Zaporožskij Medicinskij Žurnal (Dec 2018)

The features of microcirculation in the nasal mucosa in children with adenoid hypertrophy and otitis media with effusion

  • A. Ya. Zheltov,
  • O. M. Kostrovskyi,
  • O. O. Husakova

DOI
https://doi.org/10.14739/2310-1210.2018.6.146744
Journal volume & issue
Vol. 20, no. 6
pp. 811 – 816

Abstract

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At present, a reflex mechanism of the exudative otitis media (EOM) formation with pharyngeal tonsil hypertrophy (PTH) in children is suggested which includes a combination of several components on the background of neurovegetative imbalance of nasal mucosa vascular tone maintenance. Aim. To determine the state of microcirculation in the nasal mucosa in children with pharyngeal tonsil hypertrophy and exudative otitis media. Materials and methods. We observed 117 children with PTH and EOM aged between 5 and 7 years (mean age 6 years and 2 months) who had not previously undergone adenotomy or adenoidectomy. Two groups of clinical observation were formed: the group 1 included children with chronic purulent adenoiditis and EOM (n = 27); the group 2 included children with PTH and EOM (n = 90). The study of blood circulation in microvessels of the inferior nasal conchae mucous membrane was carried out using the LAKK-02 laser analyzer (RF), with the software “LDF 2.20.0.507WL”. Results. In each of the study groups, the vegetative index (VI) indicated the sympathetic tone predominance, and the values of the Hildebrandt coefficient (Q) pointed to the integrity of intersystem communication in vegetative innervation. Comparison of the VI indices, coefficient Q and microcirculation state of the inferior nasal conchae mucosa determined the statistically significant differences in all the studied parameters. Dependence of VI on neurotonus, myotonus and shunting index was not identified, reflecting the depletion of sympathetic innervation and the predominance of vagotonia. Conclusions. The presence of PTH is a focus of chronic irritation in children with EOM causing the development of vegetative innervation imbalance in the nasal and auditory tube mucosa with the predominance of parasympathetic component, prevalence of vasodilation, edema, increased vascular permeability and secretory activity of the glands, which contributes to otitis symptoms and their further maintenance.

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