Chronic tonsillitis in adults: causes, symptoms, conservative and surgical methods of treatment

Acute tonsillitis is an inflammatory process of a specific lymphatic tissue( tonsils), with time, in most cases, goes into a chronic form.This disease is infectious nature with destructive changes in tonsils and surrounding tissues, allergic and general reaction of the body, taking place with periods of improvement and exacerbation.

Tonsils located in the throat are the first to meet the causative agents of infectious diseases that penetrate into a person through the nose or mouth.It is in them that the reactions of neutralization of harmful microbes and their poisons occur.In addition to pharyngeal, these same functions in the body are entrusted to palatine, lingual and tubal tonsils.

Recommended: Why does chronic tonsillitis develop Chronic tonsillitis, the form of the disease What are the complaints with chronic tonsillitis How to determine the presence of chronic tonsillitis, diagnostic methods Treatment of chronic tonsillitis

In the XIX century, Dr. Valdeier suggested thatTonsils are a protective ring.Tonsils have the ability to contain a large number of protective cells( macrophages, leukocytes, etc.), which cause the first "blow" on trying to penetrate into the body of infection.Briefly about the causes of chronic tonsillitis:

Why there is chronic tonsillitis

Constant penetration of pathogenic microbes causes the work of protective forces in a constant "overload" mode.Especially dangerous are the so-called beta-hemolytic streptococci, microbes that have the ability to strongly allergic organism.Immunity usually copes with this problem, but as a result of various reasons, it can sometimes fail. The cause of the problems are:

• stress;
• constant supercooling;
• improper power supply;
• exposure to toxic substances;
• smoking.

As a result, protective reactions can stop coping with constant "attacks" of microorganisms and those, without encountering special resistance, settle in the tonsils and begin to multiply in them.The body includes reserve forces.Inside the tonsils begins an invisible battle to us.But we already feel it: there is a sore throat, cough, swelling of the tonsils and throat, the temperature rises, weakness develops.In most cases, the human body wins.The period of acute tonsillitis passes.Then comes recovery or. .. again an exacerbation.And everything repeats itself again.

Please note : if a person does not help their defenses with proper treatment and rational regimen, then sooner or later the immunity is greatly weakened and then the tonsillitis passes into a chronic form, which will be cured already very hard.

Development of chronic tonsillitis, the form of the disease

As we have already noted, human immunity is weakened, and the constant presence of pathogenic microorganisms in the tissues of the tonsils leads to its "perversion".Protective cells begin to "digest" not only microbes, but also their own tissues, react to them as if they were foreign.There is a so-called sensitization - hypersensitivity, allergic processes.

Tonsils devoid of normal products of vital activity - oxygen, vitamins, enzymes - begin to break down, pus appears in them, then the dying lymphoid tissue is replaced by a connective tissue, which can no longer perform protection functions. During the illness, two forms are distinguished:

• compensated - manifested by local signs of chronic inflammation of the tonsils;
• is decompensated - characterized by local signs, aggravated purulent complications in the form of abscesses( encysted purulent foci), phlegmon( diffuse purulent foci), complications of distant organs( kidneys, heart).

Some doctors allocate simple and toxic( toxic-allergic) forms of the disease.

What complaints for chronic tonsillitis

Chronic compensated tonsillitis in adults causes:

• sore throat varying degrees of intensity;
• periodic temperature increase;
• permanent redness( congestion) and falciform thickening of the edges of the palatine arch;
• purulent congestion in the lacunae of the tonsils;
• enlargement and soreness of the maxillary lymph nodes( regional lymphadenitis);
• change in taste and bad breath.

When transitioning to the decompensated stage,

• is associated with vestibular disorders( tinnitus, dizziness, headache);
• Collagen diseases, provoked by the presence of betta-hemolytic streptococcus - rheumatism, rheumatoid arthritis, etc.;
• skin ailments - psoriasis, eczema;
• kidney problems - nephritis;
• blood diseases;

How to determine the presence of chronic tonsillitis, diagnostic methods

The diagnosis of "chronic tonsillitis", as a rule, is not difficult.Usually, the doctor-otolaryngologist determines the presence of the disease according to the patient's complaints. The examination is supplemented:

• by pharyngoscopic method - examination of inflamed tonsils.The physician visually determines the contents of the lacunae and makes prints of the tonsils for bacteriological examination for the presence of pathogenic flora;
• by clinical blood analysis, which reveals signs of an existing inflammatory process with a high level of neutrophilic leukocytes, a decrease in the number of monocytes, an increase in ESR( erythrocyte sedimentation rate), etc.;
• by a biochemical blood test with the study of immunity factors, the determination of antigens to streptococcus.

Treatment of chronic tonsillitis

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Therapeutic measures for chronic tonsillitis are aimed primarily at strengthening human immunity. In case of exacerbation of acute symptoms of chronic tonsillitis treatment is carried out:

• with antiseptic compositions - irrigation of the throat with therapeutic solutions, aerosols, rinses, inhalations;
• mechanical cleaning of the tonsils;
• if necessary - with drugs with analgesic and anti-inflammatory effect;
• by warming the neck area with warm woolen things;
• in severe cases - antibiotic therapy.

