Tonsillitis chronic

Tonsillitis chronic - inflammation of the tonsils; Both adults and children are ill. The cause is repeated angina, less often other acute infectious diseases (scarlet fever, measles, diphtheria). The development of chronic tonsillitis is promoted by persistent disruption of nasal breathing (adenoids, curvature of the nasal septum), diseases of the paranasal sinuses, carious teeth, alveolar pyorrhea, chronic catarrhal pharyngitis, chronic rhinitis. According to the currently accepted Soldatov classification, chronic tonsillitis is divided into compensated and decompensated.

Symptoms, course. Feeling of perspiration, sore throat, foreign body in the throat in the tonsils, bad breath, coughing up of the so-called sluggish-caseous masses formed in the lacunae of the tonsils, a slight periodic pain when swallowing, sometimes giving in the ear. Often, the disease is accompanied by a long (for several weeks and even months) subfebrile, reduced performance, headache, sometimes cough reflex origin. Some patients with chronic tonsillitis do not make any complaints. There are frequent complications: defeat of the heart, joints, general weakness, sweating. Perhaps the development of rheumatism, nephritis. With pharyngoscopy - signs of a chronic inflammatory process: palatine tonsils loosened, scarly altered, fused with palatal arms, surface of tonsils uneven (tuberous), lacunas enlarged. With a slight pressure on the area of ​​the amygdala from the lacunae, "plugs" or pus flow often with an unpleasant odor. The mucous membrane of anterior palatine arch is hyperemic, especially their free edge. Regional lymph nodes often are enlarged and somewhat painful on palpation. Large sizes of tonsils are not always a sign of chronic tonsillitis (in children it is physiologically); On the contrary, chronic inflammatory changes often develop in small (hidden) tonsils. Chronic tonsillitis should be differentiated from pharyngomycosis.

Treatment is conservative, carried out mainly in uncomplicated forms of chronic tonsillitis: the amygdala is systematically washed with disinfectant solutions (furacilin 1: 5000, penicillin 1:10 000 ED, ethacridine lactate 1: 5000, etc.), followed by lubrication of the lacunae of the tonsils with Lugol's solution. Washing can be combined with physiotherapeutic treatment: ultraviolet irradiation through a special tube (suberythmic dose), UHF currents to the region of regional lymph nodes. If necessary, this course of treatment (12-15 washings) is repeated after 2-4 months. In the absence of effect, as well as with complicated forms of chronic tonsillitis, palatine tonsils are removed (tonsillectomy). Contraindications to surgery are blood diseases: hemophilia, thrombopenia, etc. In these cases, cryo-exposure to the tissue of the tonsils is used. Relative contraindications to tonsillectomy (tuberculosis, hypertension, diabetes, etc.) in each case the otorhinolaryngologist discusses with the therapist. The operation should be performed not earlier than 3 weeks after the transferred angina. The most common complications of surgery include bleeding and exacerbation of diseases associated with the pathology of palatine tonsils.

Prevention. Persons who often have angina (especially children) should be on dispensary records. The sanation of the oral cavity, paranasal sinuses, restoration of free breathing through the nose, hardening of the organism, improvement of working and living conditions are shown. For the prevention of complications, such as rheumatism, kidney disease, heart disease, etc., it is necessary to remove pathologically altered palatine tonsils in time.