The author - Chuklin Olga, general practitioner, internist. Work experience since 2003.
Chronic tonsillitis manifested prolonged inflammation in the tissues of the tonsils.
In humans, the palatine tonsils are part of the ring of lymphoid pharynx, they participate in the immune response by ingestion of various pathogens.
When the infection gets on the mucous membranes of the tonsils, they launched a series of immune reactions, the end result of which is to destroy harmful bacteria. But if the infectious attack prolonged, frequent, the amygdala can not handle the load. In them there is the accumulation of bacteria, formed foci of chronic inflammation.
The reason for the formation of chronic tonsillitis can be:
- the presence of chronic infection foci in the body - sinusitis, rhinitis, otitis, adenoids, dental caries, stomatitis, Pharyngitis;
- frequently recurring respiratory infections;
- the presence of septal deviation;
- primary immunodeficiency and acquired;
- nedolechennaya angina.
Cause chronic tonsillitis in most cases, streptococci, staphylococci, rarely, chlamydia, mycoplasma.
It contributes to the development of the disease:
- frequent hypothermia;
- alcohol abuse;
- poor nutrition.
Accepted provide two forms of chronic tonsillitis:
For compensated form is characterized by the fact that the patient has only local changes in the tonsils. The main function of the tonsils is not yet suffering.
For decompensated form characterized by the fact that the patient, in addition to local symptoms appear and general symptoms. This is due to the development of intoxication as a result of toxins produced by bacteria. Develop complications - tonsils no longer perform its basic security functions of the body.
Manifestations of chronic tonsillitis
Chronic tonsillitis occurs with periods of remission and periods of relapse.
During remission, the patient can have the following symptoms:
- discomfort in the throat;
- sensation of a lump in the throat;
- small pains in the morning;
- jams on the tonsils;
- small accumulation of pus in the gaps.
Also, in addition to signs of tonsillitis, can be co-morbidities and symptoms - chronic pharyngitis, rhinitis, sinusitis.
With the development of decompensated forms appear such symptoms:
- general malaise;
- long subfebrilitet (temperature kept near 37 degrees).
In addition, the signs can join complications.
The most common complication of decompensated form of chronic tonsillitis is peritonsillar abscess.
It begins as a sore throat, but later on the patient can not swallow at all, and open your mouth. There is a pronounced tissue edema of the pharynx. The patient required urgent medical assistance and hospitalization.
Provoke an aggravation of chronic tonsillitis may be hypothermia, acute respiratory viral infection, the use of cold drinks or food.
With the development of exacerbations of chronic tonsillitis develop symptoms of angina (acute tonsillitis):
- a sharp increase in body temperature to febrile digits (39-40 degrees);
- intense pain in the throat;
- increased regional lymph nodes;
- tonsillar abscess appears plaque;
- It can also be purulent follicles in the mucous membrane of the tonsils.
If signs of disease should consult an audiologist doctor.
The doctor will conduct a thorough medical history and conduct a complete examination of the patient.
On examination of the throat (pharyngoscope) are typical signs of chronic tonsillitis:
- tonsil tissue loosened;
- There are pockets of seals (scar tissue);
- valikoobraznoe thickened edges palatine arches;
- small hyperemia edges palatine arches;
- the presence of caseous plugs;
- with pressure on the tonsils lacunas can stand creamy pus;
- during long processes can be adhesions, scarring on tonsils.
Required smear taken with tonsil and washings from the mucous of the oral cavity. Research helps identify the causative agent and select the desired antimicrobial ..
In general, analysis of blood may present signs of inflammation (increase in the number of leukocytes and increased erythrocyte sedimentation rate - ESR).
Treatment of chronic tonsillitis
When treating compensated form and in the absence of complications conducted conservative treatment.
If the patient shows signs of decompensation of chronic tonsillitis and develop complications that may require surgery.
The first is taking steps to strengthen the body's defenses - proper nutrition, reducing bad habits.
In the presence of concomitant diseases, which are also sources of DC infection, they must cure:
- mandatory readjustment of the oral cavity - treatment of inflammatory diseases (caries, stomatitis);
- treatment of sinusitis, pharyngitis, rhinitis.
The following methods are used for conservative treatment of chronic tonsillitis:
- Lavage of tonsils. During the procedure erases the contents of gaps, and then treated with antiseptic solutions tonsils.
- Lubrication mucous tonsils drugs. To carry out this procedure most commonly used Chlorophillipt, Lugol solution, Propolis.
- Gargling with solutions Miramistin, chlorhexidine, furatsilina, decoction of herbs.
- Irrigation throat sprays and aerosols - Stopangin, Geksoral, Ingalipt, Kameton.
It circulated as physiotherapy:
- ultraviolet irradiation;
- magnetic therapy;
- Electrophoresis drugs;
- ultrasound treatment.
Treatment with antibacterial agents shown in the development of acute, complications. It is carried out strictly on prescription. Self-medication with antibiotics can worsen the patient's condition.
Used antibiotics with a broad spectrum of action:
- Flemoksin Soljutab;
Treatment of immune-boosting drugs is carried out after consultation of the immunologist.
Surgical treatment is carried out in the presence of strict indications:
- exacerbations more than three times a year;
- complications of chronic tonsillitis;
- after failure of conservative treatment.
Tonsillectomy performed using a laser or a scalpel.
This method is preferred. In carrying out laser removal may remove tonsils not completely, but only the affected areas.
Also, laser removal is painless and takes about 30 minutes.
Carrying laser tonsillectomy can be performed without the patient's hospitalization.
Paying scalpel tonsillectomy
A scalpel tonsil removal more traumatic, during operation there is blood loss, the duration is about 1.5-2 hours. Hospitalization is required.
Contraindications to surgical treatment are:
- active tuberculosis;
- acute viral infectious disease;
- renal failure;
- cardiovascular diseases;
complications of tonsillitis
May develop the following complications of chronic tonsillitis:
- peritonsillar abscess;
- abscess of the neck;
- heart defects;
Avoid the development of complications is possible, if early treatment of chronic tonsillitis.
Prevention of chronic tonsillitis includes compliance with these measures:
- maintaining a healthy lifestyle;
- rejection of bad habits;
- balanced diet;
- avoidance of hypothermia;
- timely and complete prolechivanie acute inflammatory diseases.