Section: 
Diseases of the lymphoepithelial pharyngeal ring and neck
Diseases of the lymphoepithelial pharyngeal ring and neckModern approaches to outpatient treatment of patients with chronic tonsillitis
Ya. A. Nakatis (1), M. A. Rymsha (2), V. S. Isachenko (3), T. M. Shishkunova (4)
(1), (2), (4) Sokolov North-West District Scientific and Clinical Center, FMBA of Russia, Saint Petersburg, 194291, Russian Federation, (2), (3), (4) Medical Institute of Saint Petersburg State University, Saint Petersburg, 199034, Russian Federation, (3) Saint Petersburg Research Institute of Ear, Throat, Nose and Speech, Saint Petersburg, 190013, Russian Federation
UDK: УДК 616.322-002.2-08-039.57
DOI: https://doi.org/10.18692/1810-4800-2024-6-54-59
ABSTRACT
Abstract. Chronic tonsillitis (CT) is the most common oropharyngeal disease, which is an immunopathological process that often causes the development of associated pathology. An increase in the number of complications and the presence of contraindications to surgical treatment determine the importance of constantly searching for new conservative methods of its treatment. There are a large number of different methods and algorithms for chronic tonsillitis therapy; however, currently, no uniform clinical recommendations have been developed for the treatment of this pathology. Based on this, the development of new minimally invasive and at the same time effective methods to improve the patient’s quality of life and reduce the risk of complications associated with surgical treatment is an urgent task. Objective. To develop new modern methods of conservative treatment and prevention of the development of chronic tonsillitis. Patients and methods. On the basis of the Department of Otorhinolaryngology of the Sokolov Educational Institution of the Russian Academy of Medical Sciences, a simple open study was conducted to study the effectiveness and tolerability of local irrigation therapy with hydroxymethylquinoxalinedioxide (1% – 10.0 per 200.0 saline solution) during vacuum washing of the lacunae of the palatine tonsils (PT) with an ultrasonic low-frequency otorhinolaryngological apparatus for the conservative treatment of diseases of the ENT organs as well as local contact therapy with a polyvalent bacteriophage in the form of a sterile suspension in patients with various forms of chronic tonsillitis. The subjects were divided into 3 groups: group No. 1 (comparative)—rinsing of the lacunae of the palatine tonsils on a low-frequency ultrasound machine without using a polyvalent bacteriophage), main group No. 2 — similar rinsing of the lacunae of the palatine tonsils using a polyvalent bacteriophage, and group No. 3 (control) — washing of the lacunae of the palatine tonsils using an instrumental method using local antiseptics. After the 5th course of rinsing the lacunae of the palatine tonsils on a low-frequency ultrasound machine, using drug therapy, carried out after 1–2 days and self-use by patients of a polyvalent bacteriophage in the next 10 days, the following results were obtained: in group No. 2, a faster relief of symptoms of chronic tonsillitis was observed mainly by the 3rd procedure, compared with patients in groups No. 1 and No. 3. By the 5th procedure, in group No. 2, complete rehabilitation of the lacunae of the palatine tonsils was noted, and an improvement in the microbiological composition of the oropharyngeal mucosa was observed, in group No. 1, after therapy, an improvement in the function of the palatine tonsils was observed in 2 (3.3%) patients; in group No. 2, in 16 (26.7%); in group No. 3, in 0 (0%). Conclusions. The proposed algorithm for the treatment of chronic tonsillitis, through the contact effect of low-frequency ultrasound and drug therapy, can be recommended for the treatment and prevention of exacerbations of chronic tonsillitis in a modern medical center.
Publication date:
17.12.2024
Keywords:
chronic tonsillitis, polyvalent bacteriophage, low-frequency ultrasound
For citation:
Nakatis Ya. A., Rymsha M. A., Isachenko V. S., Shishkunova T. M. Modern approaches to outpatient treatment of patients with chronic tonsillitis. Russian Otorhinolaryngology. 2024;23(6):54-59. (In Russ.) https://doi.org/10.18692/1810-4800-2024-6-54-59