МИОФУНКЦИОНАЛДЫ БҰЗЫЛУЛАР ЖӘНЕ ТІС-ЖАҚ АУЫТҚУЛАРЫ АДЕНОИДТЫ ГИПЕРТРОФИЯНЫҢ ҚАУІП ФАКТОРЫ РЕТІНДЕ (ӘДЕБИ ШОЛУ)

Кіріспе. Бұл шолу мақаласында аденоидты гипертрофияның, оның ішінде аденотомиядан кейінгі рецидивтердің дамуындағы миофункционалды бұзылулар мен тіс-жақ аномалияларының рөлі қарастырылады. Мәселенің өзектілігі сандық деректермен расталады: жүйелі шолу нәтижелері бойынша тіс-жақ аномалияларының әлемдік таралуы 56 %-ды құрайды, ал мұндай аномалиялар ауыз қуысы денсаулығына байланысты өмір сапасының төмендеуімен байланысты болды (RR/PR = 1.15; 95 % CI: 1.12–1.18; 3672 қатысушы). Балалар арасында жүргізілген зерттеулерде 8-10 жастағы балалардың 49,1 %-ында тіс-жақ аномалиялары анықталған, ал ауыз арқылы тыныс алу трансверсальды тістем аномалияларымен статистикалық тұрғыдан маңызды байланыста болған (PR = 6,15; 95 % СИ: 2,96–12,80).

Мақсаты. Жұтқыншақ бадамша безі гипертрофиясының дамуындағы миофункционалды бұзылулар мен тіс-жақ аномалияларының рөлі туралы әдеби дереккөздерді талдау.

Материалдар және әдістер: Google Scholar, Scopus, Web of Science, PubMed және eLIBRARY ғылыми дерекқорларындағы 2019-2024 жылдар аралығындағы жарияланымдарға аналитикалық шолу жүргізілді. Аталған мерзімнен тыс негізгі классикалық дереккөздер де енгізілді. Алдын ала белгіленген іріктеу критерийлеріне сәйкес келген 92 жарияланым қорытынды шолуға енгізілді.

Нәтижелері және талқылау. Талданған деректер аденоидты гипертрофия, мұрынмен тыныс алудың бұзылуы, ауыз арқылы тыныс алу, миофункционалды бұзылулар және тіс-жақ аномалиялары өзара тығыз байланысты екенін көрсетеді. Жұтқыншақ бадамша безінің гипертрофиясы 6 жастағы балаларда жиі кездесетін ЛОР ауруларының бірі болып табылады; жиі ауыратын балаларда ол 70-90 % жағдайда анықталады. Аденоидты гипертрофиямен байланысты ауыз арқылы немесе аралас тыныс алу артикуляциялық бұзылыстармен қатар жүруі мүмкін: тыныс алу бұзылыстары бар балалардың 81.7 %-ында сөйлеу кемшіліктері сипатталған. Қайталама операция салыстырмалы түрде сирек кездескенімен, ірі ретроспективті зерттеуде ревизиялық аденоидэктомия жиілігі 0.55 % құрады, ал ревизиялық жағдайлардың 21 %-ы аденоид тінінің шынайы қайта өсуінен емес, түтікше бадамша безінің гиперплазиясымен байланысты болды.

Қорытындылар. Әдеби деректерді талдау аденотомиядан кейінгі рецидивтердің алдын алу клиникалық тұрғыдан маңызды екенін және операциядан кейінгі кезеңді жүргізуде пәнаралық кешенді тәсілді қажет ететінін көрсетеді. Мұндай тәсіл оториноларингологиялық бақылауды, ерте ортодонтиялық бағалауды, тұрақты ауыз арқылы тыныс алуды және тіс-жақ аномалияларын түзетуді, сондай-ақ көрсетілімдер болған жағдайда миофункционалды немесе логопедиялық терапияны қамтуы тиіс.

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