Preview

Meditsinskiy sovet = Medical Council

Advanced search

Topical issues in the treatment of chronic tonsillitis

https://doi.org/10.21518/2079-701X-2021-6-67-73

Abstract

The article is devoted to the problem of chronic tonsillitis. The widespread prevalence of the disease, as well as the high risk of complications from vital organs, make this problem especially urgent. The article describes in detail the factors contributing to the formation of a focus of chronic inflammation in the amygdala. Special attention is paid to the microbiological aspects of the inflammatory process, anatomical, topographic and physiological features of the tonsils, as well as their immune function. The histological changes that form against the background of a long-term chronic inflammatory process in the tonsils are described. Changes in the parenchyma of the amygdala during inflammation can be expressed both by hyperplasia and by involution of follicles with the formation of infiltrates and the subsequent development of abscesses. In the final stages of an active inflammatory process, connective tissue grows, replacing lymphoid tissue. In the paratonsillar tissue and the capsule of the amygdala, an overgrowth of connective tissue is also observed, which is accompanied by the formation of nested infiltrates around small vessels, most pronounced at the upper pole of the amygdala. According to this classification, two clinical forms of chemotherapy are distinguished: simple and toxic-allergic of two degrees of severity. Further, in accordance with this classification, the basic principles of treatment are presented. Then the features of conservative therapy and the benefits of the herbal preparation are described. The composition of this drug includes marshmallow root, chamomile flowers, horsetail herb, walnut leaves, yarrow herb, oak bark and dandelion herb. The results of several clinical trials of the drug indicate its positive effect on the dynamics of both clinical and microbiological, immunological parameters in patients with chronic tonsillitis. All this allows us to recommend wider inclusion of this combined herbal medicinal product in the complex of treatment of chronic tonsillitis.

About the Authors

A. V. Gurov
Pirogov Russian National Research Medical University; Sverzhevsky Scientific and Research Otolaryngology Clinical Institute
Russian Federation

Alexander V. Gurov, Dr. Sci. (Med.), Professor of B.S. Preobrazhensky Department of Otorhinolaryngology, Faculty of General Medicine, Pirogov Russian National Research Medical University; Senior Research Associate, Department of Epidemiology, Methodology and Scientific Forecasting, Sverzhevsky Scientific Research Clinical Institute of Otorhinolaryngology

1, Ostrovityanova St., Moscow, 117997,

18A, Bldg. 2, Zagorodnoe Shosse, Moscow, 117152



A. V. Muzhichkova
Pirogov Russian National Research Medical University
Russian Federation

Anna V. Muzhichkova, Cand. Sci. (Med.), Teaching Assistant of B.S. Preobrazhensky Department of Otorhinolaryngology, Faculty of General Medicine

1, Ostrovityanova St., Moscow, 117997



A. A. Kelemetov
Pirogov Russian National Research Medical University
Russian Federation

Arslan A. Kelemetov, Postgraduate Student of B.S. Preobrazhensky Department of Otorhinolaryngology, Faculty of General Medicine

1, Ostrovityanova St., Moscow, 117997



References

1. Gurov A.V., Aksenova A.V., Guseva O.A. The Possibilities of Modern Macrolides in the Prevention of Associated Diseases in Chronic Tonsillar Pathology. In: Proceedings of the 1st St Petersburg Forum of Otorhinolaryngologists of Russia. 2012 Apr. 17–18; St Petersburg, Russia. St Petersburg: Poliforum; 2012. Vol. 1, pp. 329–333. (In Russ.).

2. Pal’chun V. T., Gurov A.V., Aksenova A.V., Guseva O.A. The Modern View of Toxico-Allergic Manifestations of Chronic Tonsillar Pathology, Its Etiological and Pathological Role in the Evolvement and Development of General Diseases. Vestnik otorinolaringologii = Bulletin of Otorhinolaryngology. 2012;77(2):5–12. (In Russ.) Available at: https://mediasphera.ru/issues/vestnikotorinolaringologii/2012/2/downloads/ru/030042-4668201221.

3. Pal’chun V. T., Kryukov A.I., Magomedov M.M. Otorhinolaryngology. 4th ed. Moscow: GEOTAR-Media; 2019. 592 p. (In Russ.).

4. Belov V.A., Voropaeva Y.V. Age and Gender Characteristics of the Prevalence of Chronic Tonsillitis in Children. Meditsinskiy sovet = Medical Council. 2015;(1):18–21. (In Russ.) doi: 10.21518/2079-701X-2015-1-18-21.

