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Tonsillitis

Tonsillitis (amygdalitis) is an inflammation of the tonsils. There are acute (see Angina) and chronic tonsillitis. As a rule, the term “chronic tonsillitis” is used in relation to chronic inflammation of the tonsils, although a similar process may develop in other (eg, nasopharyngeal, lingual) tonsils.

Chronic tonsillitis often develops as a result of single or repeated angina. However, there is a so-called non-anginal chronic tonsillitis. Sometimes chronic tonsillitis is preceded by scarlet fever , measles, diphtheria. Development of chronic tonsillitis is promoted by persistent obstruction of nasal breathing, diseases of the paranasal sinuses (see), carious teeth (see). Subjective symptoms are mild - a feeling of "awkwardness" in the throat, tingling, burning sensation. Sometimes sore throat, giving to the ear. Often patients note spontaneous allocation of traffic jams; bad breath. Objective symptoms: hyperemia of anterior palatine arch, uneven ("bumpy") surface of the tonsils, enlarged lacunae (Figures 1 and 2). When pressing the spatula on the front palatine arch from the lacunae, so-called caseous "plugs" or liquid pus, often with an unpleasant odor, are prominent. Less permanent signs are infiltration and swelling of the upper sections of the anterior palatal arches and the angle formed by the anterior and posterior arches. Often determined by fusion of the palatine arches with the amygdala. In some cases, whitish-yellow bubbles appear through the mucous membrane. The regional (deep cervical) lymph nodes are often enlarged and somewhat painful. Often, tonsillitis is accompanied by subfebrile temperature.

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chronic tonsillitis photo
Fig. 1. Chronic follicular tonsillitis. Fig. 2. Chronic lacunar tonsillitis. Fig. 3. Chronic tonsillitis (a sign of Transfiguration). Fig. 4. Chronic tonsillitis (a sign of Giza).

It should be emphasized that the large size of the tonsils are not a sign of chronic tonsillitis; on the contrary, chronic inflammatory changes often develop in small ("hidden") tonsils.

Differential diagnosis is carried out with pharyngomycosis (see). With pharyngomycosis in the mouths of the lacunae, white, fairly dense protrusions in the form of thorns, consisting of keratinized epithelium and fungus-driver fungi, are determined.

The most frequent complications of chronic tonsillitis are paratonsillar abscess , rheumatism , septic endocarditis , infectious polyarthritis, nephritis, pyelitis .

Conservative treatment is used mainly for uncomplicated forms of chronic tonsillitis. It consists in the systematic washing of the lacunae using a special syringe (you can use a syringe for intra-guttural infusions). For washing, solutions of penicillin, furacilin , sulfonamides, citral, etc. are used. The course of treatment is usually 12-15 washes, which are produced every other day. After washing, lubricate the mouths of the gaps with a solution of Lugol. Washings are combined with UFOs of the tonsils through a special tube, UHF currents in the region of the regional lymph nodes.

Often prescribed rinsing and lubrication of the throat and pharynx are usually ineffective.

The “semi-surgical” methods include the dissection of lacunae (with a special knife or galvanic kauter).

In the absence of the effect of conservative treatment, as well as in the complicated forms of chronic tonsillitis, they produce (in the absence of contraindications) complete removal of the tonsils - tonsillectomy (see).