Tonsil Hypertrophy Research Articles

Reaktif Hiperplazi ve Rekürrent Tonsillitlerde Lusigenin - Serbest Oksijen Radikallerinin Karşılaştırılması

Aim and Background: Today, tonsillectomy (T) used for chronic tonsillitis is among the most common surgery type that ear, nose, and throat physicians perform. The differences in the pathogenesis of chronic tonsillitis and tonsil hypertrophy are still unknown. This study aimed to compare the levels of free oxygen radicals in patients with tonsil hypertrophy and chronic tonsillitis and to investigate the role of free oxygen radicals in the pathogenesis of chronic tonsillitis.Materials and Method: The study included 40 patients who had chronic tonsillitis indications based on Paradise criteria, and T was performed. Operation materials were histopathologically examined, and their free oxygen radicals (FOR) levels were measured. Results: Based on the histopathological results, the participants were divided into two groups: one including 28 (70%) patients who had active or chronic tonsillitis, the other including 12 (30%) patients with reactive follicular hyperplasia. Lucigenin - free oxygen radicals (Luc-FOR) levels of the group with chronic tonsillitis and that of the group with reactive follicular hyperplasia were 82.29±32.3 Auc and 50.76±7.95 Auc, respectively. Luc-FOR values were found to be significantly higher in the group with chronic tonsillitis (p=0.001). Conclusion: Free oxygen radicals play an essential role in tonsillar pathologies. Differences in the Luc-FOR levels measured from tonsillar tissue in patients with tonsil hypertrophy and chronic tonsillitis demonstrate that the pathogenesis of these two diseases is different.

Fiberoptic intubation in a child with previous unexpected difficult airway due to lingual tonsil hypertrophy

Lingual tonsils are normal components of the oropharynx localized at the base of the tongue, which sometimes can become enlarged by inflammation. This may be a cause of unexpected difficult airway, considering most patients are asymptomatic and this supraglottic mass is not usually detected during a routine preoperative airway assessment. Commonly described in adults, there are limited reports in pediatric patients. We describe a case of a 12 years old boy diagnosed with a cerebellar brain tumor that was scheduled for a resection. The first surgery was postponed because of respiratory complications as a result of unexpected difficult airway due to lingual tonsil hypertrophy. His surgery was rescheduled and a plan for airway management was laid out: fibroscopic intubation with spontaneous ventilation. Considering this is a problem that cannot be identified by regular airway examination, we should be aware of the most effective ways to manage the situation as it arises.

Clinical effect of mometasone furoate nasal spray combined with montelukast in the treatment of children with obstructive sleep apnea hypopnea syndrome

Objective To explore the clinical effect of mometasone furoate nasal spray combined with montelukast in the treatment of children with obstructive sleep apnea hypopnea syndrome (OSAHS), and to analyze its feasibility and clinical application value. Methods From August 2017 to March 2019, 64 children with OSAHS who were treated in the People's Hospital of Jinhua were selected in the study.According to the random number table method, they were divided into the observation group and the control group, with 32 cases in each group.The observation group was treated with mometasone furoate nasal spray combined with montelukast for 12 weeks.The control group was treated with surgical treatment to remove hypertrophic tonsils and/or adenoids.The clinical symptom scores, polysomnography(PSG) monitoring index, adenoid and tonsil size index, and the efficacy after 12 weeks of treatment were compared between the two groups. Results There were no statistically significant differences in symptom scores and minimum arterial oxygen saturation(LSaO2) between the two groups before treatment(all P>0.05). After treatment, the symptom scores and LSaO2 of the control group were (1.90±0.53)points and (94.74±1.54)%, respectively, which of the observation group were (4.00±1.50)points and (85.34±10.57)%, respectively, the differences between the two groups were statistically significant(t=-7.416, 4.972, all P<0.05). There were statistically significant differences in the apnea hypopnea index(AHI) and obstructive apnea index(OAI) between the two groups(all P<0.05). After treatment, the A/N of the adenoids in the observation group was significantly decreased, and the difference in the tonsil classification was statistically significant(Z=-2.602, P<0.05). The effective rate of the observation group was 56.25%(18/32), which was significantly lower than that of the control group [100.00%(32/32)], the difference was statistically significant(χ2=17.920, P<0.05). Conclusion In summary, non-surgical treatment can alleviate OSAHS-related symptoms, reduce the size of tonsils and adenoids, and achieve the purpose of remission or cure.Non-surgical treatment can be selected when patients' families are reluctant to choose surgical treatment. Key words: Sleep apnea, obstructive; Glucocorticoids; Leukotriene antagonists; Tonsillectomy; Adenoidectomy; Polysomnography; Blood gas monitoring, transcutaneous; Ventilation-perfusion ratio; Children

