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NASAL AND THROAT DISEASES IN CHILDREN, THEIR
PREVALENCE, PREVENTION AND THE IMPORTANCE OF
FAMILY REHABILITATION
Boliev Islomjon Bakhtiyarovich
5th year student of the Faculty of Pediatrics, Samarkand Medical
University
Mukhammadieva Munisa Alijon kizi
6th year student of the Faculty of Pediatrics, Samarkand Medical
University
Scientific supervisor: Shamatov Islom Yakubovich
Head Teacher Department of Otorhinolaryngology № 1 of
Samarkand State Medical University
https://doi.org/10.5281/zenodo.14755281
ARTICLE INFO
ABSTRACT
Qabul qilindi:23-yanvar 2025 yil
Ma’qullandi: 25-yanvar 2025 yil
Nashr qilindi: 28-yanvar 2025 yil
This article discusses nasal and throat
diseases in children, their prevalence, prevention
and the importance of family rehabilitation during
the disease process. It considers early detection and
accurate diagnosis of the disease, along with
children's adherence to hygiene rules as the main
criteria. Children with ENT diseases are more likely
to develop other diseases, including viral and
allergic diseases, respiratory failure, changes in
visual
function,
emotional
lability,
and
rheumatological diseases. Taking this into account,
the article provides information on the analysis of
the correct care and treatment of the nasal cavity
and nasopharynx from the initial stages of various
inflammatory processes.
pharyngitis, chronic disease,
diagnostics, rehabilitation, adenoid,
tonsillitis, pathological changes.
The health of children largely depends on the socio-hygienic conditions and lifestyle, the state
of the environment and the health of family members. Of the total number of visits to an
otolaryngologist by children, up to half are due to pathology of the pharynx and nasopharynx,
about 25% are diseases of the paranasal sinuses, and the remaining 30-33% are diseases of
the middle ear. Currently, pediatric nasal and throat pathology ranks fifth in the morbidity
structure, and hearing loss and deaf-muteness are a serious social problem. Complications
that arise after insufficiently treated nasal and throat diseases lead to severe chronic
pathology and loss of ability to work in adulthood in the future, which is also an important
social problem. E.P. Karpova (2012); notes that morbidity rates play a large role in assessing
the quality of health of the child population, and the statistical data are alarming: the overall
morbidity of children is growing, while the share of respiratory diseases in its structure is
increasing, they occupy leading positions.
The prevalence of diseases of the nose and paranasal sinuses in children reaches 28-30%.
Almost every child over the age of 1.5 years suffers from one or another acute disease of the
nasal and throat organs at least once a year; of the 30-40 million cases of acute respiratory
viral infections registered annually, about 70% occur in childhood. Chronic diseases of the
pharynx in children occur in 54% of cases, diseases of the nose and paranasal sinuses - 16%,
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and ear diseases - about 28%. A pressing medical and social problem is the optimization of
treatment methods for lymphadeno-tonsillar pathology (adenoiditis, granular pharyngitis,
chronic tonsillitis), which is observed in 60-70% of children. Complications of chronic
tonsillitis, such as endo- and myocarditis, polyarthritis, glomerulo- and pyelonephritis, pose a
great danger to the child's life and the likelihood of his disability in the future. The most
common diseases of the lymphadenoid pharyngeal ring in preschool and primary school
children are hypertrophy and inflammation of the adenoid vegetations, which causes
headaches, attention disorders, nocturia, high blood pressure, and neurological disorders.
Thus, health authorities should consider timely sanitation of nasal and throat organs in
children as the most important quality indicator in the system of maternal and child health,
since failure to carry out these measures leads to chronicity of the child's diseases and serious
health problems in the future.
Treatment of children with nasal and throat diseases should be timely and comprehensive, i.e.
carried out by several specialists of different profiles (pediatrician, otolaryngologist, allergist-
immunologist, neurologist, rheumatologist, physiotherapist) to avoid complications. Medical
and pedagogical workers of preschool institutions are recommended to conduct breathing
exercises and hardening of children of different ages and promote this method among parents.
A promising organizational form of observation and health improvement of children at risk
for nasal and throat pathology attending preschool institutions is a health-improving nursery-
kindergarten operating under an innovative program for the development of organized
preschoolers. The introduction of a set of medical and social measures to strengthen the
health of risk contingents, as an integral part of this program, allows to reduce childhood
morbidity by an average of 32.3% depending on the age of the children.
