Section: 
Diseases of the lymphoepithelial pharyngeal ring and neck
Diseases of the lymphoepithelial pharyngeal ring and neckPeculiarities of course of chronic tonsillitis in association with gastroesophageal reflux disease
N. A. Petukhova (1), A. S. Tovmasyan (2), M. M. Stepanova (3)
(1), (2), (3) Sverzhevsky Research Clinical Institute of Otolaryngology, Moscow Department of Health, Moscow, 117152, Russian Federation
UDK: УДК 616.322-002.2+616.329/.33-008.1-036.12-039
DOI: https://doi.org/10.18692/1810-4800-2025-4-76-82
ABSTRACT
Abstract. The problem of chronic inflammation of the palatine tonsils (PT) remains relevant at present. The concept of epithelial-endothelial distress syndrome EEDS-NIKIO is the basis for a possible systemic, scientifically based solution to the problem of chronic tonsillitis (CT). The trigger for the development of chronic inflammation in the PT is the imbalance of the basic microbiocenosis of the biotope. According to the literature, dysbiosis of the oropharynx bioregion is observed with the development of gastroesophageal reflux disease (GERD). Objective. To investigate the clinical manifestations and systemic markers of chronic inflammation in patients with CT and CT in association with GERD. Patients and methods. Patients were divided into two groups: Group I: CT, toxic-allergic form I and II (TAF I and TAF II) in association with GERD and Group II: CT, TAF I, and TAF II. In addition to the standard otolaryngologic examination using visual analogue scales, all patients underwent a study of systemic inflammation markers. Diagnosis of GERD included the Reflux Symptom Index (RSI) questionnaire, consultation with a gastroenterologist followed by esophagogastroduodenoscopy (EGD). Results. Patients with CT in association with laryngopharyngeal reflux were found to have a more pronounced clinical symptom complex of regional and systemic manifestations of the disease. Patients in both groups were found to have an increased level of endotoxin in the oral fluid and in the blood, which initiates and maintains endotoxin chronic aggression and a systemic low-intensity inflammatory response. In patients with CT, the concentration of high-sensitivity C-reactive protein was 1.71 ± 1.26 mg/L, which indicates an average risk of chronic systemic inflammation. In patients with CT in association with GERD, this indicator reached a level of 3.01 ± 1.51, which demonstrates a high risk of developing a chronic systemic inflammatory response.
Publication date:
13.08.2025
Keywords:
chronic tonsillitis, epithelial-endothelial distress syndrome, gastroesophageal reflux disease, chronic systemic inflammation, endotoxin For citation:
Petukhova N. A., Tovmasyan A. S., Stepanova M. M. Peculiarities of course of chronic tonsillitis in association with gastroesophageal reflux disease. Russian Otorhinolaryngology. 2025;24(4):76-82. (In Russ.) https://doi.org/10.18692/1810-4800-2025-4-76-82