An increase in the incidence of chronic adenoiditis in recent years actualizes the issue of finding effective methods of treatment and indicators for evaluating their effectiveness. The purpose of the study was to evaluate the dynamics of local cellular and humoral factors in nasal secretions during the complex conservative treatment of children with recurrent adenoiditis. We examined 152 children (88 boys and 64 girls) aged 3 to 10 years (mean age 5.1±1.9 years) who are on outpatient treatment for chronic adenoiditis. Patients were divided into 2 groups: those who received local antimicrobial and irrigation-elimination therapy and those who received comprehensive treatment with laser therapy procedures. The features of the microbial landscape, the electrokinetic mobility of nasal epitheliocytes, and the level of local humoral factors (sIgA and lysozyme) were assessed. The dominant pathogens of adenoiditis are highly resistant strains of S. pneumoniae, S. aureus and M. catarrhalis. There was revealed a decrease in the concentration of sIgA and lysozyme in the nasal secretion, which had the character of a trend, a decrease by 5% in the proportion of mobile epitheliocytes, a decrease in their area by 15%, and a decrease in the amplitude of fluctuations by 21% (p < 0,05). After therapy, there was a rapid recovery of indicators to normal levels with a more pronounced effect in patients with laser therapy. After a course of laser irradiation, the proportion of sick children for 1, 6, and 12 months was 64, 62, and 55%, respectively, versus 20, 30 and 25% after conventional treatment. An effective treatment strategy involves a personalized pathogenetic approach, taking into account the dominant pathobionts, their antibiotic sensitivity as well as the selection of adequate therapeutic measures and monitoring their effectiveness using indicators of the state of the elements of the mucociliary system.