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Chronic tonsillitis in children
Last reviewed: 04.07.2025
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[ Causes of chronic tonsillitis in children
The main role in the etiology of chronic tonsillitis belongs to hemolytic streptococcus group A, staphylococcus, adenoviruses, fungal flora. Hereditary predisposition, repeated respiratory infections, etc. are important in the development of the disease.
Pathogenesis of chronic tonsillitis
Repeated tonsillitis, prolonged contact of the infectious agent with the tonsil tissue against the background of local and general immunological reactivity lead to disruption of the tonsil structure. Desquamation or keratinization of the epithelium occurs, infiltration by polymorphonuclear leukocytes, which migrate into the lacunae, where dense plugs are formed. In the parenchyma of the tonsils, foci of softening of the lymphoid tissue or massive proliferation of connective tissue - sclerosis - appear.
The tonsils normally participate in the implementation of local and general immunological protection of the body, which, therefore, suffers in the presence of chronic tonsillitis. A chronic source of infection formed in the tonsils has a significant impact on the development of many severe somatic, so-called metatonsillar, diseases: rheumatism, kidney disease, vasculitis.
Symptoms and diagnosis of chronic tonsillitis in children
The diagnosis is established based on complaints (a feeling of dryness, tingling, a foreign body when swallowing) and objective examination data (scar adhesions between the tonsils and arches, cicatricial changes and compaction of the tonsils, thickening and hyperemia of the arches, the presence of caseous plugs in the lacunae, enlargement of regional lymph nodes). The listed complaints and objective examination results are characteristic of compensated chronic tonsillitis.
In the decompensated form of the disease, repeated tonsillitis, paratonsillitis, fatigue, subfebrile temperature, and signs of metatonsillar diseases are observed.
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Treatment of chronic tonsillitis in children
During exacerbation, antibacterial therapy is carried out taking into account the sensitivity of the isolated microflora. Antiseptics for local use (pharyngosept, sebidin, calendula infusions, romazulan, etc.), local anti-inflammatory drugs (tantum verde) are used. During the remission period, lavage of the tonsil lacunae, local anti-inflammatory therapy, UF and laser irradiation of the tonsils are carried out. It is advisable to carry out a 2-week local treatment with IRS-19, which increases the content of lysozyme and stimulates phagocytosis, increases the synthesis of secretory IgA.
In the decompensated form of chronic tonsillitis, surgical treatment is indicated - tonsillectomy. Before surgical treatment, a course of conservative therapy and oral cavity sanitation are carried out.
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