Clinical characteristics of chronic adenoiditis in children aged 3–6 years with probiotic support

Background. The prevalence of chronic tonsil diseases is constantly increasing among children of different ages. To date, the treatment of pediatric patients with chronic diseases of the upper respiratory tract remains controversial and requires new therapeutic approaches.

Aim. To study the clinical and anamnestic characteristics of chronic adenoiditis in children aged 3-6 years and to evaluate the effectiveness of including a probiotic drug in postoperative rehabilitation.

Methods. A total of 100 children aged 3–6 years with chronic inflammatory processes of the nasopharynx were examined. The patients were divided into 2 comparable groups, depending on the treatment and rehabilitation measures received. A parent survey was conducted to assess the severity of clinical symptoms before treatment and 30 days after adenotomy.

Results. The frequency and duration of viral infections in children with chronic adenoiditis were assessed. Before surgery, 62 % of children had acute respiratory infections (ARIs) once every 2 months or more, and 62 % had ARI episodes lasting more than 7 days. According to the survey results, after treatment there was a statistically significant decrease in the frequency of the following symptoms in children in both study groups: difficulty in nasal breathing, snoring, cough, and bad breath. In the main group, there was a marked decrease in the intensity of nasal breathing difficulty (by 84 %) and in the frequency of sleep disorders (by 58 %) after probiotic treatment.

Conclusion. The post-treatment survey data demonstrate regression of clinical symptoms in both groups. However, with respect to symptoms such as decreased intensity of nasal breathing and reduced frequency of sleep disorders, higher therapeutic efficacy was observed when a probiotic was used as an adjunct to adenotomy.

1. Egorova KV, Zhamlikhanov NH, Mallin DА. Physical development of children with chronic inflammatory pathology of the pharynx: a review of the literature. Lechaschi Vrach. 2022; 10(25): 11-15. (In Russ.). doi: 10.51793/OS.2022.25.10.002

2. Samara P, Athanasopoulos M, Athanasopoulos I. Unveiling the Enigmatic Adenoids and Tonsils: Exploring Immunology, Physiology, Microbiome Dynamics, and the Transformative Power of Surgery. Microorganisms. 2023; 11(7): 1624. doi: 10.3390/microorganisms11071624

3. González-Díaz SN, Arias-Cruz A, Macouzet-Sánchez C, et al. Impact of air pollution in respiratory allergic diseases. Med. Univ. 2016; 18: 212–215. doi: 10.1016/j.rmu.2016.10.006

4. Sachkova LA, Balashov AL, Truhmanov MS. Frequently ill children. University therapeutic journal. 2021; 2(4): 75-85 (In Russ.).

5. Karpova EP, Gankovskaya LV, Vozgoment OB, et al. Hypertrophy of palatine tonsils — possible treatment approaches. Russian Bulletin of Otorhinolaryngology. 2020; 85(3): 57-63. (In Russ.). doi: 10.17116/otorino20208503157

6. Marazzato M, Zicari AM, Aleandri M, et al. 16S Metagenomics reveals dysbiosis of nasal core microbiota in children with chronic nasal inflammation: role of adenoid hypertrophy and allergic rhinitis. Front Cell Infect Microbiol. 2020; 10: 458. doi: 10.3389/fcimb.2020.00458

7. Gurov AV, Yushkina MA, Muzhichkova AV. Microbiocenosis-regulating therapy of inflammatory pathology of the oropharynx. Russian Bulletin of Otorhinolaryngology. 2021; 86(6): 51-56. (In Russ.). doi: 10.17116/otorino20218606151

8. Ilchenko SI, Fialkovskaya AA, Ivanus SG. The effectiveness of the use of the respiratory probiotic Streptococcus salivarius K12 in children with recurrent tonsillitis. Actual Infectology. 2020; 8(2): 25-29. (In Russ.). doi: 10.22141/2312413x822020.199732

9. Kiselev AB, Chaukina VA, Andamova OV, Avtushko AS, Vertakova OV, Shugakova EV. Guidelines for Therapists and Otolaryngologists on Chronic Pharyngeal Infections and Associated Somatic Pathology, approved at the meeting of the Coordination and Methodological Council for Postgraduate Education of the Novosibirsk State Medical University of the Ministry of Health of the Russian Federation on April 6, 2018, Minutes No. 98. (In Russ.).

10. Orlova YuE, Svistushkin VM, Nikiforova GN, et al. Treatment principles of children with pharyngeal tonsil pathology in the background of allergic rhinitis (literature review). Consilium Medicum. 2022; 24(3): 193–198. (In Russ.). doi: 10.26442/20751753.2022.3.201516

11. Zenaishvili RD, Malykhina DD. Optimization of chronic adenoiditis treatment with account of nasopharyngeal microbiota. Rossiiskaia otorinolaringologiia. 2018; 1: 54-58. (In Russ.). doi: 10.18692/1810-4800-2018-1-54-58

12. Blackshaw H, Springford LR, Zhang LY, et al. Tonsillectomy versus tonsillotomy for obstructive sleep-disordered breathing in children. Cochrane Database Syst Rev. 2020; 4(4): CD011365. doi: 10.1002/14651858.CD011365.pub2

13. Kulmakova MA, Radtsig EIu, Polunin MM. Recurrent growth of pharyngeal lymphoid tissues in children: a literature review. Pediatrics. Consilium Medicum. 2022; 4: 336–339. (In Russ.). doi: 10.26442/26586630.2022.4.201918

14. Clinical recommendations “Adenoid hypertrophy. Hypertrophy of the palatine tonsils.”Year of approval: 2024 National Medical Association of Otolaryngologists. Approved by the Scientific and Practical Council of the Ministry of Health of the Russian Federation. (In Russ.). URL: https://base.garant.ru/410612248/ [date of access: March 14, 2025].

15. Radtsig EYu, Davydova OV, Kizeva AG, et al. The effectiveness comparison of various conservative treatment options of nasopharyngeal inflammation in children. Russian Bulletin of Otorhinolaryngology. 2022; 87(4): 38 44. (In Russ.). doi: 10.17116/otorino20228704138

16. Khan Laghari I, Nawaz T, Mustafa S, et al. Role of multi-strain probiotics in preventing severity and frequency of recurrent respiratory tract infections in children. BMC Pediatr. 2023; 23(1): 505. doi: 10.1186/s12887-02304338-x

17. Maya-Barrios A, Lira-Hernandez K, Jiménez-Escobar I, et al. Limosilactobacillus reuteri ATCC PTA 5289 and DSM 17938 as adjuvants to improve evolution of pharyngitis/tonsillitis in children: randomised controlled trial. Benef Microbes. 2021; 12(2): 137-145. doi: 10.3920/BM2020.0171

18. Feklisova LV. Prospects for the use of the immobilized monocomponent probiotics in children with recurrent respiratory diseases. Infectious Diseases: News, Opinions, Training. 2021; 10(2): 60–68. (In Russ.). doi: 10.33029/2305-3496-2021-10-2-60-68