Cryptic Tonsils and Halitosis: An Overview of the Literature and a Clinical Image

Cryptic tonsils are the manifestation of repeated inflammation of the tonsils. In particular, the term is used to indicate the occupation of the space of the crypts present on the surface of the tonsillar glands, by infectious debris, deposits of calcific material or food residues. Cryptic tonsils are associated with the appearance of whitish plaques (tonsillolith) and bad breath (halitosis), ear pain, sore throat, hypertrophic tonsils and swallowing problems. A 25-year-old patient comes to the practice for oral hygiene when we notice his cryptic tonsils that cause him to form tonsilloliths and halitosis, creating embarrassment for the patient and limits in interpersonal relationships.

Lingual Tonsil Hypertrophy in Patients With Allergic Rhinitis.

Background Lingual tonsils, part of the Waldeyers’ Ring, are located in base of the tongue. They are commonly observed in childhood, due to increased immunological activity. Several factors such as laryngopharyngeal reflux, younger age, smoking, and obesity are associated with hypertrophy of lingual tonsils (LTH) in adulthood. However, the relation between allergic rhinitis and LTH is not clearly highlightened in the literature so far. Objective To investigate the role of allergic rhinitis in the development of LTH. Methods Adult patients who were diagnosed with allergic rhinitis were included in the study group. The control group consisted of age- and sex-match healthy volunteers. Complete otorhinolaryngology examination including fiberoptic endoscopic evaluation was performed to both groups. Blood samples were obtained for total immunglobulin E levels, and skin prick tests were performed to both groups. Patients with allergy complaints and positive skin prick tests were included in the study group, while healthy volunteers with negative skin prick tests were enrolled in the control group. The grading for LTH was achieved by a physician who was blind to the study. Results The incidence of LTH was significantly higher in the study group when compared to the control group ( P = .001). Similarly, the incidence of grade 3 LTH was significantly higher in the study group compared to the controls ( P = .002). Conclusion According to our results, LTH is more frequently observed in patients with allergic rhinitis. Grade 3 representing larger LTH is more commonly seen in patients with allergic rhinitis.

Lingual tonsils hypertrophy and possibility of its correction by physical factors

