Chronic tonsillitis is a common and frequent disease in otolaryngology, mostly caused by recurrent episodes of acute tonsillitis or due to recurrent bacterial and viral infections in the tonsillar crypts.
I. Clinical manifestations are.
1. In acute attacks, it is manifested as sore throat, painful swallowing, fever, etc. At this time, the tonsils are acutely congested and purulent secretions are attached to the surface.
2, usually non-acute attacks can be no obvious discomfort, but can also be manifested as dryness, itching, foreign body sensation, irritating cough and bad breath in the pharynx. When the tonsils are too enlarged, it can cause snoring, difficulty in swallowing and abnormal speech resonance. Some patients may also experience recurrent low-grade fever, indigestion and headache. At this time, the tonsils are chronically congested and sometimes yellow dotted pus plugs are seen in the crypt.
Possible complications of chronic tonsillitis include rheumatoid arthritis, rheumatic fever, heart disease, and nephritis. Once these complications have occurred and the tonsils are then removed, these morbidities do not alleviate themselves or heal on their own.
II. Treatment.
1.Non-surgical treatment.
(1) In addition to antibiotic treatment, immunotherapy can also be used, using bacterial products with desensitizing effect, such as streptococcal allergens and vaccines for desensitization, the effect remains to be clinically observed.
(2) Local drug application, crypt irrigation, laser and other treatments, but the effect is not satisfactory.
(3) Physical exercise to enhance physical fitness and resistance to disease, but the effect is limited.
2.Surgical treatment
(1)The cases suitable for surgical treatment are
(1) Chronic tonsillitis with recurrent acute attacks and more than 4 attacks per year can be considered for surgery; peri-tonsillar abscesses occur several times.
(2) Those with tonsillar hypertrophy affecting breathing and swallowing (one of the main causes of pediatric snoring is tonsillar hypertrophy, which causes persistent brain hypoxia of varying degrees during sleep, reducing sleep quality and affecting learning and memory).
(3) Those with chronic tonsillitis causing systemic complications such as rheumatism and nephritis.
(2) Contraindication to surgery
①In acute attacks of tonsillitis, it is advisable to remove the tonsils after 2 to 3 weeks after the inflammation has subsided.
(2) Those with abnormal blood clotting mechanism;
③People with serious systemic diseases;
④Women with premenstrual period, menstrual period and pregnancy.