Dynamics of osteopathic status in patients with chronic tonsillitis during complex treatment with inclusion of osteopathic correction

Introduction. Chronic tonsillitis does not always lend itself well to standard treatment, so it requires interdisciplinary cooperation with the search for new methods of diagnosis and treatment, one such method may be osteopathic correction. Changes in the structure of connective tissue in chronic inflammation contribute to the development of biomechanical disorders in the form of limitation of tissue mobility and increase in their density, which, in turn, may be prerequisites for the formation of somatic dysfunctions (SDs). There are no data on the peculiarities of osteopathic status in patients with chronic tonsillitis in the available literature, which predetermined the purpose of this study.

The aim of the study: to study the features of osteopathic status in patients with chronic tonsillitis and its dynamics after a course of complex therapy including osteopathic correction.

Materials and methods. The prospective randomized controlled study, conducted on the basis of the Department of Osteopathy with a course of functional and integrative medicine and the Department of Otorhinolaryngology of I.I. Mechnikov NWSMU in the period from 06.2022 to 04.2024, included 93 patients with the diagnosis of «Chronic tonsillitis» who visited a doctor about the recurrence of the disease. All patients were divided into two groups, main (n=44) and control (n=49), depending on the treatment performed, using the randomisation envelope method. All patients were examined by osteopathic examination with the formation of an osteopathic report before treatment, as well as 30 and 90 days after the start of treatment. Patients of both groups received otorhinolaryngological treatment in the form of washing of the palatine tonsils (five washing procedures with antiseptic solution, the interval between the procedures was 2 days). Patients of the main group additionally received osteopathic correction of the identified somatic dysfunctions, which included five procedures: three procedures with an interval of 14 days. The total duration of the course was 1 month. Osteopathic correction was performed to each patient individually, based on the results of osteopathic diagnostics and a completed osteopathic report.

Results. Regional (neck region, visceral and structural components; thoracic region, structural and visceral components; head region) level dysfunctions were the most characteristic for patients with chronic tonsillitis. Global SDs were dominant in 23 % of patients and regional SDs in 77 %. After the complex (including otorhinolaryngological treatment and osteopathic correction) treatment in the patients of the main group, the frequency of detection of regional and local SDs statistically significantly decreased, global level SDs were not detected (p<0,05 by the McNemar criterion). With regard to the frequency of detection of global, regional and local SDs in patients of the control group receiving only otorhinolaryngological treatment, there was no statistically significant dynamics (p>0,05 by the McNemar criterion).

Conclusion. According to the results of the study, the peculiarities of osteopathic status in chronic tonsillitis were shown. The inclusion of osteopathic correction in the complex treatment of patients contributes to a statistically significant decrease in the frequency of detection of somatic dysfunctions of different levels compared to conventional conservative treatment. It is necessary to continue the study and analyse the relationship between the identified somatic dysfunctions and the presence of objective and subjective symptoms of the disease.

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