Introduction: The component of the lymphopharyngeal ring is the lingual tonsil (LT), located on the root of the tongue. With pathological changes in the lymphoid tissue of the pharynx, surgical removal of the tonsils, as a result of increased antigenic load, a compensatory increase in LT is observed – «lingual tonsillar hypertrophy». This is observed against the background of age-related involutive changes, when the remaining elements of the lymphopharyngeal ring begin to perform anti-antigenic and adaptive activity. The processes taking place in, the structure of the LT, which is familiar to the body, changes - the receptor apparatus creates pathological impulses from the organ. The severity of clinical manifestations correlates with the degree of increase in LT. The emphasis on these manifestations, psychosomatic conditions, create a complex of pathological sensations that violate the quality of patients’ life. The goal and objectives of the study are aimed at improving the quality of patients’ life with lingual tonsil hypertrophy (LTH), by developing effective methods of diagnosis and treatment, assessing the role of the immunoregulatory shift in the pathogenesis of LTH of the possibility of their correction by the action of a physical factor (cold destruction). Materials and methods: When examining 850 people who underwent complex research and instrumental diagnostics in connection with the pathology of ENT organs, 119 people (the main group) were diagnosed with different degrees of LTH, with control of 30 healthy people. Cryosurgical treatment was offered to 76 patients who used the method for treating of lingual tonsil hypertrophy by cryodestruction using a hook-shaped applicator with a heat-insulating nozzle on the back surface, an individual polyethylene cap, and a cryoapparatus. Results and discussions: With LTH, an increase in the volume and mass of tissues forming the morphological basis of the tonsil was detected: the main substance was an increase in the number and size of layers of coarse fibrous fibers, fields of fat cells, and the growth of mucous glands. The mucous membrane, thinning, undergoes dystrophic-degenerative changes. The rate of proliferation correlates with the severity of inflammation, the causes of which are multifactorial, individual. There is an increased sensitivity reaction to microbial and household allergens, an increase in the content of antibodies in the blood to LT tissues, a change in microbiocinosis of the pharyngeal mucosa, and vegetation of non-resident microflora. As a result of cryosurgical treatment in 56 (73.68%) cases, a decrease in the volume of LT tissue was observed. The deep layers, partially absorbed, were replaced by healthy tissues, the surface layers were rejected with the formation of an atrophic scar or regenerate, the structure of which was close to organotypic. The cause of pathological impulse was eliminated, clinical indicators were normalized, the quality of life of patients was improved. Conclusions: LTH should be considered as a continuation of the development of a productive process associated with immunoregulatory changes in chronic infectious and allergic conditions. Local cryogenicity on LTH was accompanied by normalization of the structure of its own substance, LT, and a decrease in inflammatory changes in surrounding tissues. The development of inflammatory changes in LT was a local manifestation of a general disturbance in the functioning of the immune defense system. Achieving a persistent positive effect in the treatment of LTH requires an integrated approach with mandatory systemic immune correction and hormonal correction.

Comparison Between Radiological Versus Endoscopic Assessment of Adenoid Tissue in Patients of Chronic Adenoiditis.

The adenoids are a common cause for morbidity in pre-school and school going children. Adenoid hypertrophy is common cause of nasal obstruction in pediatric population. The assessment of the size of palatine tonsil hypertrophy is quiet easy to perform, however, measuring the size of nasopharyngeal tonsil and establishing its connection with the given symptoms is more difficult. This is basically due to the location of a tonsil in the nasopharyngeal cavity. Since the cavity is inaccessible directly and cannot be examined visually, many direct and indirect methods of adenoid size evaluation have been developed. The objective of this study is to compare the diagnostic efficacy of both X-ray soft tissue nasopharynx lateral view and nasoendoscopy in evaluation of adenoid size in patients having chronic adenoiditis. Our study included 50 children in age group of 3-14years who had signs and symptoms of adenoiditis clinically. After comparing X-ray and endoscopic findings we found that there was good agreement between X-ray and endoscopic method. Sensitivity of X-ray was 79.41% and specificity of 75% whereas sensitivity of nasoendoscopy was 87.10% and specificity was 63.16%. Nasal endoscopy is good screening method and more accurate method to assess the size of adenoids in patients of chronic adenoiditis.

Outcomes of Tongue Base Reduction and Lingual Tonsillectomy for Residual Pediatric Obstructive Sleep Apnea after Adenotonsillectomy.

Introduction Upper airway obstruction at multiple sites, including the velum, the oropharynx, the tongue base, the lingual tonsils, or the supraglottis, has been resulting in residual obstructive sleep apnea (OSA) after tonsillectomy and adenoidectomy (TA). The role of combined lingual tonsillectomy and tongue base volume reduction for treatment of OSA has not been studied in nonsyndromic children with residual OSA after TA. Objective To evaluate the outcomes of tongue base volume reduction and lingual tonsillectomy in children with residual OSA after TA. Methods A retrospective chart review was conducted to obtain information on history and physical examination, past medical history, findings of drug-induced sleep endoscopy (DISE), of polysomnography (PSG), and surgical management. Pre- and postoperative PSGs were evaluated to assess the resolution of OSA and to determine the improvement in the obstructive apnea-hypopnea index (oAHI) before and after the surgery. Results A total of 10 children (5 male, 5 female, age range: 10–17 years old, mean age: 14.5 ± 2.6 years old) underwent tongue base reduction and lingual tonsillectomy. Drug-induced sleep endoscopy (DISE) revealed airway obstruction due to posterior displacement of the tongue and to the hypertrophy of the lingual tonsils. All of the patients reported subjective improvement in the OSA symptoms. All of the patients had improvement in the oAHI. The postoperative oAHI was lower than the preoperative oAHI ( p < 0.002). The postoperative apnea-hypopnea index during rapid eye movement sleep (REM-AHI) was lower than the preoperative REM-AHI ( p = 0.004). Obstructive sleep apnea was resolved in children with normal weight. Overweight and obese children had residual OSA. Nonsyndromic children had resolution of OSA or mild OSA after the surgery. Conclusions Tongue base reduction and lingual tonsillectomy resulted in subjective and objective improvement of OSA in children with airway obstruction due to posterior displacement of the tongue and to hypertrophy of the lingual tonsils.

