The influence of osteopathic correction on the functional activity of the palatine tonsils in the complex therapy of chronic tonsillitis

Introduction. The relevance of chronic tonsillitis (CT) is due not only to the polyetiology of the disease and its relationship with autoinfection, but also to the fact that non-almonds are an important component of the MALT system and act as a first-line protection when interacting with various pathogens. Thus, according to various immunological studies it has been proven that significant immune activity is maintained even with a recurrent tonsillitis, and the morbidity of autoimmune pathology in persons who underwent tonsillicectomy, is much more common in the context of developing immune dysfunction after it. The protective function of non-bile tonsils is carried out at the expense of their production of lymphocytes and delivery of them, as well as other factors of immunity through the epithelium into the cavity of the crypt. However, with a persistent inflammatory reaction in the nebbs, there is a decrease in the number of lymphoid cells in the crits and a significant increase in bacterial insemination. The change in the architect′s crypt leads to a disruption of their drainage function, and contained in their illuminations ejected epithelial cells, lymphocytes and diverse microflora can lead to inflammation. The high immune activity of lymphocytes in crypts allows us to believe that information about cytological composition and characteristics of bacterial excretion of crypts can contain the most complete information about the functional state of amygdales and adapted to new conditions microorganisms. This complex pathogenesis of the disease suggests that the treatment of CT should be aimed not only at eradicating from the depths of the patogenic pathogens, but also at developing more effective methods of conservative treatment, promoting the restoration of functional activity of the amygdala itself, and also requires the involvement of specialists in related fields to treat this immunopathology.

The aim of the study: to assess the impact of a comprehensive therapy of CT, including osteopathic correction, on the functional activity of nebbia tonsillines.

Materials and methods. The prospective controlled randomized, conducted on the basis of the Department of Osteopathy and the Department of Otorhinolaryngology of I. I. Mesnikov North-Western State Medical University in the period from 06.2022 to 06.2023, were included 120 patients with an established diagnosis of chronic tonsillitis. This study was carried out by a team of researchers from the Russian Federation. All patients according to treatment were divided by the randomization envelope method into three groups — main (n=56), control (n=49) and comparison group (n=15). Patients of the three groups received an otorhinolaryngological treatment in the form of a lavage of the amygdala (ten procedures with antiseptic therapy, interval between procedures — 2 days). The main group of patients received additional osteopathic correction (three procedures with an interval of 14 days). Patients in the comparison group were additionally treated with an imaginary therapy, which is a method of manual exposure to the patient without clear intention of treatment (three procedures at 14-day intervals). Before, after 1 month and after 3 months of treatment, all patients were tested for non-benthic amygdala functional activity.

Results. In patients of the main group with inclusion of osteopathic correction in the complex treatment of CT, statistically significant increase in the functional activity rates of nebbene tonsillins (number of lymphocytes, epitheliocytes and K coefficient, p<0,05) was detected 1 month and 3 months after the start of the study. There were no statistically significant differences between the patients in the control and comparison groups (p>0,05).

Conclusion. The inclusion of osteopathic correction in the complex therapy of patients with chronic tonsillitis contributes to a more significant improvement of the condition of the neb-tonsilline, increasing the spectrum of their functional activity and reducing the degree of insemination in early and long-term periods compared to only conventional conservative treatment and sham therapy. This indicates a positive and long-term effect when the manual method is included in the treatment of the disease.

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