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DOI 10.37219/2528-8253-2024-4-6-7

Pukhlik SM, Zaporozhchenko PO

Modern aspects of the treatment of different etiopathogenetic variants of chronic nasopharyngitis 

Pukhlik Sergey Mikhailovich
Odessa National Medical University
Head of the Department of Otorhinolaryngology
Doctor of Medical Sciences, Professor
E-mail: lor@te.net.ua
Orchid ID: http://orcid.org/0000-0001-7196-9642
https://www.scopus.com/authid/detail.uri?authorId=6506298353
Zaporozhchenko Pavlo 
Odessa National Medical University
Postgraduate student of the Department of Otorhinolaryngology
E-mail: 7770105@ukr.net
ORCID ID: http://orcid.org/0009-0009-4961-6571

MODERN ASPECTS OF THE TREATMENT

OF DIFFERENT ETIOPATHOGENETIC VARIANTS OF CHRONIC NASOPHARYNGITIS

Pukhlik SM, Zaporozhchenko PO

Department of Otorhinolaryngology of the Odessa National Medical University (Odessa, Ukraine)

E-mail: lor@te.net.ua

Abstract

Topicality: Chronic inflammation of the pharyngeal tonsil (PT) is a common disease in the pediatric population, which to one degree or another is determined by a tendency to increase in the size of lymphoid tissue in anatomically narrow places, the presence of background conditions and diseases (persistent infection or foci of chronic inflammation), a deviation in allergic status. Among the most important reasons for the development of recurrent respiratory infections (RRI) and their influence on the chronicity of inflammation in pediatric patients are a significant number of respiratory pathogens and the ease of their transmission, the lack of acquired immune experience in children who did not attend preschool education institutions, the formation of only type-specific post-infectious immunity, presence of somatic pathology, functional immaturity of the immune system in children. The negative effect of antibiotic therapy of exacerbations of chronic nasopharyngitis and its complications on the child’s microbiota, a high level of comorbidity and the initiation of a vicious circle in the nasopharyngeal zone accelerates the determination of actions in the direction of a preventive approach to control the frequency and severity of the course of recurrent and chronic diseases of the upper respiratory tract and ear, in particular, chronic nasopharyngitis (CNP), especially in conditions of high allergy of the modern children’s organism.

Objective: On the basis of a review of modern literature, to highlight the etiopathogenetic role of factors of immune protection of the nasopharynx in CNP and some of its complications in children in conditions of comorbidity in order to improve treatment and prevention possibilities. On the basis of a review of modern literature, to highlight the etiopathogenetic role of factors of immune protection of the nasopharynx in CNP and some of its complications in children in conditions of comorbidity in order to improve treatment and prevention possibilities.

Conclusions: The analysis of literary sources indicates the current relevance of the problem of correcting the child’s immunological status as a preventive means of controlling the incidence of PRI and the chronicity of the elements of inflammation of the lymphoepithelial ring, which is defined as a predominant problem of childhood with constant rates of morbidity and the possibility of developing complications. Despite the fact that innate immunity theoretically provides protection of the upper respiratory tract and ear from pathogens at almost all levels, including the molecular, multifactorial nature of etiopathogenesis and comorbidity contribute to the formation of many clinical variants of the course of CNP, which reduces the effectiveness of the use of unified approaches. The lack of research on the problem should be recognized as insufficient attention to determining the characteristics of the course of CNP in children without hypertrophy of the GM and the influence of concomitant pathology of the nasopharyngeal zone. In addition, as evidenced by the literature, successful immune protection, in turn, depends on the timely and sufficiently strong inclusion of a certain mechanism or factor. This is all the more important because the creation of artificial immune protection in an atopic child and an inadequate immune system can cause or maintain the opposite pro-inflammatory effect. Therefore, in the absence of a “gold standard” for the treatment of CNP and the risk of developing algorithms with the presence of a surgical factor, research into the preventive direction of conservative treatment of CNP and its complications in children is relevant.

Keywords: chronic nasopharyngitis, adenoiditis, allergic rhinitis, pharyngeal tonsil hypertrophy, immunocorrection, conservative treatment, recurrent respiratory infections, rhinosinusitis.

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