Chronic tonsillitis
Chronic tonsillitis is a disease that is associated with multiple and prolonged inflammatory processes of the palatine and pharyngeal tonsils. Most often, chronic tonsillitis occurs as a consequence of transferred or untreated sore throat, scarlet fever, diphtheria, pharyngeal abscess and other infectious diseases, during the course it is associated with inflammation of the mucous membrane of the pharynx. The cause of such a disease may be the presence of not only a bacterial pathogen, but also a banal curvature of the nasal septum.
The content of the article:
Causes of chronic tonsillitis
Classification of chronic tonsillitis
Treatment of chronic tonsillitis
Chronic tonsillitis
This disease is not just a long-term inflammation of the tonsils and nearby tissues, it is also particularly dangerous because it will be a permanent focus of infection in the body, which entails much more serious problems. Chronic tonsillitis continuously attacks the body, causing more and more complications. It is very difficult to determine the percentage of patients with chronic tonsillitis, all this because the course of tonsillitis, especially the simple form, is almost asymptomatic and very few people with such a disease go to the doctor. A simple form of chronic tonsillitis is expressed mainly by local symptoms (redness and sore throat), if in addition to these symptoms there is also an increase in body temperature, persistent cervical lymphodenitis, a change in the functioning of the cardiovascular system, then the form of chronic tonsillitis develops into a toxic-allergic one. Rheumatism, thyrotoxicosis, nephritis and many other diseases often have a causal relationship with chronic tonsillitis.
Causes of chronic tonsillitis
A fairly large number of causes of chronic tonsillitis are known, but the most common are untimely diagnosed and untreated inflammatory diseases of the throat or sore throat. These situations occur after attempts to self-treat angina (more often in children), parents themselves, without consulting a specialist, use antibiotic therapy and other medications. Or there may be a situation when after the doctor’s appointment to take antibiotics for 7-10 days, the recommendations are not followed. Usually, after taking antibiotics for 3-4 days, the result becomes visible and treatment very often ends there. After such unfinished therapy, the acute process can develop into chronic tonsillitis. In addition, microflora and bacteria acquire resistance (resistance) to antibacterial drugs, the course of which was interrupted. Consequently, during a repeat illness, even large doses of a previously used drug will not bring any results.
In addition to these main factors of the appearance of chronic tonsillitis, there are also other causes that need to be paid special attention to. These factors include:
the presence of inflammatory processes in the oral cavity, carious teeth;
infections in the nasal, maxillary or frontal sinuses;
other foci of chronic infections in the body, etiological factors may be the presence of fungi, protozoan bacteria or viruses;
hypertrophy of nasal conch tissues;
injuries of soft tissues of a mechanical nature;
sudden hypothermia of the body and in particular the nasopharynx;
errors in nutrition and the presence of products in it that cause allergic reactions;
weakening of immunity;
curved nasal septum and hypertrophied adenoids;
stressful situations that push the immune system to reduce its functionality.
The infection is transmitted by contact of a sick person with a healthy one. This is usually a contact-household or airborne infection pathway. Sometimes the microflora of the oral cavity at the time of a decrease in immunity turns into pathogenic microorganisms and causes the appearance of an inflammatory focus.
As a result of the chronic course of tonsillitis or relapses of its acute forms, functional processes and structural changes occur in the tonsils, which no longer have a way back. This becomes the reason for the appearance of other foci of diseases in the body.
Classification of chronic tonsillitis
The chronic form of tonsillitis has its own classification. The nonspecific form of this disease is divided in turn into compensated and decompensated. Specific forms are also known — infectious granulomas, these include syphilitic, tuberculous granuloma and scleroma. Depending on the hypertrophy of the tonsils, their degrees are determined. There are only three degrees of hypertrophy of the tonsils. The degrees are determined using posterior rhinoscopy.
There are several authors of theories by which this disease can be classified (Lukovsky, Preobrazhensky, Palchun), but the meaning remains approximately the same, since there is a simple form and a form that entailed complications.
During chronic tonsillitis, a roller-like thickening and hyperemia of the edges of the palatine arches are visualized. Cicatricial changes appear in the tonsils, they become loose. Liquid pus or caseous-purulent plugs are collected in the lacunae. Regional lymphodenitis is determined by palpation. Sometimes scar adhesions form between the palatine arches and tonsils.
Chronic tonsillitis is sometimes complicated by paratonsilar abscesses, in 97% of cases this is an indication for tonsillectomy.
Treatment of chronic tonsillitis
The choice of tactics for the treatment of chronic tonsillitis depends on the form of the disease, concomitant pathologies and the general condition of the patient. The main principle of treatment of this disease is complexity, but the main methods are surgical and conservative treatment. Conservative treatment is enough for the vast majority of patients, but there are cases when it is worth thinking about surgical intervention. The minority category includes patients who have urgent and absolute indications for tonsillectomy.
Conservative treatment can be general or local. General methods include restorative procedures: sports, hardening of the body, contrast shower. Such procedures, of course, give results, but it is very important to remember that they help only at the time of complex application, with compensated tonsillitis, just not in its acute period. This means that after hearing the diagnosis of “chronic tonsillitis”, you should not panic at any time, but you need to strengthen the body in time. The main task of the doctor in such a situation is to control the use of wellness procedures by the patient, because if you do not temper correctly, you can only harm yourself.
Physiotherapy procedures (submandibular diathermy, short-wave ultraviolet irradiation) and therapeutic gymnastics are also relevant for chronic tonsillitis, especially this type of therapy is indicated for patients with subcompensated chronic tonsillitis. When physiotherapy is used, it is important to exclude all kinds of physical exertion and monitor the otorhinolaryngologist in dynamics.
Local treatment of chronic tonsillitis includes lubrication of the tonsils and lacunae with different solutions (lugol’s solution, iodine solution, iodine glycerin, and others), local ultraviolet irradiation and lacunae washing.
Washing lacunae is one of the most effective ways to combat this forged disease. This procedure is performed with the use of liquids for washing lacunae, of which there is an abundance today. Mainly use products with anti-inflammatory, astringent and soothing properties.
Indications for the use of surgical treatments are conditionally divided into absolute and relative. Absolute indications are metotonsilar diseases that have arisen in the patient, in particular, myocarditis, rheumatism, cholangiohepatitis and nephritis. Also, decompensated tonsillitis, which does not respond to conservative methods of treatment, can be attributed to the absolute indications.
Moderate tonsilogenic intoxication (moderate disorders of the functioning of various organs) is a relative indication for the use of a surgical treatment method.
As the practice of otorhinolaryngologists shows, with frequently recurring sore throats, the most productive method of treatment is still tonsillectomy (or another type of surgical intervention). Of course, not in all cases, after the removal of the tonsils, the functions of the affected organs are restored, but still the chances are very high.
After the operation, the patient needs to stay in a hospital, undergo a course of antibacterial therapy, restorative, detoxification and anti-inflammatory therapy. A gentle regime is required — the exclusion of spicy, salty and sour from the diet, abundant rinsing and constant observation by a doctor.