Adult sleep apnea and tonsil hypertrophy: should pharyngoplasty be associated with tonsillectomy?

Velopharyngoplasty and palatine tonsillectomy are at the very heart of the surgical treatment of obstructive sleep apnea syndrome (OSAS) care. In cases of major tonsil hypertrophy, we evaluated the relevance of associating soft palate surgery with palatine tonsillectomy, independent of the soft palate length. We conducted a retrospective single-center study in OSAS patients with grade III or IV tonsils treated with tonsillectomy. Preoperative assessment included an upper airway examination performed while the patient was awake, a polysomnography and a drug-induced sedation endoscopy (DISE). Surgical efficacy was assessed on postoperative polysomnography. Success was considered when the postoperative apnea-hypopnea index (AHI) was less than 20 events/h with a 50% reduction. We compared palatine tonsillectomy efficacy alone (group A) and associated with soft palate surgery (group B). We analyzed 33 patients who had undergone surgery between December 2006 and May 2018. Their preoperative mean BMI and mean AHI were 27.3 ± 7.5kg/m2 and 38.6 ± 21.4 events/h, respectively. The two groups (A, n = 18 and B, n = 15) were clinically comparable. The success rate was 72.2% in group A and 60% in group B. There was no statistically significant difference between the two groups (p > 0.1). According to this study, in our institution, in cases of major tonsillar hypertrophy, simultaneous soft palate surgery had no significant impact on the success rate, regardless of soft palate length. Associating soft palate surgery with palatine tonsillectomy does not seem mandatory to increase the success rate. III. Retrospective comparative study.

CONTINUOUS VERSUS ON-DEMAND PROTON PUMP INHIBITOR TREATMENT FOR LARYNGOPHARYNGEAL REFLUX: A RANDOMIZED CLINICAL TRIAL

Objective: This study aimed to compare continuous and pro re nata (PRN) proton pump inhibitor (PPI) treatments for laryngopharyngeal reflux (LPR).&#x0D; Methods: This randomized clinical trial included 52 LPR patients with lingual tonsil hypertrophy (LTH). Those patients who showed LPR improvement with an initial PPI trial were randomly divided into continuous and PRN PPI treatment groups. The Reflux Symptom Index (RSI) score, Reflux Finding Score (RFS), and LTH grade were used to assess the treatment results.&#x0D; Results: The PPI treatment (30 mg of lansoprazole twice daily) for 6 mo resulted in a significantly decreasing RSI score (p&lt;0.001). The PPI treatments for the first 8 w and the second 8 w also showed significant LPR improvement. However, there was no significant improvement after the third 8 w (p&gt;0.05). After 6 mo, the PPI treatment also resulted in a continuous decrease in the RFS (p&lt;0.001). There were no significant differences in the mean RSI scores (p=0.518) and mean RFSs (p=0.393) between the continuous and PRN PPI groups. In the grade II LTH cases, there was a significant improvement after 6 mo of PPI treatment (p&lt;0.001), although there was no improvement after the first 2 mo in the treatment group. For the grade III LTH cases, there was no significant improvement after the first 2 mo and 6 mo of the PPI treatment.&#x0D; Conclusion: Six months of PPI treatment improved the RSI score, RFS, and LTH grade, although there was no difference between the continuous and PRN PPI treatment groups.

