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

Authors

  • A. Ya. Zheltov SI "Zaporizhzhia Medical Academy of Post-Graduate Education Ministry of Health of Ukraine",
  • O. M. Kostrovskyi Zaporizhzhia State Medical University, Ukraine,
  • O. O. Husakova SI “Zaporizhzhia Medical Academy of Post-Graduate Education Ministry of Health of Ukraine”,

DOI:

https://doi.org/10.14739/2310-1210.2018.6.146744

Keywords:

child, adenoids, otitis media, microcirculation, diagnosis

Abstract

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.

 

References

Svistushkin, V. M., Nikiforova, H. N., Shewchyk, E. A., Zolotova, A.V. (2014). Ekssudativnyy sredniy otit – sovremennyye vozmozhnosti konservativnogo lecheniya [Otitis media with effusion – modern capabilities of conservative treatment]. Rossyiskaia otorynolarynholohyia, 2(69), 153-161. [in Russian].

Kastoer, C., Leach, R., & Vanderveken, O. (2016). Face and neck: airway and sensorial capacities. B-ENT, 12(26/1), 11-19.

Gilialov, M.N.& Ismagilov, Sh.M. (2015). Funktsional'nyye narusheniya vegetativnoy nervnoy sistemy pri patologii nosa i okolonosovykh pazukh [The functional disturbances in the vegetative nervous system associated with nasal and paranasal sinuses pathology]. Vestnik otorynolarynholohii, 80(4), 18-21. [in Russian].

Doyle, W. J., Winther, B., & Alper, C. (2009). Daily tympanometry as a functional measure of middle ear status and Eustachian tube function. Auris Nasus Larynx, 36(1), 20-25.doi:10.1016/j.anl.2008.03.004

Yu, F., Winegar, B., Schneider, A., Tantiwongkosi, B., & Altmeyer, W. (2016). Neural Nexus: A Radiologic Review of Relevant Anatomy and Pathology of the Pterygopalatine Fossa. Neurographics, 6(5), 270-280.

Jufas, N., Treble, A., Newey, A., & Patel, N. (2016). Endoscopically guided transtympanic balloon catheter dilatation of the eustachian tube: a cadaveric pilot study. Otology & Neurotology, 37(4), 350-355.10.1097/MAO.0000000000000975

Eliçora, S. Ş., Öztürk, M., Sevinç, R., Derin, S., Dinç, A. E., & Erdem, D. (2015). Risk factors for otitis media effusion in children who have adenoid hypertrophia. International journal of pediatric otorhinolaryngology, 79(3), 374-377.

Nespoli, L., Caprioglio, A., Brunetti, L., & Nosetti, L. (2013). Obstructive sleep apnea syndrome in childhood. Early human development, 89, S33-S37.

Park, C. S., Guilleminault, C., Park, H. J., Cho, J. H., Lee, H. K., Son, H. L., & Hwang, S. H. (2014). Correlation of salivary alpha amylase level and adenotonsillar hypertrophy with sleep disordered breathing in pediatric subjects. Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine, 10(5), 559 566. 10.5664/jcsm.3712

Kozhevnikova, O.V., Namazova-Baranova, L.S., Abashidze, E.A., Altunin, V.V., Balabanov, A.S., Shirokova, I.V., Kondrahina, I.I., Polunina, T.A., Margieva, T.V. (2015). Sindrom obstruktivnogo apnoe sna u detey kak risk razvitiya serdechno-sosudistoy patologii [Obstructive Sleep Apnea Syndrome in Children as a Risk of Cardiovascular Pathology Development]. Vestnik Rossyiskoi akademyy medytsynskykh nauk, 70(1), 32-40. [in Russian].

Sutton, C. (2015). The Effects of Obstructive Sleep Apnea on Autonomic Function during Steady-State Exercise. (2014). Masters Theses, paper 344.

Patrushev, A.V., Sukharev, A.V., Ivanov, A.M., Samtsov, A. V. (2015). Teoriya ochagovoy infektsii: proshloye i nastoyashcheye [Focal infection theory: past and present]. Vestnik Dermatologii i Venerologii, 4, 36-41. [in Russian].

Kushnyr, S.M., Antonova, L.K. (2016). Tipologicheskiye osobennosti vegetativnoy regulyatsii u detey doshkol'nogo vozrasta [Typological peculiarities of vegetative regulation in preschool children]. Smolenskyi medytsynskyi almanakh, 3, 104-107. [in Russian].

Gurova, O.A., Kozlov, V.I., Ryzhakin, S.M. (2016). Lazernaya dopplerovskaya floumetriya (LDF) v issledovanii reaktivnosti mikrotsirkulyatsii u ispytuyemykh raznogo pola [Laser Doppler flowmetry for the assessment of microcirculation in studied subjects of both sexes]. Lazernaia medytsyna, 20(3), 102-102. [in Russian].

Virabyan, V., Danilina, T., Naumova, V., Zhidovinov. A. (2017). Otsenka sostoyaniya mikrotsirkulyatsii sosudov s pomoshch'yu lazernoy dopplerovskoy floumetrii [Laser doppler flowmetry evaluation of vascular microcirculation]. Vrach, 3, 74-75. [in Russian].

Robinson, H., & Engelhardt, T. (2017). Ambulatory anesthetic care in children undergoing myringotomy and tube placement: current perspectives. Local and regional anesthesia, 10, 41-49 .https://doi.org/10.2147/LRA.S113591

Pavlenko, V.A., Mel'nikova, I.M., Mizernitskiy, Yu.L. (2015). Prognosticheskoye znacheniye funktsional'nykh pokazateley dykhatel'noy sistemy i vegetativnoy nervnoy sistemy u detey rannego vozrasta, perenesshikh ostryy obstruktivnyy bronkhit na fone perinatal'nogo porazheniya tsentral'noy nervnoy sistemy [The prognostic significance of functional parameters of the respiratory system and autonomic nervous system in infants with a history of acute obstructive bronchitis against the background of perinatal lesion of the central nervous system]. Voprosy prakticheskoi pediatrii, 10(1), 7-14. [in Russian].

Karpova, E.P., & Burlakova, K.Y. (2017). Vospalitel'nye zabolevanija srednego uha u detej [Inflammatory diseases of the middle ear in children]. Meditsinskii sovet, 9, 65-69. [in Russian].

Latysheva, E.N., Rusetsky, Yu.Yu., Arutyunyan, S.K., Malyavina, U.S., & Polunina, T.A. (2015). Nekotoryye aspekty protivovospalitel'noy terapii pri patologii verkhnikh dykhatel'nykh putey i srednego ukha [Some aspects of antiinflammatory therapy for upper respiratory tract and middle ear pathology]. Pediatria. Zhurnal im. H.N. Speranskoho, 94(6), 159-164. [in Russian].

Jeong, J. H., Guilleminault, C., Park, C. S., Son, H. L., Lee, H. K., Hwang, S. H., & Choi, Y. S. (2014). Changes in salivary cortisol levels in pediatric patients with obstructive sleep apnea syndrome after adenotonsillectomy. Sleep medicine, 15(6), 672-676.10.1016/j.sleep.2013.12.019

How to Cite

1.
Zheltov AY, Kostrovskyi OM, Husakova OO. The features of microcirculation in the nasal mucosa in children with adenoid hypertrophy and otitis media with effusion. Zaporozhye Medical Journal [Internet]. 2019Feb.1 [cited 2024Nov.23];(6). Available from: http://zmj.zsmu.edu.ua/article/view/146744

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Section

Original research