[The specific pathogenetic features of the development of chronic tonsillar pathology]

[Chronic tonsillitis and periodontal diseases]

INTRODUCTION

Chronic tonsillitis is a multifactorial immunopathological process that contributes to the development of tonsillitis-associated pathology. In turn, this tonsillitis-associated pathology potentiates and aggravates the course of chronic tonsillitis. In the literature, there are data on the possible influence of oropharyngeal loci of focal chronic infection on the body as a whole. One of such foci that can aggravate the course of chronic tonsillitis and maintain sensitization of the body are periodontal pockets formed during the inflammatory process in periodontal tissues. Highly pathogenic microgranisms of periodontal pockets secrete bacterial endotoxins, stimulating the immune response of the human body. Bacteria and their waste products cause intoxication and sensitization of the whole organism. A vicious circle is formed, which is quite difficult to break.

OBJECTIVE

To study the effect of chronic inflammatory process in periodontal disease on the course of chronic tonsillitis.

MATERIAL AND METHODS

70 patients with chronic tonsillitis were examined. Together with a dentist-periodontist, an assessment of the state of the dental system was carried out, according to the results of which all patients with chronic tonsillitis were divided into 2 groups: with and without periodontal diseases.

RESULTS

In patients with periodontitis, highly pathogenic flora is found in periodontal pockets. When examining patients with chronic tonsillitis, it is important to assess the condition of the dental system, to calculate dental indices, the key of which are periodontal and bleeding index. It is necessary to recommend comprehensive treatment for patients with CT and periodontitis by otorhinolaryngologists and periodontists.

CONCLUSION

It is necessary to recommend comprehensive treatment by otorhinolaryngologists and dentists to patients with chronic tonsillitis and periodontitis.

[The role of tonsillectomy in the treatment of chronic tonsillitis]

The problem of chronic tonsillitis remains one of the urgent problems of modern otorhinolaryngology. The article discusses the statistics and complications of chronic tonsillitis, provides indications for tonsillectomy and its main complications.

OBJECTIVE

Generalization and systematization of data on the impact of surgical treatment on the quality of life of patients with chronic tonsillitis.

MATERIAL AND METHODS

Search for literary sources, carried out using the search engines of the RSCI, PubMed, Web of Science, and eLibrary.

RESULTS

A review of literature sources demonstrates a significant improvement in the quality of life of patients after tonsillectomy; however, data from some studies show a trend towards a decrease in the number of planned tonsillectomies and an associated increase in the detection of local purulent-septic complications.

[The problem of chronic tonsillitis as a priority area of scientific research of the Department of Otorhinolaryngology named after acad. B.S. Preobrazhensky]

The article summarizes data on many years of versatile research on the problem of chronic tonsillitis, which were conducted at the Department of Otorhinolaryngology named after acad. B.S. Preobrazhensky Medical Faculty of the Russian National Research Medical University N.I. Pirogov. The research results are presented in the context of the history of the department and the formation of the problem of chronic tonsillitis.

[Possibilities of modern forms of antimicrobial peptides in the treatment of inflammatory pathology of the pharynx]

Inflammatory diseases of the pharynx occupy one of the leading places in the structure of otorhinolaryngological pathology. Acute and chronic inflammatory processes in the pharynx, as well as exacerbations of the latter, are faced by doctors of a wide range of specialties. Oropharyngeal swab laboratory testing is required to identify a specific pathogen, which takes time. In this regard, of particular interest are local drugs with the necessary spectrum of action, the use of which is possible, both as monotherapy and in combination with systemic therapy. The combination of tyrothricin (tyrothricin), benzalkonium chloride (benzalkonium chloride), and benzocaine (benzocaine) (dorithricin) is highly effective in the treatment of bacterial, viral and fungal infections of the pharynx, and microorganisms consistently demonstrate high sensitivity to the components of the drug.

[Small salivary glands in the paratonsillar space in children]

Was to study the changes in the small salivary glands in chronic tonsillitis and paratonsillar abscess in children. A histological examination of the palatine tonsils of 22 children aged 5 to 14 years old who had a paratonsillar abscess and 18 children suffering from chronic tonsillitis was carried out. Fragments of small salivary glands, located both superficially, in the mucous membrane between the stratified squamous non-keratinizing epithelium and the lymphoid tissue of the palatine tonsils, and between the muscles of the amygdala were found in 42 of the 80 (52.5%) tonsils studied. Along with the unchanged glandular structure, 26 (61.9%) samples revealed areas of destruction foci in small salivary glands with signs of inflammatory and compensatory regenerative activity. The presence of separate interlobular ducts of the salivary glands with pronounced periductal lymph - macrophage infiltration was noted. The subepithelial lymph-macrophage infiltrates found in the lamina propria are associated with the exit of the excretory ducts of the salivary glands to the surface of the mucous membrane. Many thin-walled veins are surrounded by perivascular lymphocellular infiltrates. The inflammatory and post-inflammatory changes in the small salivary glands revealed by us in children with chronic tonsillitis do not exclude their participation in the pathogenesis of paratonsillitis. At the same time, inflammation in the salivary gland can be both primary, as a result of its infection with live microorganisms from the tissues of the tonsil, and secondary, due to the compression of the excretory ducts by the edematous tissue of the tonsil in acute tonsillitis.

[Reflections on some issues of the combined pathology of the upper and lower respiratory tract]

The purpose of this work is to generalize and critically evaluate current literature data on the state of problem of the relationship between acute and chronic diseases of upper and lower respiratory tract. Modern ideas about the mechanisms of relationship of pathological processes of ENT organs with bronchopulmonary pathology are considered. A number of organizational issues are discussed in order to optimize the medical diagnostic process in the pathology of respiratory system.

[Palatine tonsils: physiology and pathology]

The article presents modern ideas about the etiology, pathogenesis, and features of the clinical picture of chronic tonsillar pathology. Specific attention is paid to the classification of chronic tonsillitis, in particular the classification of B.S. Preobrazhensky - V.T. Palchun. Data on modern methods for assessing the morphofunctional state of palatine tonsils, including immunohistochemical studies, are presented. Modern approaches to therapy are considered.

[Subcutanious emphysema and pneunomediastinum - the rare complication of tonsillectomy]

Tonsillectomy is one of the most common surgical interventions in the practice of ENT hospitals. As a rule, complications of tonsillectomy are early and late postoperative bleeding. However, in extremely rare cases tonsillectomy can be complicated by subcutaneous emphysema and pneumomediastinum. The mechanism by which these complications develop are poorly understood. The article describes the case of a rare complication of tonsillectomy - the intraoperative development of subcutaneous emphysema and pneumomediastinum. Such complications are most likely caused by deep trauma of the pharyngobasilar fascia of the tonsillar fossa, which causes the penetration of the air into the parapharyngeal space and its subsequent spread to the mediastinum.