The child's home environment plays an important role in the development of frequent upper
respiratory tract and ear diseases: close contact with relatives, kisses from sick parents,
shared dishes and towels, shared toys with sick brothers and sisters - all this contributes to
infection and further illness of small patients. Inadequate exercise, failure to follow a daily
routine, late waking, the presence of a large amount of computer equipment in the room, the
noise of a working TV or loud music, crowding of family members in a small living space,
smoking relatives and drinking alcoholic beverages - all this contributes to the child's fatigue,
weakening of his nervous and immune systems and, as a result, frequent illnesses. Sometimes
parents get animals at home for educational purposes, not taking into account that this
contributes to the occurrence of allergic diseases and helminthic invasions in children if
hygiene skills are not observed.
Medical statistics claim that the incidence of helminthic invasions (helminthiasis) is very high.
Among children attending preschool and school children's institutions, the infection rate is
close to 80%. Experts are sure that most of the population (even those who observe hygiene
rules) has worms. A large number of helminthic invasions at an early stage of formation occur
in a latent form, and not every doctor can make a correct diagnosis in time. At the same time,
no organ or tissue of a person is insured against the possibility of invasion by one or another
type of worms. Parasites can live in the human div for years, even decades, adapting to the
most unfavorable conditions, and not manifest themselves in any way. They become active
when the carrier's immunity decreases. Allergists claim that more than half of all allergic
reactions are the result of existing or previously experienced helminthiasis. Parasites
negatively affect the div's defenses, and this leads to a decrease in immunity, which in turn
leads to an increase in the frequency of acute respiratory and infectious diseases,
prolongation and complication of their course. Special tests are needed to diagnose
helminthiasis. Children are usually prescribed stool tests for helminth eggs and scrapings for
enterobiasis. The results may be inaccurate. To detect eggs, it is necessary to catch the
moment when the parasites multiply. To do this, it is necessary to take a three-time test with
an interval of several days. Concomitant examinations can also confirm helminthiasis - a test
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for dysbacteriosis (suppression of normal E. coli) and general (low hemoglobin, increased
eosinophils and ESR).
It is advisable to donate blood to determine immunoglobulins to the main types of helminths.
If in adults this disease usually proceeds asymptomatically, then in a child the disease most
often manifests itself as an allergy. The presence of foci of chronic infection in relatives also
contributes to the weakening of the protective mechanisms of the child in contact with them.
Such diseases can be: chronic sinusitis, tonsillitis, bronchitis, sluggish infections and a number
of others. Clinical example: We observed a child S. 8 months old, who moved with his parents
from N-sk. For 3 months, he suffered from recurrent tubootitis: hearing was reduced, the child
slept restlessly, pulled at the auricles, did not latch on well when feeding, often cried and was
irritable. Periodically, the parents contacted the pediatrician about inflammatory diseases and
a runny nose that developed in the child, the child was treated several times by an
otolaryngologist with a diagnosis of acute right-sided otitis. Despite 3 courses of active full-
fledged treatment (antibacterial and hyposensitizing therapy, sanitation of the nose and
nasopharynx, instillation of drops into the ear - otipax, furacilin alcohol, etc., physiotherapy),
complete recovery did not occur: the eardrum on the right remained cloudy pink, edematous,
the light cone was absent, there were no perforations of the eardrum and discharge from the
ear canal. Runny nose with greenish thick mucus periodically resumed. The child's mother
was examined, she is healthy, continues to breastfeed her son and follows all the
recommendations of the pediatrician and otolaryngologist.
During the follow-up visit, the doctor noticed that the child's father was very tender towards
him, played with him and often kissed him on the face, cheeks and eyes. When the child
subsequently fell ill with acute tonsillopharyngitis, it was suggested to examine his father,
although he had no health complaints. After the examination, the diagnosis was: Exacerbation
of chronic tonsillitis. Hypertrophy of the palatine tonsils of the III degree. Treatment was
prescribed for the child and his father. But, despite this, the child continued to be ill for
another six months, until the purulent focus of the father's palatine tonsils was sanitized (a
bilateral tonsillectomy was performed under general anesthesia). And only after that was it
possible to cure the child and restore his hearing. Now S. is 3 years old, he is practically
healthy.
Proper balanced nutrition and routine are of great importance for immunity. If a child spends
little time outdoors, inhales tobacco smoke from smoking parents, leads a sedentary lifestyle -
all this can lead to a weakening of the immune defense.
