and 6 months. Outcomes. Adenoids extracted from paediatric patients diagnosed with CRS and CA presented bacterial biofilms coverage on almost the entire mucosa (86.75%). Conclusions. Adenoid mases removed from paediatric patients with CSR and CA have most of their mucosal covered with bacterial biofilm. In the nasopharynx of paediatric patients with CSR and CA, bacterial biofilm can play the role of a constant fountain of infection. Adenoid mass removal explains the symptomatic improvement observed post operatory in the CRS with CA paediatric patients that do not respond to antibiotic therapy.

Comparative clinicopathological aspects of chronic tonsillitis and adenoiditis in children.

Chronic palatal and nasopharyngeal inflammations are common lesions in pediatric pathology, with major effects on children’s development. The study included 34 cases of chronic tonsillitis and adenoiditis for which we quantified immunohistochemically and analyzed the distribution of inflammatory elements in the follicular, extrafollicular and epithelial compartments, in relation to the composite histological scores and the clinico-epidemiological profile of the lesions. The cases were more frequent under the age of 10, in female patients, coming from urban areas, with the diagnosis of tonsillitis. B-lymphocytes have been associated with follicular areas in tonsillitis and epithelial areas in adenoiditis. In all compartments, T-lymphocytes were more frequently associated with tonsillitis and plasma cells associated with adenoiditis. Macrophages and dendritic cells had a relatively uniform distribution for the three compartments in all cases. The results obtained indicate different inflammatory phenotypes for chronic tonsillitis and adenoiditis, an aspect that may be useful for stratifying patients for optimal therapy.

Эндогенная интоксикация при хронической патологии глотки у детей

A review of scientific Russian and foreign articles devoted to the development of endogenous intoxication in chronic inflammatory pathology of the lymphoepithelial pharyngeal ring is carried out. Chronic tonsillitis and adenoiditis in children are one of the unsolved issues in otorhinolaryngology. Chronic tonsillitis is a chronic inflammation of the palatine tonsils characterized by recurrent exacerbations in the form of tonsillitis and a general toxic-allergic reaction. Adenoid vegetation is a pathological hypertrophy of the pharyngeal tonsil. Chronic adenoiditis is a chronic polyetiologic disease, which is based on a violation of the physiological immune processes of the pharyngeal tonsil. In children, one cannot talk about an isolated inflammation of the pharyngeal tonsil, since as a result of exposure to antigens, an immune response arises, which involves all structures of the lymphoepithelial pharyngeal ring in the process, therefore some authors distinguish the term «adenotonsillitis». With pronounced activation of microflora in the nasopharynx and oropharynx, the body’s resistance to pathogenic microorganisms decreases, as a result of which decay products and toxins damage the vascular endothelium, disrupt their permeability and, penetrating through the epithelial barrier, contribute to the development of chronic intoxication and sensitization of the body. Endogenous intoxication is a polyetiologic and polypathogenetic syndrome characterized by the accumulation of endogenous toxins in tissues and biological fluids. Diagnostics of the endogenous intoxication severity includes a number of clinical and laboratory indicators and immunological markers. But, despite the constant improvement of the research methods, the issue of endotoxicosis diagnosis in chronic tonsillitis and adenoiditis remains insufficiently studied. As a result of the inadequate diagnosis, there is often a simultaneous removal of the pharyngeal and palatine tonsils, which in turn can lead to irreversible consequences.

Fungal adenoiditis and tonsillomycosis in children: features of diagnosis and therapy

The purpose of the work is to study the current state of the problem of diagnosing and treating fungal adenoiditis and tonsillomycosis in children. This article summarizes the literature data on the predisposing factors and characteristics of the occurrence of fungal infections of adenoid vegetations and tonsils in children. The works present modern approaches to the diagnosis and treatment of children with fungal adenoiditis and tonsillomycosis, depending on the selected genus and the type of fungus. Based on the conducted research, performed on the basis of "The Sverzhevskiy Otorhinolaryngology Healthcare Research Institute", we found that the incidence of fungal adenoiditis in children is 16.4%, and the incidence of tonsillomicosis in children with chronic tonsillitis is 21.5%. The most frequently detected strain in this pathology is C. albicans. In the presented study, a justification of the chosen treatment regimen was made on the basis of the data obtained during microbiological (bacteriological and mycological) studies.