Проблема рецидивов роста лимфоидных структур глотки у детей (обзор литературы)
Проблема рецидивов роста лимфоидных структур глотки у детей (обзор литературы)
Кульмакова М.А., Радциг E.Ю., Полунин М.М. Проблема рецидивов роста лимфоидных структур глотки у детей (обзор литературы). Педиатрия. Consilium Medicum. 2022;4:336–339.
DOI: 10.26442/26586630.2022.4.201918
Kulmakova MA, Radtsig EIu, Polunin MM. Recurrent growth of pharyngeal lymphoid tissues in children: a literature review. Pediatrics. Consilium Medicum. 2022;4:336–339. DOI: 10.26442/26586630.2022.4.201918
Проблема рецидивов роста лимфоидных структур глотки у детей (обзор литературы)
Кульмакова М.А., Радциг E.Ю., Полунин М.М. Проблема рецидивов роста лимфоидных структур глотки у детей (обзор литературы). Педиатрия. Consilium Medicum. 2022;4:336–339.
DOI: 10.26442/26586630.2022.4.201918
Kulmakova MA, Radtsig EIu, Polunin MM. Recurrent growth of pharyngeal lymphoid tissues in children: a literature review. Pediatrics. Consilium Medicum. 2022;4:336–339. DOI: 10.26442/26586630.2022.4.201918
Гипертрофия аденоидов и/или небных миндалин – распространенное состояние в детском возрасте, которое снижает качество жизни ребенка. Оперативное лечение имеет широкое применение в Российской Федерации и в мире, однако некоторые пациенты сталкиваются с рецидивом заболевания. От 0,55 до 25,7% прооперированных детей подвергаются повторной аденотомии; 0,12–11,9% переносят повторную тонзиллотомию/тонзилэктомию. Причины повторного роста лимфоидных структур глотки у некоторых пациентов остаются до конца не ясны, а оценка частоты случаев рецидива затруднительна в связи с отсутствием определенных клинико-диагностических критериев самого понятия «рецидив». К факторам, ассоциированным с более высокой частотой повторного роста лимфоидных структур глотки, можно отнести наличие у ребенка заболеваний (аллергия, бронхиальная астма, гастроэзофагеальный рефлюкс), особенности анамнеза (перенесенные тонзиллиты, множественные курсы антибактериальной терапии), а также ранний возраст выполнения первичной операции и проведение аденотомии без визуального контроля. Обсуждаемые вопросы актуальны для оториноларингологов и педиатров в контексте прогнозирования и сокращения риска рецидива у детей перед первичной операцией.
Hypertrophy of the nasopharyngeal and/or palatine tonsils is a common condition in children that reduces patients' quality of life. Surgical treatment is widely used in the Russian Federation and worldwide, but some patients experience a relapse of the disease. From 0.55% to 25.79% of children with a history of surgery undergo repeat adenotomy; in 0.12–11.9% of patients, repeat tonsillotomy/tonsillectomy is performed. The reasons for the re-growth of lymphoid tissue in the pharynx in some patients remain unclear. It is difficult to estimate the recurrence rate due to the lack of definite clinical and diagnostic criteria for the concept of "recurrence" itself. Factors associated with a higher frequency of re-growth of lymphoid structures in the pharynx include some conditions (allergy, bronchial asthma, gastroesophageal reflux), the history aspects (tonsillitis, multiple courses of antibiotic therapy), and early age at the time of primary operation and adenotomy without visual monitoring. The issues discussed are relevant to E.N.T. specialists and pediatricians in predicting and reducing the risk of recurrence in children before primary surgery.
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1. Bogomil'skii MR, Chistiakova VR. Detskaia otorinolaringologiia: uchebnik dlia vuzov. Moscow: GEOTAR-Media, 2002 (in Russian).
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4. Otorinolaringologiia. Natsional'noe rukovodstvo. 2-e izdanie. Pod red. VT Pal'chuna. Moscow: GEOTAR-Media, 2016 (in Russian).
5. Pereira L, Monyror J, Almeida FT, et al. Prevalence of adenoid hypertrophy: A systematic review and meta-analysis. Sleep Med Rev. 2018;38:101-12. DOI:10.1016/j.smrv.2017.06.001
6. Aydin S, Sanli A, Celebi O, et al. Prevalence of adenoid hypertrophy and nocturnal enuresis in primary school children in Istanbul, Turkey. Int J Pediatr Otorhinolaryngol. 2008;72(5):665-8. DOI:10.1016/j.ijporl.2008.01.028
7. Halder AL, Biswas SS. Prevalence and clinical presentation of adenoid hypertrophy among children attending at pediatric outpatient department of a tertiary care general hospital of Dhaka. BIRDEM Medical Journal. 2022;12(2):111‑6. DOI:10.3329/birdem.v12i2.59611
8. Sapozhnikov VG, Kholina YuA, Larikova AD. On hypertrophy of the pharyngeal tonsil in pediatric practice. Bulletin of new medical technologies. 2017;1. Available at: https://cyberleninka.ru/article/n/o-gipertrofii-glotochnoy-mindaliny-
v-pediatricheskoy-praktike. Accessed: 17.09.2022 (in Russian).
9. Krukov AI, Ivoilov AIu, Zakharova AF, et al. The structure of childhood diseases in the patients presenting with hospital-acquired ENT pathology estimated based on the results of monitoring children’s hospitals in Moscow. Vestnik Oto-Rino-Laringologii. 2015;80(4):65-8 (in Russian).
10. Uijen JH, Bindels PJ, Schellevis FG, van der Wouden JC. ENT problems in Dutch children: trends in incidence rates, antibiotic prescribing and referrals 2002–2008. Scand J Prim Health Care. 2011;29(2):75-9. DOI:10.3109/02813432.2011.569140
11. Kara CO, Ergin H, Koçak G, et al. Prevalence of tonsillar hypertrophy and associated oropharyngeal symptoms in primary school children in Denizli, Turkey. Int J Pediatr Otorhinolaryngol. 2002;66(2):175-9. DOI:10.1016/s0165-5876(02)00247-1
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Авторы
М.А. Кульмакова, E.Ю. Радциг*, М.М. Полунин
ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России, Москва, Россия
*Radtsig_e@rsmu.ru
________________________________________________
Maria A. Kulmakova, Elena Iu. Radtsig*, Mihail M. Polunin
Pirogov Russian National Research Medical University, Moscow, Russia
*Radtsig_e@rsmu.ru