A weakening of the protective barrier can be affected by long-term and, sometimes,
unreasonable use of certain medications, in particular, antibiotics and other chemotherapy
drugs. If a child is often ill, it is necessary to begin preventive general health measures: walks
in the fresh air for at least 2 hours (dressing the child according to the weather, not wrapping
up excessively) adequate physical activity, it is necessary to review and balance the diet, treat
foci of chronic infection.
A frequently ill child requires examination and consultation with a doctor to select
medications in order to speed up recovery, reduce the risk of complications, and activate the
div's defenses. For this purpose, enzymes are used - the basis of life, regulators of all
biochemical processes in the div. It is with the help of enzymes that it is possible to renew
aged cells, convert nutrients into energy, and neutralize foreign substances and
microorganisms. The method of systemic enzyme therapy is based on the use of combinations
of highly active enzymes that can strengthen the immune system, reduce inflammation, and
improve microcirculation. One of the drugs of systemic enzyme therapy is the drug
Wobenzym. This combination of enzymes of plant and animal origin defines a new approach
to the problem of complex treatment of frequently ill children.
In fact, one drug implements its action in 5 therapeutic areas: optimizes the course of the
inflammatory process, accelerating recovery, activates the div's defenses in the fight against
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viruses and microbes, improves microcirculation and tissue oxygen supply, increases the
concentration of antibiotics in the inflammation site, reduces the side effects of antibiotics,
intestinal dysbacteriosis. Recommended for the treatment of frequently and long-term ill
children Immunorix is a multi-directional immunomodulator, the only systemic
immunomodulator for the treatment of respiratory infections recommended by WHO. The
high proportion of acute diseases of the ear, throat and nose in frequently ill children is due to
their age characteristics - the maximum number of acute cases occurs in preschool age - from
1 year to 4 years, then this level decreases. The maximum number of chronic diseases of the
nasal and throat organs (by appeal) occurs at the age of 5-6 years. The maximum prevalence
of chronic tonsillitis, both according to examination data and appeals, is noted in children
aged 10-14 years. Chronic otitis media, diseases of the nose and paranasal sinuses, and larynx
diseases are equally common in girls and boys. The ratio of acute and chronic diseases in the
prevalence of ear, nose and throat diseases is 10:1.
The results of the study showed that certain diseases are characteristic of a certain age.
According to our data, the frequency of combined pathology increases with the age of children,
and at the age of 14, it exceeds the level of children under 1 year by 1.8 times. The influence of
climatic and geographical factors on the prevalence of individual groups of nasal and throat
diseases has been established. Thus, the study revealed that in settlements located in the
southern regions of the country, the prevalence of inflammatory diseases of the middle ear is
significantly lower than in research bases located in geographic zones with sharp fluctuations
in climatic conditions. A decrease in the incidence rate was noted during the first three years
of a child's attendance at children's educational institutions.
In the structure of morbidity in the studied groups of children after entering school, the
leading reasons for seeking help are respiratory diseases (60.4% and 73.9%). Analysis of the
structure of morbidity of children who moved to middle and senior grades of school showed
that the leading conditions were respiratory diseases (65.5% and 79.9%). It is advisable to
improve the health of children with a high risk of developing the main types of chronic
pathology of the nasal and throat organs all year round. A survey of mothers showed that
there are many risk factors for nasal and throat diseases in the conditions and lifestyle of
families with children. Among them: an unfavorable living environment associated with
overcrowding of family members, smoking parents, air pollution, noted by respondents in 45-
50% of cases; insufficient sanitary literacy and low medical activity - 32-57% of respondents,
the spread of smoking among mothers - in 19-34% of cases; alcohol consumption by mothers
(2-8% of respondents). Thus, it becomes clear that the child's rehabilitation should be family-
based, since the presence of harmful factors in the child's home environment, where he
spends a lot of time with his family members, can have both a negative and positive effect on
his health, depending on the health of his relatives and the presence (or absence) of bad
habits. Health authorities should consider timely sanitation of nasal and throat organs in
children as the most important quality indicator in the system of maternal and child health,
since failure to carry out these measures leads to the chronicity of the child's diseases.
Treatment of children with nasal and throat diseases should be timely and comprehensive, i.e.
carried out by several specialists of different profiles (including an otolaryngologist,
pediatrician, allergist-immunologist, physiotherapist, etc.) in order to avoid subsequent
complications. Medical and pedagogical workers of preschool institutions are recommended
to conduct physical education classes and hardening of children of different ages and promote
this method among parents.
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