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Chronic tonsillitis in children
Last reviewed: 23.04.2024
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[Pathogenesis of chronic tonsillitis
Repeated sore throats, prolonged contact of the infectious agent with the amygdala tissue against the background of local and general immunological reactivity lead to a breakdown in the structure of the tonsils. Desquamation or keratinization of the epithelium occurs, infiltration of polymorphonuclear leukocytes, which migrate into lacunae, where dense plugs are formed. In the parenchyma of the tonsils there are foci of softening of the lymphoid tissue or massive proliferation of connective tissue - sclerosing.
Tonsils normally participate in the local and general immunological defense of the body, which, consequently, suffers in the presence of chronic tonsillitis. The chronic foci of infection, formed in the tonsils, has a significant effect on the development of many severe somatic, so-called metatonsillar diseases: rheumatism, kidney disease, vasculitis.
Symptoms and Diagnosis of Chronic Tonsillitis in Children
Diagnosis is established on the basis of complaints (sensation of dryness, tingling, foreign body when swallowing) and objective examination data (cicatricial adhesions between the tonsils and arches, cicatricial changes and consolidation of the tonsils, thickening and hyperemia of the arches, the presence of caseous stoppers in lacunae, an increase in regional lymph nodes) . The above complaints and the results of an objective examination are typical for compensated chronic tonsillitis.
With a decompensated form of the disease, repeated angina, paratonzillitis, fatigue, subfebrile temperature, signs of metatonzillar diseases are noted.
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Treatment of chronic tonsillitis in children
With an exacerbation, antibacterial therapy is performed taking into account the sensitivity of the isolated microflora. Use antiseptics for topical application (pharyngosept, sebidin, calendula infusions, romazulan, etc.), anti-inflammatory drugs of local action (tantum verde). In the period of remission, lacunae of tonsils, local anti-inflammatory therapy, CUF and laser irradiation of tonsils are washed. It is advisable to conduct a 2-week local treatment with IRS-19, which increases the lysozyme content and stimulates phagocytosis, increases the synthesis of secretory IgA.
With the decompensated form of chronic tonsillitis, surgical treatment is indicated - tonsillectomy. Before surgical treatment, a course of conservative therapy, sanation of the oral cavity is carried out.