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.
Improvement of therapeutic tools is one of topical issues in modern otorhinolaryngology. The article is devoted to the study of the stimulating effect of physical therapy on the concentrations of secretory IgA in nasal secretions, from the entries of auditory tubes and nasopharynx in the patients suffering from adenoiditis, rhinosinusitis, and exacerbation of chronic otitis media. The increase in clinical and immunological efficiency when using low-frequency ultrasonic cavitation therapy in combination with photochromotherapy in combined treatment of these conditions was evaluated in dynamics by measuring concentrations of secretory immunoglobulin levels in nasal secretions using enzyme immunoassay technique (Vector-Best, Russia). The purpose of this study was to improve clinical and immunological effectiveness of treatment of patients with chronic adenoiditis, sinusitis and exacerbation of chronic purulent otitis media when using low-frequency ultrasound cavitation and photochromotherapy in complex therapy. The study involved 54 patients. The control group consisted of 25 patients who received conventional treatment (topical and systemic antibacterial and anti-inflammatory drugs, unloading and elimination procedures, symptomatic and restorative therapy) and the main group of 29 people who, in addition to etiotropic therapy, received low-frequency ultrasound cavitation irrigation of the nasal cavity followed by a course of photochromotherapy. Evaluation of the effectiveness of treatment was carried out by studying the barrier state of the nasal mucosa by the levels of secretory IgA concentration by the method of enzyme immunoassay. The low-frequency ultrasound cavitation in combination with photochromotherapy as an adjunct to etiotropic treatment in patients with adenoiditis, rhinosinusitis and exacerbation of chronic otitis media promotes an earlier increase in secretory IgA concentration of nasal mucosa and entry of the auditory tube when compared to standard treatment methods. The trend to IgA increase by 14 days reached maximal values and was slightly decreased month later. An early increase in the concentration of secretory IgA in nasal secretions and the entry of auditory tube, and positive clinical results of treatment are observed when low-frequency ultrasound cavitation is used in etiotropic therapy in combination with photochromotherapy in patients with adenoiditis, rhinosinusitis and exacerbation of chronic otitis media. The results substantiate the opportunity of introducing these physical methods of physical therapy into complex etiotropic therapy, as a non-invasive and effective method.
Introduction. According to the literature, oxidative stress is described as one of the main factors in the pathogenesis of chronic suppurative otitis media, supporting the inflammatory process at the local level. The transition of inflammatory mediators to the systemic level is associated with the risk of developing ear purulent-destructive complications. The study of the products of lipid peroxidation in comparison with morphological changes in the structures of the temporal bone will justify the tactics of the operation.Aim. Comparison of the levels of lipid peroxidation products at the local and systemic levels in chronic suppurative otitis media, depending on the nature of pathomorphological changes in the structures of the temporal bone.Materials and methods. A prospective study of 130 patients with chronic suppurative otitis media at the age of 20-62 years with a verified diagnosis of chronic suppurative otitis media, admitted for surgical treatment, was carried out. To study the indicators of oxidative stress at the systemic level, the blood serum of patients was used; at the local level, the bone biomaterial obtained from patients during the surgical treatment of chronic suppurative otitis media was used. The quantitative determination of the primary, secondary and final products of peroxidation was carried out in the groups of patients with separate registration of lipoperoxides in the heptane and isopropanol phases of the lipid extract by spectrophotometry.Results and discussion. In the observation of patients with morphological signs of purulent destruction of the temporal bone, not only a local level of inflammation activity, but also a systemic level of an unfavorable outcome was revealed in two variants: osteoproliferation or osteonecrosis of the bone tissue of the temporal bone in chronic purulent otitis media with a constant threat to the patient's life due to intracranial purulent complications.Conclusion. The appearance in low concentrations of lipid peroxidation products in serum in patients with chronic purulent otitis media substantiates the need for a behind-the-ear approach in reconstructive-sanitizing otosurgery even with minimal clinical manifestations and CT scan data, since at the preclinical level it confirms the osteonecrotic type of bone remodeling with the risk of delayed death.
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