THE EFFECT ON THE CLINICAL COURSE OF ADENOID VEGETATIONS ANATOMICAL LOCATION PHARYNGEAL TONSIL

Abilova F. A.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

Goal. To determine the effect of anatomical location of adenoid vegetations on the clinical course of the disease and its complications of the ears, nose and throat. Materials and methods. Under our observation were 67 patients, 39 boys and 28 girls aged from 5 to 12 years. In 7 patients with adenoid vegetation was accompanied by exudative otitis media, one patient had chronic otitis media, 5 patients with sinusitis and 19 patients in addition to the adenoid vegetations was diagnosed with chronic tonsillitis. All patients underwent adenotomy, 4 patients except adenotomy was performed shunting of the tympanic cavity on both sides, 19 patients made adenotonsillectomy. In the postoperative period in 3 patients after adenotonsillectomy showed signs of paresis of the soft palate, one patient had severe pain and discharge from the ear. A year after the inspection one patient was observed a recurrence of adenoids. Results and discussion. According to radiological studies, depending on the shape of the adenoids clinical course had a different. In the first form (adenoid vegetation are closer to choanae) patients complaints and clinical signs are associated with more abnormalities of the ears. In these patients during the inspection were determined signs of exudative otitis media, one patient had chronic otitis media. During the audiological tests revealed a hearing loss of conductive type by more than 40 dB. Patients who have defined the second form of adenoid vegetations, the complaints were specific, nasal obstruction, nasal discharge, frequent colds. Endoscopic examination by the ears was marked retraction of the tympanic membrane. When audiological study only 5 patients were identified hearing loss by conductive type than 30 dB. The remaining patients of this group audiological hearing loss was 25 dB. However, these patients do not focused their complaints on hearing loss. Under the third form of the location of adenoid vegetations in patients with clinical symptoms of adenoids were not pronounced and the complaints are more focused on obstructive phenomena, such as snoring, sleep apnea. In these patients, the adenoids were accompanied by chronic tonsillitis. It should be noted that in classical rhinoscopy and pharyngoscope the magnification of adenoid vegetations do not always coincide with the manifest symptom and the anatomical location of adenoids. Patients with adenoid vegetation were closer to choanae (I form) in addition to adenotomy 4 patients underwent bypass grafting of the tympanic cavity. Patients who were determined II form of adenoid vegetation was conducted only adenotomy. Patients who were determined form III adenoid vegetations were adenotonsillectomy. Conclusions 1. The clinical course of adenoid vegetations depends on the anatomical position of lymphadenoid tissue. When I form is dominated by symptoms associated with the ears. II form if the clinic is more diverse. When form III is dominated by symptoms of disease of the pharynx. 2. The anatomical location of adenoid vegetations to prevent possible complications in I the form of the adenoids need to spend endonasal endoscopic control. III in the form of adenoids removal of tonsils advisable to spend a cold way, and to prescribe rehabilitation measures in the postoperative period.

adenoids, adenoids form, the radiological study

• 1. Васильева Н. И. Особенности применения топических антибактериальных препаратов в терапии воспалительных заболеваний полости носа, носоглотки и околоносовых пазух у детей / Н. И. Васильева // Вопросы современной педиатрии. — 2012. — Т. 11. №. 5. — С. 142-148.
• 2. Детская оториноларингология: Руководство для врачей / под ред. М. Р. Богомильского, В. Р. Чистяковой. — Т. 1. М.: ОАО «Издательство «Медицина», 2005. — 660 с.
• 3. Дмитриев Н. С. Экссудативныйсреднийотит. Оториноларингология: национальное руководство / Н. С. Дмитриев / под ред. В. Т. Пальчуна. М.: ГЭОТАР–Медиа, 2008. — С. 553-565.
• 4. Зельдмайер Б. Факторы, влияющие на постоперативное течение и возникновение рецидива экссудативного среднего отита у детей / Б. Зельдмайер, Л. Моравитц, М. Юма, Х. Шайхова, М. Тухтаев // Рос. оториноларингология. — 2009. — № 5. С. 54-59.
• 5. Коваленко С. Л. Исследование слуха у детей дошкольного возраста на современном этапе / С. Л. Коваленко // Рос. оториноларингология. — 2009. — № 4. С. 69-74.
• 6. Мельников М. Н. Эндоскопическая шейверная аденоидэктомия / М. Н. Мельников, А. С. Соколов // Российская ринология. — 2000. — № 1. С. 4-8.
• 7. Cannon C. R. Endosccopic assistend adenoidectomy / C. R. Cannon, W. H. Replog, M. P. Schenr // Otolaryngol. HeadNeak Surg. — 1999. — № 6. P. 740-744.
• 8. Gallagher T. Q. Analyzing factors associated with major complications after adenotonsillectomy in 4776 patients: comparing three tonsillectomy techniques / T. Q. Gallagher [et al.] //Otolaryngology — Head and Neck Surgery. — 2010. — Т. 142. №. 6. С. 886-892.
• 9. Ramos S. D. Tonsillectomy and adenoidectomy / S. D. Ramos, M. Shraddha, S. Harold // Pediatric clinics of North America 60.4 (2013) — Р. 793-807.
• 10. Zielhuis G. A. The prevalence of otitis media with effusion: a critical review of the literature / G. A. Zielhuis, G. H. Rach, A. Van-den-Bosch // Clin. Otolaryng. — 1990. — Vol. 15. P. 283-288.

«Bulletin of problems biology and medicine» Issue 1 part 1 (126), 2016 year, 111-114 pages, index UDK 616-053.2