Chronic tonsillitis: symptoms and treatment, photos, causes

Chronic tonsillitis is one of the most common diseases in otolaryngological practice.

As a rule, it occurs as a result of frequent acute inflammation of the palatine tonsils, which creates conditions for the chronicization of the pathological process.

According to statistical data, chronic tonsillitis in adults occurs with a frequency of 4 to 37%, and in children - from 15 to 63%.

Prevalence combined with the development of possible complications that pose a threat to the life of the patient, cause the increased urgency of the disease.

Causes of development of

Chronic tonsillitis is an infectious-dependent inflammation that is associated with the presence of microorganisms in the tonsils.

Predisposing factors to this disease are:

• curvature of the nasal septum;
  
• frequent rhinitis;
  
• allergic rhinitis;
  
• inflammatory processes of other ENT organs;
  
• tooth decay;
  
• foci of chronic infection in the body;
  
• decreased immunity;
  
• is a condition of the body's allergic mood, especially in childhood.

Symptoms of chronic tonsillitis

Clinical signs of the disease depend on its shape. Chronic tonsillitis in adults, depending on the symptoms classified into the following types:

1. 1) Simple form.
   
2. 2) Toxico-allergic form of the first degree.
   
3. 3) Toxico-allergic form of the second degree.

A simple form is characterized by the following manifestations:

• exacerbations occur one to two times throughout the year;
  
• remissions are asymptomatic - the general condition of the patient does not suffer;
  
• intoxication syndrome is absent;
  
• complications are not observed.

For the toxic-allergic form, there are signs such as:

• frequent occurrence of exacerbations;
  
• between exacerbations the general condition is broken, there are immunological changes, etc.

The main objective signs of chronic tonsillitis are the following:

1. 1) Increase the number of nodes located toward the tonsils, the appearance of their soreness.
   
2. 2) The front and back arms are soldered to the palatine tonsil, then it speaks of a chronic inflammatory process( to identify this sign, the doctor probes the space between the bow and amygdala).
   
3. 3) Appearance of puffiness in the corner, which is formed by converging front and back bow of the tonsils.
   
4. 4) Increase the edges of the arms.
   
5. 5) Redness of the front arches, which is almost always present in contrast to acute tonsillitis.
   
6. 6) Purulent plaque in the lacunae of palatine tonsils, which is always present during exacerbation of the inflammatory process.
   
7. 7) Unpleasant smell of purulent plaque, which can limit the social role of the patient.

Diagnosis of chronic tonsillitis

Diagnostic search for suspected chronic tonsillitis includes the following:

1. 1) Pharyngoscopy - close examination of palatine tonsils and adjacent areas to identify the main signs of the disease.
   
2. 2) A general clinical blood test to assess the severity of the inflammatory response.
   
3. 3) Bacteriological study of detachable from palatine tonsils with determination of sensitivity to antibiotics.
   
4. 4) Biochemical blood test to identify markers of the immune process - seromucoid, sialic acids, fibrinogen and others.

However, in order to establish a definitive diagnosis of chronic tonsillitis, the doctor should conduct a thorough analysis of the patient's complaints and conduct a pharyngoscopy.

See also: symptoms and treatment of tonsillitis.

Possible complications of

In the event that the diagnosis and treatment of chronic tonsillitis in adults is delayed for various reasons( patient reluctance, refusal of treatment, etc.), certain complications develop.

These include the following:

• parathonsillar abscess;
  
• rheumatism - defeat of the heart muscle and joints;
  
• glomerulonephritis is an autoimmune lesion of the renal glomeruli;
  
• chronic intoxication perversions of the immune system due to constant allergization.

In addition, chronic tonsillitis is a predisposing factor for the development of many pathological processes on the part of almost all organs and systems. This is due to a violation of the mechanisms of endocrine and neuro-reflex regulation.

Such associated conditions are a violation of the ovarian-menstrual cycle, depression, encephalopathy, Meniere's syndrome and many others.

Treatment of chronic tonsillitis

Treatment of chronic tonsillitis can be carried out by both conservative methods and through surgical intervention. As a rule, medical measures almost always begin with a conservative stage.

It includes:

1. 1) Washing of the tonsils with antiseptic solutions that penetrate into the lacunae where the pathogenic microorganisms are concentrated.
   
2. 2) Physiotherapeutic procedures - application of ultrasound, UHF therapy and ultraviolet irradiation.

The use of antibiotics is justified only in case of exacerbation of chronic tonsillitis. Preference modern otolaryngology gives penicillins semisynthetic, cephalosporins and macrolides.

Anti-inflammatory drugs are used in case of a pronounced body reaction, which is manifested by high temperature, intoxication syndrome, etc. For this purpose, paracetamol, phenylephrine and others are shown.

The main indications for surgical treatment, that is, removal of palatine tonsils, are:

• no therapeutic effect from the two courses of the above therapy;
  
• tonsillitis, against which the parathonsillar abscess developed;
  
• sepsis of tonsilogenous origin;
  
• glomerulonephritis on a background of tonsillitis;
  
• rheumatism;
  
• suspected malignancy( malignant) pathological process.

However, before carrying out an operative intervention, it is necessary to evaluate possible contraindications. These include:

• cardiovascular pathology with severe circulatory failure;
  
• marked renal failure;
  
• uncompensated diabetes mellitus;
  
• is an uncorrected arterial hypertension in which there is a real threat of hypertensive crisis and intensive bleeding from a postoperative wound;
  
• diseases of the blood system, in which the probability of bleeding is high.

The operation has to be postponed in the following clinical cases:

• untreated caries;
  
• acute periodontitis;
  
• menstruation;
  
• gestational age, close to term;
  
• marked atrophy of the upper respiratory system.

Complications of tonsillectomy are extremely rare, including:

• bleeding from a postoperative wound;
  
• penetration of air under the skin;
  
• pharyngeal hematoma;
  
• inflammatory complications( otitis media, stomatitis, glossitis and others);
  
• exacerbation of common diseases.

Prevention

Prophylaxis of chronic tonsillitis is nothing more than the prevention and treatment of angina, that is, acute damage to the tonsils. It consists of the following activities:

• strengthening of the body's immune forces in various ways;
  
• suppression of supercooling;
  
• regular exercise;
  
• walking in the fresh air;
  
• hardening, conducted according to the rules;
  
• timely treatment of dental diseases and ENT diseases;
  
• rational nutrition.

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