In the stage of attenuation of the disease, treatment should not stop.The emphasis is on fortifying methods of influence.

Conservative treatment of chronic tonsillitis

It is prescribed in all cases and stages of the disease, as well as contraindications to surgical removal of tonsils in chronic tonsillitis. Based on the nature of the main effect, the treatment is distinguished:

• with measures aimed at improving the body's resistance: rational day regimen, vitaminized nutrition, moderate exercise, running in the fresh air, climatic effects.The use of tissue therapy, the introduction of sera, blood plasma, gamma globulin preparations, the intake of iron-containing drugs;
• medications that reduce allergies( hyposensitizers).These include preparations of calcium, vitamin C( ascorbic acid).In severe cases, resort to hormones( corticosteroids);
• immunocorrectors - autoserotherapy, immunostimulants( levamisole, prodigiozan, etc.) Affect the tissues of the tonsils with a helium-neon laser.Useful injections of the extract of aloe, vitreous, FIBS;
• by means of sanifying action on tonsils: by washing lacunae with antiseptics with suction of purulent contents.The introduction of medicinal pastes( therapeutic filling), ultraviolet irradiation, ultrasonic therapy, electromagnetic field influence, interferon interferon phonophoresis;
• by means of reflex action: blockades with novocaine, acupuncture.

The courses are held twice a year, usually during periods of possible exacerbations, that is, in the fall and spring.Correctly organized therapy achieves efficacy in 85% of cases. In case of failure of conservative treatment of tonsillitis it is possible to apply:

• electroplating;
• diathermocoagulation of the tissue of the tonsils;
• cryotherapy( freezing);
• laser lacunotomy and destruction of tonsils.

Abundance of methods is caused by the need to take into account the treatment of anatomical features of the structure of the tonsils, their location, size.

Surgical methods for the treatment of chronic tonsillitis in adults

Indications for the removal of tonsils( or partial removal) is the failure of the conservative measures discussed above, acute purulent complications.The type and volume of the operation is decided each time individually.The operation is performed by adults in a hospital under local anesthesia.

Preparation for surgical treatment begins in the clinic with a complete examination of the patient: fluoroscopy of the lungs, blood and urine tests. Contraindications for surgery are the following problems:

• severe degree of circulatory failure;
• hypertension III degree;
• is a severe form of diabetes mellitus;
• kidney disease in decompensation stage;
• blood diseases with a high risk of bleeding.

There are two main methods of tonsillectomy:

• tonsillotomy - partial removal of tonsils;
• tonsillectomy - complete removal of tonsils.

The operations are performed with a scalpel or laser technique, sometimes with the joint application of both methods.

Important: is a more modern, gentle and safe method for the removal of tonsils is laser tonsillectomy.The laser beam has the ability to fold blood, so the removal of tonsils occurs completely bloodless, while in normal tonsillectomy cases of bleeding are not uncommon.In addition, the unpleasant sensations are minimized, since the contact of the laser with the tissues is a fraction of a second.

After the operation, the patient is shown bed rest.Bed with an elevated position for the head.The first day is not allowed.You can only do a few sips of water.Then, liquid and unheated food is taken.More details about the operation for removing tonsils are told in the video clip:

Treatment of chronic tonsillitis at home

There are many people's remedies for chronic tonsillitis.It is important to remember that all of them should be used as an addition to the main methods of treatment, but not replace them. Let's consider some of the most interesting recipes, which include honey and its derivatives:

• for lubricating tonsils, a mixture consisting of 1/3 of the freshly squeezed juice of aloe leaves and 2/3 of natural honey is prepared.The mixture is neatly mixed and stored in the refrigerator.Before use, the medicinal composition should be warmed to 38-40 degrees Celsius.A wooden or plastic spatula is carefully applied to sick tonsils 1-2 times a day, at least 2 hours before meals.Treatment should be repeated daily for two weeks.Then the procedure is done every other day;
• for oral administration, prepare in half the juice of onions and honey.Stir thoroughly and drink 1 teaspoonful 3 times a day;
• mix the flowers of chamomile and oak bark in 3: 2 proportions.Four tablespoons of the mixture pour 1 liter of hot water and boil for 10 minutes on a small fire.Before turning off add a tablespoon of linden flowers.Let cool, drain, add a teaspoon of honey into the solution.Stir thoroughly and gargle in a warm form.

Prophylaxis of chronic tonsillitis

Includes general hygiene and sanative( cleansing) measures.The most significant result is hardening.A big role is played by a diet that excludes hot and cold hot dishes.

Compliance with the rules of home hygiene reduces allergic and bacterial factors.Sanitation of the tonsils is performed by a doctor, which must be visited twice a year.If necessary, the doctor will make therapeutic procedures, appoint immunomodulators, which have a very effective result in the prevention of exacerbations of chronic tonsillitis.

Timely and qualitative treatment together with preventive measures give a positive prognosis of the disease.

Stepanenko Vladimir Alexandrovich, Surgeon