Hans Manee, Kalinichenko S. V., Sklyar N. I., Dubinina N. V.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

In recent years, in the practice of Otorhinolaryngologists for the treatment of chronic tonsillitis (CT), a high-energy laser has been used. But to date no methods of laser blast have been proposed for practical Health Care, which on the one hand would be aimed at eliminating the pathological process in the palatine tonsils and on the other, would be organ-sparing since it is known that after tonsillectomy the existing imbalance of local and systemic immunological reactivity of the organism not only does not disappear, but can even increase. Significant changes in the level of cytokines in the study of patients immediately after the course of treatment is not manifested. However, after a month of monitoring the patients, a certain normalization of the indices was observed, which were investigated: in patients receiving conservative treatment of the tonsils, the level of IL-10 was on average 1,4 times higher (p<0,05) of the same parameters of patients who had pinpoint laser blast on the tonsils. As for the patients of the III and IV groups, the results of the comparison of the cytokine profile one month after the treatment indicated a more effective therapy in patients who underwent laser tonsilotomy followed by immunomodulation with a drug based on bacterial lysates “Ismigen”. According to the results of the research, it was established that the treatment of patients with chronic tonsillitis with the use of a high-energy laser promoted more active normalization of the immune status indicators in comparison with conservative therapy and classical tonsillectomy. Thus, to improve the efficiency of organ-sparing treatment of patients with chronic tonsillitis, it is recommended to use a high-energy laser.

palatine tonsils, chronic tonsillitis, cytokine profile, pinpoint laser impaction, local immunity, phagocytosis