Adenoids – a review of kantha shalook

Nasal obstruction &amp; mouth breathing frequently caused by multiple factors, one of them being hypertrophied adenoid and tonsils. It is perhaps one of the usually discussed reasons for partial airway obstruction &amp; related respiratory abnormalities.&#x0D; The aim of this article is to provide a lucid illustration of issues pertaining to obstructive breathing and its implication on craniofacial growth.&#x0D; Inefficient medical management and reluctance to surgery necessitates an alternative and novel non-surgical approach to deal this condition. With the very aim of fulfilling the same this case study was taken which involved intake of Ayurvedic medicines and an adoption of Ayurvedic procedure.

Impact of adenoid hypertrophy on the open bite in children

Nasal obstruction caused by adenoid hypertrophy can lead to malocclusion. The research material consisted of children aged 7-12 years with adenoid hypertrophy qualified for adenoidectomy. On the basis of the conducted tests (laryngological, orthodontic, pediatric), the occurrence of open frontal bite in children with pharyngeal tonsil hypertrophy, in particular in boys, was confirmed in comparison to children without hypertrophy correctly breathing through the nose.

Glutathione S-transferase enzyme activity and protein expression in patients with recurrent tonsillitis and idiopathic tonsillar hypertrophy.

The palatine tonsil is a significant part of the secondary immune system. Tonsillitis and idiopathic tonsillar hypertrophy (ITH) are the most common pathologies of this component. Although there are studies on their pathogenesis, there is insufficient study of the role of antioxidant agents. Glutathione S-transferase (GST) isozymes contribute to the antioxidation reactions in the tissue via the glutathione pathway. The purpose in this study was to reveal the levels of the GST enzyme activity and protein expression of GSTP1 and GSTA1 isozymes in patients with tonsillitis and tonsil hypertrophy, and to investigate their role in the pathogenesis of these diseases. Sixteen patients with recurrent tonsillitis and 5 patients with ITH and were included in the study. Cytosolic extracts were prepared from post-tonsillectomy tissues of both patient groups and GST enzyme activities were measured. The expression of GSTP1 was found to be significantly higher than GSTA1 in tissue samples of patients with ITH and recurrent tonsillitis (P<0.001). Increased GST activity and GSTP1 isozyme expression were shown in patients with recurrent tonsillitis compared to the idiopathic tonsillar hypertrophy study group. There was a positive correlation between the expressions of GSTP1 (P=0.040; r=0.47). Increased GST activity and GSTP1 isozymes were demonstrated histologically in the pathogenesis of ITH and recurrent tonsillitis. We believe that the data of changes in antioxidant capacity, obtained from studies with more extensive and larger samples, would support our findings.

Robot-assisted Tongue Base Resection ensures favorable therapeutic outcome to Obstructive Sleep Apnea patients with Lingual tonsil hypertrophy

Tongue base (TB) narrowing is recognized as a significant site of upper airway collapse during sleep in obstructive sleep apnea (OSA) patients and robot technology is expected to have promising clinical utility in OSA patients with TB narrowing. The purpose of our study is to demonstrate the better therapeutic conditions and favorable indications of robot-assisted TB resection (TBR) in OSA. We performed robot-assisted TBR combined with nasal and palatal surgery in 16 OSA patients with any of the following characteristics: severe TB narrowing (over grade II) and moderate or severe OSA. The preoperative median AHI was 48.8/hr and the median lowest SaO2 was 82.0%. The median AHI decreased to 18.7/hr and ten patients (62.5%) were included in the responder group following robot-assisted TBR combined with nasal and palatal surgery. The lowest SaO2 improved to 90.5% and the posterior airway space (PAS) was significantly increased following robot-assisted TBR. Cephalometric results showed that wider PAS were observed in responders compared to non-responders prior to robot-assisted TBR. Interestingly, there was greater improvement in the objective parameters including PAS in the OSA patients with lingual tonsilar hypertrophy than they were in those without and all patients with lingual tonsillar hypertrophy (n = 6) responded to robot-assisted TBR. Robot-assisted TBR exhibited minimal morbidity and postoperative complications in OSA patients. Robot-assisted TBR can be considered a promising and innovative surgical option to reduce TB volume and improve sleep parameters in OSA patients with TB narrowing. OSA patient with TB narrowing due to lingual tonsil hypertrophy shows greater therapeutic outcome and lingual tonsil hypertrophy appears to be most favorable surgical indications of robot-assisted TBR.

