What Is Chronic Tonsillitis?

Chronic tonsillitis usually changes from recurrent acute tonsillitis to chronic. Acute infectious diseases (such as scarlet fever, measles, flu, diphtheria, etc.) can cause chronic tonsillitis. Sinus infections in the nasal cavity can also accompany the disease. The most common pathogens are streptococcus and staphylococcus. Clinical manifestations are often symptoms of pharyngeal discomfort, foreign body sensation, dryness, itching, irritating cough, and bad breath.

Basic Information

Visiting department: ENT
Common locations: tonsil

Common causes: Bacteria and secretions accumulate in the tonsil fossa, allergic to itself
Common symptoms: Recurrent sore throat, bad breath, tonsil enlargement, etc.

Causes of chronic tonsillitis

Caused by the accumulation of bacteria and secretions in the tonsil fossa. Autologous allergies may also be the cause.

Clinical manifestations of chronic tonsillitis

Recurrent sore throat

Every time a cold, cold, tired, poor sleep or irritated by tobacco and alcohol, sore throat, and pharynx discomfort and feeling of blockage.

2. Bad breath

Due to the multiplication of bacteria in the tonsils and the purulent emboli remaining in the tonsils, they can often cause bad breath.

3. Swelling of tonsils

More common in children, hypertrophic tonsils can make swallowing difficult, have slurred speech, have trouble breathing, or burp during sleep.

4. Whole body performance

Bacteria in the tonsils, pus plugs often enter the digestive tract with swallowing, thereby arching indigestion. If bacterial toxins enter the body, there may be headaches, limb weakness, fatigue or low fever.

Examination of chronic tonsillitis

Examination revealed chronic congestion of the tonsils, unevenness of the tonsil surface, scars, and adhesions to surrounding tissues. Occasionally, the crypts were closed with small yellowish-white dots and covered with phenanthrene thin mucosa or adhesions. There may be purulent secretions or casein-like secretions at the opening of the crypt, and the secretions overflow when squeezed. Congestion of the lingual arch and pharyngeal arch. Mandibular lymphadenopathy. In addition, the tonsil challenge test, the dynamic observation of serum anti-streptolysin "O", anti-streptokinase and anti-hyaluronidase titers have certain reference significance for diagnosis.

Diagnosis of chronic tonsillitis

It should be comprehensively analyzed based on medical history, local and systemic examinations, and mutual reference.

Differential diagnosis of chronic tonsillitis

Keratosis of tonsil

Excessive keratinization of the tonsil crypt mouth epithelial cells, shaped like yellow-white horny or pointed grit-like keratin, which is hard to touch, has a firm foundation, cannot be wiped off, may have no obvious conscious symptoms, or feel pharynx or foreign body , Can occur at the same time in the posterior pharyngeal wall, pharyngeal tract and tongue base. The course of the disease is longer, mostly occurring in young people before the age of 30. The cause is not clear, and generally does not require special treatment.

2. Tonsilloma

The rapid enlargement of the tonsil on one side or swollen tonsils with ulcers should consider the possibility of tumors. Such as tonsil sarcoma, early can be confined to the tonsil mucosa, the surface is smooth, the main symptoms are rapid enlargement of the tonsil on one side, often with cervical lymph node metastasis, more common in young people, biopsy can confirm the diagnosis.

3. Symptoms of tonsil hypertrophy

It is a local manifestation of some systemic diseases. For example, in the case of leukemia, the tonsils may be swollen symmetrically. Sometimes pharynx symptoms can be their first symptoms. Diagnosis is based on peripheral blood and bone marrow images.

Complications of chronic tonsillitis

Chronic tonsillitis not only causes infection of adjacent organs due to the spread of inflammation, such as otitis media, sinusitis, larynx, trachea, bronchitis, etc., but also one of the most common infections in the human body. It is also associated with acute nephritis and rheumatoid arthritis. , Rheumatic fever, heart disease, chronic low fever and other diseases are closely related.

Treatment of chronic tonsillitis

General treatment

(1) Keep your mouth clean . Brush your teeth before bedtime and rinse your mouth after meals to reduce the chance of bacterial infection in your mouth.

(2) You can use iodine tablets for gargle method , 1-2 tablets each time, 3 to 4 times daily. Rinse with fresh salt water is simple and convenient. Take a cup of warm water after meals and before going to bed, add a little salt, and taste salty. Repeat the mouthwash for about 5 minutes each time.

(3) Vitamin C can be taken for a long time, 1 tablet each time, 3 times a day. Physical weakness is often prone to authors and should be used under the guidance of a doctor to improve the body's immune function. Do not abuse anti-inflammatory drugs during non-acute episodes.

(4) Physical exercise Participate in physical exercise to enhance physical fitness and disease resistance.

2. Choice of surgical treatment

(1) Excessive hypertrophy of the tonsils, which prevents breathing and swallowing.

(2) Repeated acute attacks, more than 4 to 5 times per year, with a history of abscesses around the tonsils.

(3) Those with long-term low fever and no pathological changes except tonsillitis.

(4) Nephritis, rheumatism and other diseases caused by tonsillitis should be selectively operated under the guidance of a doctor.

3. Not suitable for surgery

(1) Acute inflammation and the period of suffering from acute diseases, upper respiratory infections and epidemics.

(2) Patients with hematopoietic diseases, hypocoagulation, hypertension, heart disease, tuberculosis, etc. are not suitable for surgery.

(3) Women do not undergo surgery during the menstrual period and 3 to 5 days before menstruation.

(4) Patients with dry or atrophic pharyngitis may not be operated if it is not necessary, otherwise, the symptoms of pharyngeal inflammation will increase.