Chronic tonsillitis

Tonsillitis is a very common type of inflammation, especially chronic tonsillitis, which is caused by the accumulation of some bacteria in the tonsils. Tonsillitis has a great impact on us and can cause symptoms such as fever and sore throat. Generally, chronic tonsillitis is caused by acute tonsillitis, and chronic tonsillitis has a greater impact on our physical health and requires active treatment.

Chronic tonsillitis is very common. It is usually caused by the failure to treat acute tonsillitis in a timely manner or the incomplete treatment. Chronic tonsillitis can cause cough, fever, and discomfort in the throat, so it must be diagnosed and treated in a timely manner.

Chronic tonsillitis is caused by the accumulation of bacteria and secretions in the tonsillar fossa. These accumulated bacteria continue to secrete toxins, which spread throughout the body through the vascular network around the glandular crypts. Therefore, tonsils become the lesions of many systemic diseases such as rheumatic fever, nephritis, etc., which is also where their harm lies. Chronic tonsillitis is often caused by repeated attacks of acute tonsillitis. Chronic tonsillitis may occur after suffering from acute infectious diseases (such as scarlet fever, measles, influenza, diphtheria, etc.), and sinus infections in the nasal cavity may also be associated with this disease. The most common pathogens are streptococci and staphylococci.

In chronic tonsillitis, the epithelium in the crypts necrotizes and falls off, and bacteria and inflammatory exudates accumulate in them. Small ulcers and scars may form in the crypts, resulting in poor drainage, which is suitable for bacterial growth and reproduction, making the infection difficult to eliminate. Repeated episodes of acute tonsillitis reduce the body's resistance or if treatment is not thorough, it is more likely to become a chronic disease. The mechanism of this disease is still unclear, but in recent years, based on the immunological viewpoint, it is believed that autoallergic reaction is an important mechanism causing chronic tonsillitis.

1. According to its pathological changes, it can be divided into three types.

1. The hyperplastic type is more common in children. Tonsillar lymphoid tissue hyperplasia, increased lymph follicles, increased connective tissue, and chronic congestion and hypertrophy of the tonsils.

2. The fibrous type is more common in adults. The tonsil lymphoid tissue atrophies, the fibrous scar tissue proliferates in the interstitium, the crypt openings are blocked, and the tonsils become smaller and tougher.

3. The main lesions of the crypt type are deep in the tonsillar crypts, the lymph follicles are chronically inflamed, and the lymphatic tissue is scarred. Because the crypt opening is blocked by scar tissue and drainage is poor, the crypt may be significantly enlarged, or a large number of desquamated epithelium, bacteria, lymphocytes and white blood cells may gather to form pus plugs. Because the disease is serious and complications may easily occur, it is also called chronic septic tonsillitis.

2. Clinical manifestations

Patients often have sore throat, are prone to colds and have a history of acute tonsillitis. Usually, there are fewer subjective symptoms, which may include throat discomfort, foreign body sensation, irritating cough, bad breath or slight pain. Children with enlarged tonsils often have symptoms such as difficulty breathing, snoring, slurred speech and slow eating. Due to frequent swallowing of inflammatory secretions, the gastrointestinal tract or bacteria in the crypts are stimulated, and toxins are absorbed, causing systemic reactions, leading to symptoms such as indigestion, loss of appetite, fatigue, easy fatigue, weight loss, headache, and low fever.

Examination revealed chronic congestion of the palatine arches and tonsils, and the mucosa was dark red. Tonsils are often inflammatoryly adhered to the anterior and posterior tonsils; the surface may be smooth, uneven, or lobed. Linear scars, enlarged crypt openings, and caseous plugs or yellowish-white spots under the mucosa may sometimes be seen. Use a tongue depressor to squeeze the tonsils on the outside of the palatoglossal arch, and secretions may overflow from the crypt opening. Enlarged lymph nodes can often be felt under the angle of the mandible.

Diagnosis

Examination may reveal chronic congestion of the tonsils, uneven surface, scars, and involvement with surrounding tissues. Sometimes the crypt openings are closed and appear as small yellow-white dots, covered with a thin mucosa or adhesions. There may be purulent or cheesy secretions at the opening of the crypt, which overflow when squeezed. The palatoglossal and pharyngeal arches are congested. Swollen lymph nodes in the jaw.

When chronic tonsillitis has caused systemic complications, the levels of immunoglobulin A, immunoglobulin G and mucin in the serum are often abnormally elevated, the reactive protein test is often positive, the titer of antistreptolysin "O" is increased, and the erythrocyte sedimentation rate is often accelerated. Through immunohistochemical examination, amino acid quantification, and high levels of α2 protein in serum, it is of great significance for focal tonsillitis. Using electron microscopy and serum fluorescent antibody examination, the quality changes of tonsil formation (IgG dominant) can be identified in tonsil tissue sections. If it can be determined that such changes are mainly located in the crypt-lymphoid stroma (the latter does not have this function under normal circumstances), there is sufficient evidence to prove the presence of latent or active lesions in the palatine tonsils.

Preventive Care

1. Patients with chronic tonsillitis should develop good living habits, ensure adequate sleep time, add or remove clothes in time with weather changes, and remove humid air indoors. These are all important. Sick children should develop good habits of not being picky about food and not overeating.

2. Keep exercising to improve the body's ability to resist disease. Do not overwork. If you feel tired, you should adjust and rest in time. Quitting smoking and drinking is an important step in preventing chronic tonsillitis.

3. Acute tonsillitis should be cured thoroughly to avoid future problems.

4. Prevent all kinds of infectious diseases and epidemics. Liquid or semi-liquid food. If the fever is high, use alcohol bath to help reduce the temperature.

5. Active treatment of acute tonsillitis can prevent this disease.

Chronic tonsillitis has become very common. If you have chronic tonsillitis, you must be able to develop good habits in your daily life. You must ensure good sleep, pay attention to adding or removing clothes in time, and avoid some indoor moisture in time. It is also important to exercise regularly. Only when your physical fitness is good can you get sick less often.