The effect of hypertrophied tonsils on the velopharyngeal function in children with normal palate

ObjectiveTonsillar hypertrophy may affect velopharyngeal closure and speech resonance. The aim of this study was to assess the impact of hypertrophied tonsils on velopharyngeal function in children with normal palate and to measure the effect of tonsillectomy on velopharyngeal closure and speech resonance. MethodsEighty seven children with hypertrophied tonsils and normal palate were subjected to tonsillectomy for indications other than speech problems. Preoperative and postoperative evaluation of velopharyngeal function was performed. Auditory perceptual assessment of speech (APA) and nasometric assessment of nasalance was measured, and velopharyngeal closure was evaluated by flexible nasopharyngoscopy. ResultsThirteen patients were excluded from the study because of associated adenoid hypertrophy. The mean baseline of APA scores showed insignificant changes postoperatively. However, significant postoperative changes of nasometric parameters were detected, and the overall postoperative nasalance score was improved for nasal and oral sentences. Also, improvement of velopharyngeal closure was observed postoperatively with accession of palatal mobility and significant increase in coronal closure pattern. Conclusionhypertrophied tonsils may impair velopharyngeal function in children with normal palate by hindering palatal elevation. Tonsillectomy is a beneficial procedure for such patients as it can improve the velopharyngeal closure and speech resonance.

Prevalence of atopy in children with hypertrophic tonsil and recurrent/chronic tonsillitis

The incidence of allergic diseases is increasing every day. Many studies have been conducted to investigate the relationship between many diseases and the presence of atopy. However, there is not enough publication about the presence of atopy and a similar relationship between tonsil diseases. The aim of this study was to determine how hypertrophic, recurrent / chronic tonsils are affected by the presence of atopy. Study was conducted by produced from the thesis of Atopy Prevalence in Hypertrophic Tonsil and Recurrent / Chronic Tonsillitis Children. This study was carried out in Azerbaijan, Neriman Nerimanov Medical University, Department of Ear-Nose-Throat, on the children under the age of 15 years (minimum 2, largest 15 years, mean age 6.3). Tonsillectomy was diagnosed as recurrent / chronic tonsillitis or tonsillar hypertrophy and the first 50 patients were included in the study group and discussed with the literature. In our study, the presence of atopy in 50 children between the ages of 2-15 with tonsillar hypertrophy and recurrent / chronic tonsillitis was investigated. In 27 patients with advanced hypertrophic tendencies 7 (25.9%), in 23 patients with recurrent / chronic tonsillitis, atopy was detected in 1 (4.3%) and the difference was statistically significant. Serum total IgE levels were higher in patients with hypertrophic tonsil than patients with recurrent / chronic tonsillitis. This difference seems to be related to the high atopy rate seen in the hypertrophic tonsil group. As a result of these evaluations, it can be predicted that atopic patients may have hypertrophy in tonsils and atopy may be present in patients with tonsillar hypertrophy. Thus, tonsils may be one of the allergic organs such as lower respiratory tract, nose, skin, eye.

Relationship between mouth breathing etiology and maximum tongue pressure.

To verify the relationship between maximum tongue pressure and the etiology of oral breathing in oral breathing children attended at the Oral Respiratory Outpatient Clinic. A descriptive and analytical cross-sectional study was accomplished with 59 mouth breathing children aged 3 to 12 years (mean age 6.5 years and SD: standard deviation= 2.4). To collect tongue pressure, the Iowa Oral Performance Instrument (IOPI) was used and data regarding the etiology of oral breathing and dental occlusion were collected in the records of these patients for analysis. The associations between the maximum tongue pressure and the etiology of oral breathing, age, gender and dental occlusion were verified by the T test, ANOVA, Spearman's coefficient and Tuckey's test, using a significance level of 5%. There was a moderate and positive correlation between age and maximum pressure, it was verified that there was a statistically significant difference between the maximum tongue pressure and the variables pharyngeal tonsil hypertrophy and palatine tonsil hypertrophy. There were no statistical differences between the other variables. It was concluded that mechanical obstructions, among them the pharyngeal and palatine tonsil hypertrophy alter the maximum tongue pressure in oral breathing children.