5. Kosyakov S.Y., Agnotoeva I.B., Muldasheva A.A. The Contradictory Nature of Current Views on the Problem of Chronic Tonsillitis. Meditsinskiy sovet = Medical Council. 2015;(3):35–39. (In Russ.) doi: 10.21518/2079-701X-2015-3-35-39.

6. Hoefakker S., van ‘t Erve E.H., Deen C., van den Eertwegh A.J., Boersma W.J., Notten W.R., Claassen E. Immunohistochemical Detection of Co-Localizing Cytokine and Antibody Producing Cells in the Extrafollicular Area of Human Palatine Tonsils. Clin Exp Immunol. 1993;93(2):223–228. doi: 10.1111/j.1365-2249.1993.tb07970.x.

7. Bhattacharyya N., Kepnes L.J. Economic Benefit of Tonsillectomy in Adults with Chronic Tonsillitis. Ann Otol Rhinol Laryngol. 2002;111(11):983–988. doi: 10.1177/000348940211101106.

8. Kharayeva Z.F., Azamatova E.K. Factors of Persistence of Pathogens of Chronic Tonsillitis. In: Ilyinskikh N. (ed.). Issues and Perspectives in Contemporary Science. Tomsk; 2009. Vol. 2(1), рр. 234–235. (In Russ.) Available at: http://tele-conf.ru/sborniki-nauchnyih-trudov/sbornik-nauchnyih-trudov-problemyi-i-perspektivyi-sovremennoy-nauki-2009-god-tom2-vyipusk-1.html.

9. Azamatova E.K., Kharaeva Z.F., Maltseva G.S. Сharacteristics of Microbial Properties of Persistence in Children with Chronic Tonsillitis. Rossiyskaya otorinolaringologiya = Russian Otorhinolaryngology. 2011;(3):3–6. (In Russ.) Available at: http://entru.org/files/preview/2011/03/j_rus_LOR_3_2011.pdf.

10. Maltseva G.S. The Role of Group A Beta-Hemolytic Streptococcus in Tonsillar Pathology. Rossiyskaya otorinolaringologiya = Russian Otorhinolaryngology. 2007;(3):131–139. (In Russ.) Available at: http://entru.org/files/preview/2007/03/j_rus_LOR_3_2007.pdf.

11. Pal’chun V. T., Luchikhin L.A., Kryukov A.I. Inflammatory Diseases of the Pharynx. Moscow: GEOTAR-Media; 2012. 288 p. (In Russ.) Available at: https://rosmedlib.ru/book/ISBN9785970421437.html.

12. Pal’chun V. T., Magomedov M.M., Luchikhin L.A. Otorhinolaryngology. 3rd ed. Moscow: GEOTAR-Media; 2013. 584 p. (In Russ.).

13. Aznabaeva L.F., Aref’eva N.A. Immunological Aspects of Chronic Tonsillitis. Vestnik otorinolaringologii = Bulletin of Otorhinolaryngology. 2013;78(4):4–9. (In Russ.) Available at: https://mediasphera.ru/issues/vestnik-otorino-laringologii/2013/4/030042-4668201341.

14. Kryukov A.I., Zayrat’yants O. V., Tsarapkin G.Yu., Ivoilov A.Yu., Kucherov A.G., Tovmasyan A.S. et al. Age Features of the Vascular Organization of the Adenoid Tissue. Morfologicheskie vedomosti = Morphological Newsletter. 2017;25(2):32–36. (In Russ.) doi: 10.20340/mv-mn.17(25).02.05.

15. Pal’chun V. T., Gurov A.V., Guseva O.A. The Specific Pathogenetic Features of the Development of Chronic Tonsillar Pathology. Vestnik otorinolaringologii = Bulletin of Otorhinolaryngology. 2018;83(2):30–33. (In Russ.) doi: 10.17116/otorino201883230-33.

16. Preobrazhenskiy B.S., Popova G.N. Angina, Chronic Tonsillitis, Related General Diseases. Moscow: Meditsina; 1970. 384 p. (In Russ.).

17. Pal’chun V.T. Classification and Therapeutic Strategy for Chronic Tonsillitis. Vestnik otorinolaringologii = Bulletin of Otorhinolaryngology. 2013;78(3):8– 11. (In Russ.) Available at: https://mediasphera.ru/issues/vestnik-otorinolaringologii/2013/3/030042-4668201332.

18. Karpova E.P., Bozhatova M.L. Modern Possibilities of Antibacterial Therapy in Children with Chronic Tonsillitis. RMZH = RMJ. 2010;(1):8–10. (In Russ.) Available at: https://rmj.ru/articles/pediatriya/Sovremennye_vozmoghnosti_antibakterialynoy__terapii_u_detey_s_hronicheskimi_tonzillitami.