1.  Aznabayeva LF, Aref’yeva NA. Immunologicheskiye aspekty khronicheskogo tonzillita. Vestn. otorinolaringologii. 2013 Grud 18;4(69):4-9.[in Russiаn]. 
2. Garyuk GI. Khronicheskiy tonzillit, adenoidy, rinosinusit – problema otorinolaringologov i / ili pediatrov? Prirodnaya meditsina. 2011 Dek 22;8(122):18-9. [in Russiаn]. 
3. Zabolotniy DÍ, Lutsenko VÍ. Zv’yazok khroníchnogo tonzilítu z khroníchnimi zapal’nimi protsesami v organízmí za danimi yelektropunkturnoí̈díagnostiki. Zhurn. vushnikh, nosovikh í gorlovikh khvorob.2003 Grud 21;4(48):16-8.[in Ukrainian].
4. Zaytsev VM, redaktor. Prikladnaya meditsinskaya statistika. Sankt-Peterburg: SPbGMA im. I. I. Mechnikova; 2000. 299 s. [in Russiаn].
5. Zbyshko YaB. Effektivnost’ primeneniya uglekislotnogo lazera v lechenii bol’nykh khronicheskim tonzillitom. Vestn. otorinolaringologii. 2007 Okt 28;5:57-9. [in Russiаn]. 
6. Kamenskaya VN. Lazernaya meditsina v zerkale otechestvennoy nauchnoy periodiki. V: Vyal’tseva NI, redaktor. Materialy nauch.-praktich. konf. Lazernaya meditsina: «Innovatsionnyye tekhnologii v lazernoy meditsine»; 2011 Iyun’ 8-9; Moskva. Moskva: FMBA; 2011. s. 27. [in Russiаn]. 
7. Kíshchuk VV. Kliniko-immunologicheskiye podkhody k otsenke funktsional’nogo sostoyaniya nebnykh mindalin dlya diagnostiki i lecheniya bol’nykh khronicheskim tonzillitom [disertatsíya]. Kií̈v: DU «Ínst. Otolaringologíí̈NAMNU»; 2001. 254 s. [in Russiаn]. 
8. Kíshchuk VV. Khroníchniy tonzilít: stan problemi. Zdorov’ya Ukraí̈ni. 2010 Ver 19;3:58-9. [in Ukrainian].
9. Kryuchkov AS, Lyandres IG. Lazernaya tonzillektomiya s ispol’zovaniyem poluprovodnikovogo khirurgicheskogo lazera «Diolaz-940». Lazernaya meditsina. 2011 Dek 18;15(2):93-5. [in Russiаn]. 
10. Mel’nikov OF, Layko AA. Immunologicheskaya kharakteristika lokal’nogo i sistemnogo immuniteta nebnykh mindalin pri ikh gipertrofii i khronicheskom vospalenii u detey. Soobshcheniye 1. Soderzhaniye tsitokinov i zashchitnykh belkov v kletkakh nebnykh mindalin i syvorotke krovi pri gipertrofii i khronicheskom tonzillite. Zhurn. vushnikh, nosovikh í gorlovikh khvorob. 2008 Ver 25;3:19-23. [in Russiаn]. 
11. Mel’nikov OF. Khronicheskiy tonzillit. Kliniko-immunologicheskiye podkhody diagnostiki i lecheniya. 2005 Yanv 29;1:31-3. [in Russiаn]. 
12. Mítín YuV, Shevchuk YuV. Deyakí aspekti anatomíí̈í fízíologíí̈pídnebínnikh migdalikív v patogenezí khroníchnogo tonzilítu. Zhurn. vushnikh, nosovikh í gorlovikh khvorob. 2001 Sích 30;1:23-6. [in Ukrainian].
13. Ovchinnikov AYu. Etiopatogenez i adekvatnoye lecheniye vospalitel’nykh zabolevaniy rotoglotki. Farmateka. 2011 Okt 26;20:59-62. [in Russiаn]. 
14. Perederiy VG. Immunnyy status, printsipy yego otsenki i korrektsii immunnykh narusheniy. Kií̈v: Zdorov’ya; 1995. 210 s. [in Russiаn]. 
15. Pluzhnikov MS, Karpishenko SA. Vozmozhnosti lazernoy khirurgii v otorinolaringologii. Vestn. otorinolaringologii. 2008 Dek 23;4:18-28. [in Russiаn]. 
16. Tsimar AV, Mel’nikov OF. Immunomoduliruyushchaya aktivnost’ tsitokinovogo «kokteylya» pri kul’tivirovanii kletok nebnykh mindalin bol’nykh khronicheskim tonzillitom s gribkovymi i mikrobnymi allergenami in vitro. Materíali shchoríchnoí̈traditsíynoí̈vesnyanoí̈ konf. Suchasní metodi díagnostiki ta líkuvannya khroníchnikh zakhvoryuvan’ LOR-organív u doroslikh ta dítey; 2013 Trav 20-21; Sevastopol’. Sevastopol’: ZHVNGKH; 2013. s. 294. [in Russiаn].
17. Gumerova MI, Aznabaeva LF. The function of palatine tonsils in pathological changes of oral mucosa and the possibilities of immunorehabilitation. Vestn. Otorinolaringol. 2012 Jan 19;6:57-60.
18. Jahnke K. Laser-tonsillotomy, state of the art and open questions Laryngorhinootologie. 2005 Apr 23;84(9):651-2.
19. Jäckel MC, Petzold S. Tonsillectomy by CO(2) laser microsurgery – an analysis of clinical and morphological data. HNO. Epub. 2003 Dec 16;51(8):634-9.
20. Kaplan E.L. Immunologic impact of tonsillophayngitis associated with group A streptococci. Adv. Otorhinolaryngol. 2011 May 26;72(3):129-31.
21. Reichel O, Mayr D. Tonsillotomy or tonsillectomy? – a prospective study comparing histological and immunological findings in recurrent tonsillitis and tonsillar hyperplasia. Eur. Arch. Otorinolaryngol. 2007 Oct22;264(3):277-84.

«Bulletin of problems biology and medicine» Issue 1 Part 1 (142), 2018 year, 209-212 pages, index UDK 616.322-002.2-085.849.19-089(043.3)

10.29254/2077-4214-2018-1-1-142-209-212