Introduction: Tonsillar hypertrophy is one of the most common illnesses among children. The tradition- al treatment involves a series of different drugs. Un- fortunately, the effect is often short-lived, and that re- quires finding other more effective methods that are not so hard on the body.
Goal: To study the effectiveness of a complex of physical factors in treating tonsillar hyperplasia in children and the associated with it symptoms of sleep disordered breathing (SDB).
Materials and methods: 50 children 3-10 years old diagnosed with tonsillar hypertrophy level 3+,4+ and one or several symptoms of SDB with or without behavioral issues, that have gone through the physio- therapy ward with Medical center `Sv. Marina` Var- na. Therapy with ultrasound and polarized, polychro- matic, incoherent low energy light has been carried out.
Results: 78% of the participating children exhib- ited a notable decrease in the size of the tonsils that correlates with a reduction of the symptoms of SDB (p<0.001). The positive results observed in the tracked parameters gives us ground to think , that the applied physiotherapeutic treatment can serve as an alternative to the drug based treatment, when possible or be carried out alongside it as a means of increasing effec- tiveness in children with tonsillar hypertrophy.
Conclusion: The developed physiotherapeutically methods can not only serve as a means of treatments, but can also be used as a means of prophylaxis in chil- dren that have a higher risk of developing tonsillar hy- pertrophy, to prevent further development of SDB.
Димов Д, Георгиев Г. Ушни, носни, гърлени болести.
Коровина Н. А., Леписева И. В., Заплатникова Л. В. и др. Эффективность топической иммунотерапии бактериальными лизатами у часто болеющих детей. Педиатрия. 2009; 5: 104–109.
Русева Ж, Михайлова М, Приложение на поляризиранатаполихроматична, некохерентна и нискоенергийна светлина във физиотерапевтичната практика, Варненски медицински форум, т. 5, 2016
Сапунджиев Н., Генова П , Тонзилотомия минало в бъдеще време, Med info, 2014
Baugh RF1, Archer SM, Mitchell RB, et al . Clinical practice guideline: tonsillectomy in children. Otolaryngol Head Neck Surg. 2011 Jan;144(1 Suppl):S1-30
Gelardi M, Iannuzzi L, Greco Miani A, Cazzaniga S, Naldi L, De Luca C, Quaranta N. Double-blind placebo-controlled randomized clinical trial on the efficacy of Aerosal in the treatment of sub-obstructive adenotonsillar hypertrophy and related diseases. Int J Pediatr Otorhinolaryngol. 2013;77(11):1818-1824.
Lai CC, Friedman M, Lin HC, Wang PC, Hsu CM, Yalamanchali S, Lin MC, Chen YC. Objective versus subjective measurements of palatine tonsil size in adult patients with obstructive sleep apnea/hypopnea syndrome. Eur Arch Otorhinolaryngol. 2014;271(8):2305-2310.
Pirsig W, Diagnostic for OSA in Children. 42 Braziliancongress of othorinolarymgology and cervico facial surgery , 2012
Reginald F. Baugh, Sanford M. Archer, Ron B. Mitchell, et al. Clinical Practice Guideline : Tonsillectomy in Children. Otolaryngology -- Head and Neck Surgery 2011
Sakarya EU, Bayar Muluk N, Sakalar EG, Senturk M, Aricigil M, Bafaqeeh SA, Cingi C. Use of intranasal corticosteroids in adenotonsillar hypertrophy. J Laryngol Otol. 2017;131(5):384-390.
Å ujanská A, ÄŽurdÃk P, Rabasco J, Vitelli O, Pietropaoli N, Villa MP. Surgical and non-surgical therapy of obstructive sleep apnea syndrome in children. Acta Medica (Hradec Kralove). 2014;57(4):135-141.