19. Pal’chun V. T., Polyakova T.S., Romanova O.N. Therapeutic and Diagnostic Approaches to the Problem of Chronic Tonsillitis. Vestnik otorinolaringologii = Bulletin of Otorhinolaryngology. 2001;(1):4–7. (In Russ.).

20. Ryazantsev S.V., Krivopalov A.A., Eremin S.A. Features of Nonspecific Prevention and Treatment of Patients with Exacerbation of Chronic Tonsillitis. RMZH = RMJ. 2017;(23):1688–1694. (In Russ.) Available at: https://rmj.ru/articles/otorinolaringologiya/Osobennosti_nespecificheskoy_profilaktiki_i_lecheniya_pacientov_s_obostreniem_hronicheskogo_tonzillita/.

21. Pal’chun V. T., Kryukov A.I., Magomedov M.M. (eds). Guide to Focal Infection in Otorhinolaryngology. Moscow: GEOTAR-Media; 2015. 224 p. (In Russ.) Available at: https://rosmedlib.ru/book/ISBN9785970434741.html.

22. Selimzianova L.R., Vishneva E.A., Fedoseenko M.V., Promyslova E.A. Phytotherapy: Present State of the Issue. Pediatricheskaya farmakologiya = Pediatric Pharmacology. 2016;13(5):488–493. (In Russ.) doi: 10.15690/pf.v13i5.1645.

23. Miraj S., Alesaeidi S. A Systematic Review Study of Therapeutic Effects of Matricaria Recuitta Chamomile (Chamomile). Electron Physician. 2016;8(9):3024–3031. doi: 10.19082/3024.

24. Dayronas Zh.V., Kuleshova S.A., Pshukova I.V. Phytochemical Study of Walnut Leaves as a Source of Antioxidants. Khimija rastitel’nogo syr’ya = Chemistry of Plant Raw Material. 2010;(4):95–98. (In Russ.) Available at: https://elibrary.ru/item.asp?id=15578097.

25. Kurkin V.A., Aznagulova A.V. Phytochemical Study of Aerial Parts of Taraxacum Officinale Wigg. Khimija rastitel’nogo syr’ya = Chemistry of Plant Raw Material. 2017;(1):99–105. (In Russ.) doi: 10.14258/jcprm.2017011027.

26. Mel’nikov O. F., Zabolotnyy D.I. Immunomodulatory Properties of the Phytopreparation Tonzilgon N. Zdorov’ya Ukrayini = Health of Ukraine. 2006;(5):136–137. (In Russ.) Available at: https://bionorica.ru/rep/4_TonzilgonN/1_Pediatri/1_orvi-u-chbd/5_Melnikov_ImmsvvafitoprepTonz_2006.pdf.

27. Drynov G.I. Clinical and Immunological Characteristics and Effectiveness of Conservative Treatment of Chronic Tonsillitis in Children. Zdorov’ya Ukrayini = Health of Ukraine. 2013;(4):34–35. (In Russ.) Available at: http://health-ua.com/pics/pdf/ZU_2013_Pediatr_4/34-35.pdf.

28. Gurov A.V., Yushkina M.A. Opportunities of Tonsilgon N Use in Complex Treatment of Chronic Tonsillitis. Consilium Medicum. 2018;20(11):20–24. (In Russ.) doi: 10.26442/20751753.2018.11.000027.

29. Piskunov V.S., Nikitin N.A. Experience of the Usage of Tonsilgon N in the Complex Treatment of Chronic Tonsillitis with Irrigations of Palatine Tonsils in Adults. Consilium Medicum. 2018;20(3):48–52. (In Russ.) Available at: https://consilium.orscience.ru/upload/iblock/f81/f81df7c75ad00936821b25ce0ac0a598.pdf.

30. Feyzullayev E.F., Karpova E.P., Baykova V.N. Features of the antioxidant protection system and its correction in children with chronic tonsillitis. RMZH = RMJ. 2009;(4):303–307. (In Russ.) Available at: https://rmj.articles/otorinolaringologiya/Osobennosti_sistemy_antioksidantnoy__zaschity_i_ee_korrekciya_u_detey_s_hronicheskim_tonzillitom/


Review

For citations:


Gurov AV, Muzhichkova AV, Kelemetov AA. Topical issues in the treatment of chronic tonsillitis. Meditsinskiy sovet = Medical Council. 2021;(6):67-73. (In Russ.) https://doi.org/10.21518/2079-701X-2021-6-67-73

Views: 1110


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2079-701X (Print)
ISSN 2658-5790 (Online)