Introduction. The immune function of the palatine tonsils is associated with a constant proliferation of lymphocytes, therefore, the indicators of proliferation, apoptosis and anti-apoptotic activity in the palatine tonsils are quite informative for assessing their functional state and contribution to adaptive immunity. Chronic inflammation in the palatine tonsils affects their functional state. Understanding the immunocompetence of the palatine tonsils at different stages of the course of chronic tonsillitis allows the optimal tactics of treating this disease, including timely tonsillectomy.Objective. Based on the results of research and literature sources, to find a comparative characteristic of the contribution of palatine tonsils to adequate immunity, ways to assess their proliferative and anti-apoptotic activity.Materials and methods. The study included 158 patients with various forms of chronic tonsillitis and 8 patients without signs of chronic tonsillitis, who were divided into 4 study groups, in accordance with the clinical classification of chronic tonsillitis according to B.S. Preobrazhensky and V.T. Palchun. The tissue samples of the palatine tonsils obtained from patients were examined immunohistochemically in an automatic mode using markers of Ki67 proliferation and Bcl2 antiapoptosis.Results. When conducting an immunohistochemical study with markers of  proliferation and anti-apoptosis, an increase in the proliferative and anti-apoptotic activity of lymphoid tissue cells in chronic tonsillitis of a simple form was revealed, and a significant decrease in these indicators in chronic tonsillitis of toxic-allergic forms of I and II stage.Conclusions. Data were obtained on the planned tonsillectomy in chronic tonsillitis of the toxic-allergic form of II degree, as well as in case of ineffectiveness of conservative therapy of tonsillitis of toxic-allergic form of I degree.

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The article is devoted to the problem of chronic tonsillitis. The widespread prevalence of the disease, as well as the high risk of complications from vital organs, make this problem especially urgent. The article describes in detail the factors contributing to the formation of a focus of chronic inflammation in the amygdala. Special attention is paid to the microbiological aspects of the inflammatory process, anatomical, topographic and physiological features of the tonsils, as well as their immune function. The histological changes that form against the background of a long-term chronic inflammatory process in the tonsils are described. Changes in the parenchyma of the amygdala during inflammation can be expressed both by hyperplasia and by involution of follicles with the formation of infiltrates and the subsequent development of abscesses. In the final stages of an active inflammatory process, connective tissue grows, replacing lymphoid tissue. In the paratonsillar tissue and the capsule of the amygdala, an overgrowth of connective tissue is also observed, which is accompanied by the formation of nested infiltrates around small vessels, most pronounced at the upper pole of the amygdala. According to this classification, two clinical forms of chemotherapy are distinguished: simple and toxic-allergic of two degrees of severity. Further, in accordance with this classification, the basic principles of treatment are presented. Then the features of conservative therapy and the benefits of the herbal preparation are described. The composition of this drug includes marshmallow root, chamomile flowers, horsetail herb, walnut leaves, yarrow herb, oak bark and dandelion herb. The results of several clinical trials of the drug indicate its positive effect on the dynamics of both clinical and microbiological, immunological parameters in patients with chronic tonsillitis. All this allows us to recommend wider inclusion of this combined herbal medicinal product in the complex of treatment of chronic tonsillitis.

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Introduction. There is an abundance of various methods of surgical treatment in the world, which include: classical tonsillectomy (TE), shaver TE, unipolar and bipolar bilateral TE, laser TE, palatine tonsil coblation, etc. However, there is still a risk of recurrence of chronic tonsillitis after TE there is a need for a study in the late postoperative period.Purpose of the study. Improving the efficiency of surgical treatment of patients with chronic tonsillitis based on the analysis of five main methods of surgical treatment of chronic tonsillitis according to clinical and laboratory criteria.Materials and methods. Patients were divided into 5 study groups depending on the method of tonsillectomy: The first group consisted of 60 patients after classical tonsillectomy. In the second group there were 55 patients after palatine tonsil coblation. The third group included 48 patients after laser tonsillectomy. The fourth group consisted of 64 patients after tonsillectomy using the surgitron apparatus. The fifth group consisted of 58 patients after microdebrider tonsillectomy.Results. By analysis, it was found that the best results were obtained in patients of the 1st group, who underwent classical tonsillectomy. In this group, there are fewer cases of subjective and objective clinical symptoms (sore throat, signs of subatrophic pharyngitis, hypertrophy of the lateral folds of the pharynx, remnants of the lymphoid tissue of the palatine tonsils, as well as postoperative cicatricial changes). In a laboratory study, patients of the 1st group had the lowest values of the indicators (ASL-O titer, CRP and DNase B levels, negative results of the Streptatest).