TONSILLITE CHRONIC

TONSILLITE CHRONIC - chronic inflammation of the tonsils. It is more common in children, very rarely in people over 60 years of age.

Development of the disease is facilitated by unfavorable climatic conditions and working conditions (dustiness, gas contamination of the air), cooling of the body , inadequate nutrition with excessive consumption of proteins, carbohydrates, presence of carious teeth, purulent sinusitis, difficulty in nasal breathing (eg, rhinitis, adenoids).

The focus of infection in tonsils is of great importance in the genesis of many diseases and pathological conditions, in particular rheumatism, nephritis, sepsis, a number of skin diseases - psoriasis, eczema, and diffuse connective tissue diseases. The development of the latter, in particular systemic lupus erythematosus, nodular polyarteritis, scleroderma, dermatomyositis, is especially characteristic of patients with chronic tonsillitis of children. Prolonged tonsilloid intoxication can promote the development of immune disorders, thrombocytopenic purpura and hemorrhagic vasculitis.

Clinical picture . With the compensated form of tonsillitis there are only local signs of chronic inflammation of the tonsils without a pronounced general reaction of the organism. Usually patients notice bad breath, pain or tingling, sometimes - dryness or the presence of a foreign body in the throat. Children often complain of tingling or a small shooting pain in the ear. The decompensated form is manifested by relapses of angina, paratonzillitis, paratonsillar abscesses, as well as various pathological reactions of other organs. Frequent complaints of fast fatigue, lethargy, headache, disability, subfebrile body temperature are frequent.

Tonsils are hyperemic, scarly changed and compacted, the edges of the palatine arch are thickened. In the lacunae there are purulent plugs or liquid pus, the regional lymph nodes are enlarged.

Conservative treatment is indicated with a compensated form of tonsillitis, as well as in those cases when there are contraindications to the operation. Effective lavage washing with solutions of penicillin, furacilin, sulfacil sodium, potassium permanganate, boric acid, ethacridine lactate, dioxidine, iodinol, lysozyme, antiviral agents (interferon), stimulants (peloidin). Washings are carried out using a thin cannula and a 20 ml syringe (every other day, the course includes 10-15 procedures). The washing of the lacunae can be carried out simultaneously with the suction of their contents, for which a vacuum cap connected to the electric pump and to the solution of the drug is used. Effective use of antibiotics (taking into account the sensitivity of microflora). More commonly used penicillin, which is injected into the tissue of the tonsils and into the paratonsillar tissue. They also apply filling of lacunae with medicinal pastes, inhalation of antibiotics and phytoncides, hydrocortisone phonophoresis, interferon, etc., ultrasound therapy, ultraviolet irradiation, laser therapy. Effective thermal effects on the tonsils and regional lymph nodes - UHF-therapy, microwave therapy, mud therapy, etc.

To increase the natural resistance of the body, vitamins B, PP, ascorbic acid, resort and climatic factors are widely used. Assign injections of an extract of an aloe, a vitreous; Inside - calcium gluconate, fitin. Apply serum, blood plasma and gamma globulin, corticosteroids, antihistamines, calcium preparations.

Conservative treatment courses are usually conducted 2 times a year, preferably in the spring and in the spring.

Surgical treatment - tonsillectomy is indicated in cases of decompensation of the process (recurrent angina, peritonzillitis and paratonzillar abscesses, pronounced tonsillogenic toxicity, tonsillogenic sepsis , diseases of distant organs), and also in those cases when conservative treatment was unsuccessful.

The operation is contraindicated in hemophilia, severe heart failure, kidney failure, angina pectoris, high arterial hypertension, severe diabetes mellitus, active form of tuberculosis, acute infectious diseases, and in the last months of pregnancy and during menstruation. Tonsillectomy is preferable to conduct in the so-called cold period - 2 to 3 weeks after angina; With rheumatism it is carried out after a course of antirheumatic treatment or in the inactive phase of the disease.

Prevention includes hardening, rational nutrition, observance of the rules of hygiene of dwellings and working premises, elimination of contamination, dust and gas contamination of the air, detection and treatment of diseases of gums and teeth, sinusitis, nasal breathing disorders,