Surgical interventions on the pharynx in the structure of otorhinolaryngological care to the population of the city of Moscow

The authors studied the reporting documentation of otorhinolaryngological hospitals of the city of Moscow on the surgical treatment of pharyngeal pathology in adults from 2002 to 2017. It was found that for 16 years surgical treatment of 290 362 patients with ENT-diseases was performed: 181.206 (62.4%) patients with diseases of the nose and paranasal sinuses, 24.981 (8.6%) patients with ear pathology, 60.346 (20.8%) patients with diseases of the pharynx and 23.829 (8.2%) - with diseases of the larynx. The assessment of the overall dynamics of the studied indicators was carried out on the 'trend lines'. For the considered period, the number of patients with surgical pathology of the pharynx increased by 33.2%. The proportion of tonsillectomies increased by 1.85 times to 56.5%, drainage of peritonsillar abscesses and abscesses-tonsillectomies decreased by 19%, uvulopalatoplastic increased 4.1 times, removal of neoplasms of the pharynx increased 2.2 times, adenotomies decreased by 2.4 times. Analysis of the data allowed to establish that, against the background of an ever-increasing number of surgical interventions for diseases of the pharynx in adults, a descending trend was noted only in the treatment of complicated forms of chronic tonsillitis and hypertrophy of the pharyngeal tonsil.

Сравнительное морфометрическое изучение носоглоточного пространства у детей с хроническим аденоидитом и челюстно-лицевой дизморфией

The growth and function of the nasal cavity, nasopharynx, and oropharynx are closely related to the normal growth of the skull in children. The lack of theoretical knowledge, the demand for knowledge, the complexity of prediction impelled the authors to conduct a comparative morphometric study of MRI scans of the nasopharyngeal space in children with chronic adenoiditis and maxillofacial dysmorphism to search for a rational approach and technology that preclude the progression of irreversible craniofacial changes. The study was performed by a group of authors in the premises of the University clinic. A total of 490 patients suffering from chronic adenoiditis were examined. The authors established the prevalence of comorbid pathology of chronic adenoiditis with hypertrophy of the pharyngeal tonsil and neurological pathology of the brain, which allowed substantiating the performance of brain MRI, it constituted 3.2%. This comorbid pathology was studied in conjunction with the acquired maxillofacial dysmorphism. For statistical calculation, the authors chose non-parametric methods with the use of affine relationships space theory from the section of Riemannian Geometry. The authors pointed out topographic landmarks and formed the control points which made it possible to evaluate the nasopharyngeal spaces, changing under the effect of the pharyngeal tonsil, taking into account the complexity of the anatomical three-dimensional structure. The measurements and control point calculations were carried out using the software RadiantDicomViewer v4.2 Identification of the dependence made it possible to calculate the adeno-nasopharyngeal index, which provides the assessment of maxillofacial dysmorphism risk and its reversibility.

Взаємозв’язок виникнення сагітальних аномалій прикусу з порушенням носового дихання

The main etiological factor in the formation of narrowing of the dental rows is a violation of the function of breathing and, as a consequence, a bad habit – mouth breathing. The first causes that cause the appearance of oral breathing: hypertrophy of adenoids and tonsils, rhinitis, curvature of the nasal septum, foreign bodies, nasal polyposis. The development of the airways and facial skeleton are closely interrelated: mouth breathing slows down the growth and narrowing of the maxillary sinuses and upper jaw, which causes the formation of the Gothic shape of the palate. The etiopathogenetic mechanism for the development of narrowing of the dental rows is very diverse, but information on the relationship between the narrowed dental rows and the nasal cavity, which determines changes in the facial skull, is not enough.Key words. Violation of the nasal breathing, oral breathing, narrowing of the upper jaw, sagittal bite anomalies