Morphofunctional condition of palatine tonsils in various forms of chronic tonsillitis

Abstract

Introduction. According to different authors, 4 to 40% of the child and adult population suffer from chronic tonsillitis (СT), with many authors noting an increase in the number of cases and no tendency to decrease the frequency of this pathology.Objective. To optimize diagnostics and treatment tactic of taking patients with chronic tonsillitis (CT) using our own clinical and laboratory data and morphological data as well as literature data.Materials and methods. Аt the first stage of work, 166 patients were examined. They were divided into 4 categories (experimental groups) depending on clinical CT classification according to B.S. Preobrazhensky and V.T. Palchun. We also formed a group of patients who did not have CT symptoms. All patients underwent tonsillectomy or tonsillotomy. All tissue samples of palatine tonsils we got were investigated using immunohistochemical markers and default histological colorings. At the second stage, the dynamics of complaints, clinical symptoms and laboratory parameters were assessed in 247 patients diagnosed with CT Toxic-Allergic Form I (CT TAF I) before conservative treatment and 3 months after conservative treatment. Patients were divided into 3 groups depending on the conservative treatment regimen: a course of flushing the lacunae of the tonsils; antibiotic therapy with a retard form of clarithromycin; complex treatment combining the first two options.Results. Тhe chronic inflammatory process in the palatine tonsils changes their cytoarchitectonics. At the same time, there is a direct correlation between the presence and severity of changes with the clinical classification of chemotherapy according to B.S. Preobrazhensky and V.T. Palchun.Conclusion. With CT TAF II, the palatine tonsil not only loses its importance as an organ of the immune system, but also becomes a hotbed of infection in the body, which can cause severe complications. Only tonsillectomy can effectively protect the patient from these complications. At the stage of CT TAF I, the formation of metatansillar complications occurs. Patients with this form of CT require special attention, and correctly conducted conservative therapy can protect patients from local and general complications of CT. A variant of such conservative therapy that gives a lasting effect is complex therapy with washing the lacunae of the palatine tonsils with an antiseptic solution and simultaneous antibiotic therapy with 14-membered macrolides that can accumulate in the lymphadenoid tissue.

Prediction of the risk of recurrence of the leprosy process

“…Зрелые Мф, которые составляют основную массу гранулемы при лепре, в норме имеют низкий уровень активности МП [16,17]. В ходе нашего исследования установлено, что во всех случаях, если степень активности МП в нейтрофилах крови высокая, то и Мф имеют уровень активности МП, достаточный для лизиса и деградации патогенных микроорганизмов.…”

“…В ходе нашего исследования установлено, что во всех случаях, если степень активности МП в нейтрофилах крови высокая, то и Мф имеют уровень активности МП, достаточный для лизиса и деградации патогенных микроорганизмов. Способность к активному лизису бактерий макрофагами, после поглощения нейтрофилов, богатых МП, определяет один из механизмов барьерной функции организма [17,18].…”

Comparative characteristics of the options for conservative therapy of chronic tonsillitis of toxic-allergic form I

“…После установления диагноза необходимо подобрать оптимальную тактику лечения, которая основывается на морфофункциональном состоянии небных миндалин при каждой конкретной форме ХТ [24][25][26][27].…”