What are the symptoms of chronic tonsillitis?
Patients often have a history of sore throat, susceptibility to colds and acute tonsillitis attacks. Usually there are few conscious symptoms, but there may be throat discomfort, foreign body sensation, irritating cough, bad breath or slight pain. In children with excessive tonsillar hypertrophy, there are often symptoms such as poor breathing, snoring, slurred speech and slow eating. Due to frequent swallowing of inflammatory secretions that stimulate bacteria in the gastrointestinal tract or crypt, toxins are absorbed causing systemic reactions, resulting in symptoms such as indigestion, loss of appetite, lethargy, easy fatigue, emaciation, headache, and low fever.
Symptoms of chronic tonsillitis – classification
1.Proliferative type Most often seen in children. Tonsillar lymphoid tissue hyperplasia, increased lymphoid follicles, increased connective tissue, chronic congestion and hypertrophy of tonsils.
2.Fibrotic type Most commonly seen in adults. The tonsil lymphoid tissue is atrophied, the interstitial fibrous scar tissue is proliferated, the crypt is blocked, and the tonsils become smaller and tougher.
The main lesion is deep in the tonsillar crypt, with chronic inflammation of the lymphatic follicles and scarring of the lymphatic tissue. The crypt is blocked by scar tissue and the drainage is poor, so that the crypt is obviously enlarged, or a large number of exfoliated epithelium, bacteria, lymphocytes and leukocytes gather to form a pus plug. It is also called chronic septic tonsillitis because it is prone to complications.
Symptoms of chronic tonsillitis – clinical manifestations
The main symptom is recurrent acute tonsillitis. Some patients have no obvious history of acute attacks. The symptoms are frequent pharyngeal discomfort, foreign body sensation, dryness, itching, irritating cough, and bad breath. Excessively enlarged tonsils in children can cause breathing, swallowing, and speech disorders. If accompanied by adenoid hypertrophy can cause nasal congestion, snoring and stopping symptoms of otitis media. Due to frequent swallowing of secretions and bacterial toxins in the crypt, it can cause indigestion, headache, weakness, and low fever.
Examination reveals chronic congestion of the tonsils, uneven and scarred tonsil surface, and involvement with surrounding tissues. Sometimes, the crypt opening is seen to be closed with yellowish-white dots, which are covered with phenanthrene mucosa or adhesions. There may be purulent or cheese-like secretions at the opening of the saphenous fossa, and the secretions spill out when squeezed. The lingual-palatal arch and pharyngopalatal arch are congested. The mandibular lymph nodes are enlarged. Roughly, there are four points as follows.
1.Recurrent episodes of sore throat: episodes of sore throat with pharyngeal discomfort and blockage after every cold, cold, exertion, poor sleep or stimulation by tobacco and alcohol.
2, bad breath: due to the reproduction and growth of bacteria in the tonsils and the residual purulent emboli in the tonsils, can often cause bad breath.
3.Tonsil enlargement: Mostly seen in children, enlarged tonsils can make swallowing difficult, slurred speech, poor breathing or snoring during sleep.
4. Systemic manifestations: Bacteria and pus plugs in the tonsils often enter the digestive tract with swallowing, thus causing indigestion. If bacterial toxins enter the body, the town has headache, weakness of the limbs, easy fatigue or low fever and other manifestations.
Symptoms of chronic tonsillitis – diagnosis
Based on medical history, local examination and laboratory tests. The general basis is.
(1) A history of recurrent acute tonsillitis ;
(2) chronic congestion of the tonsils and tongue and palate arch;
(3) uneven tonsil surface, scarring or yellowish-white dots, and discharge of secretions from the crypt opening when squeezed.
Symptoms of chronic tonsillitis – differentiation
(1) Differentiation from simple tonsillar hypertrophy: The size of the tonsils is not the only criterion to determine whether they have chronic inflammation, and many people with tonsillar hypertrophy do not show chronic inflammation, so whether they have chronic tonsillitis depends on the clinical features.
(2) Differentiation from tonsil tumors: tonsil tumors are seen in young and middle-aged people, mostly manifesting as unilateral tonsils that are significantly enlarged in a short period of time (mostly 3 months to 6 months). In this case, it is necessary to go to the hospital for examination in time to avoid delaying the disease.
Symptoms of chronic tonsillitis – treatment
Experts point out that surgery should not be considered once tonsillitis has set in. Surgery can be considered if the following situations occur.
1. Tonsillitis occurs more than three times a year for three consecutive years;
2.Tonsillitis more than 5 times a year for two consecutive years;
3. If there are more than two weeks in a year when you are unable to go to school or work because of tonsillitis attacks.
There are other cases that require surgical removal of the tonsils, such as tonsillar hypertrophy causing sleep disorders or preventing the child from swallowing food; patients with a history of peri-tonsillar abscesses; patients with recurrent tonsillitis complicated by rheumatic heart disease and rheumatoid arthritis or nephritis; unexplained fever caused by tonsils, etc.