Pathology of inflammation around the tonsils

2021-01-31 12:00 AM

The purulent inflammation around the tonsils can rupture on their own, drain pus into the throat and leave hard, cramping scars. Pus can also pass through the throat wall into the anterior chamber or under the jaw, causing inflammation around the throat.

Concept

Perioral tonsillitis is inflammation of a loose connective tissue outside the tonsils sheath. The disease is common in teenagers and young people. However, older people sometimes suffer.

Reason

The disease usually occurs due to an inflammation in the side mainly due to tonsillitis, sometimes due to gingivitis ...

Derived from the inflammatory foci next to spread by the way that the lymph infiltrates the surrounding tonsils, causing inflammation around the tonsils. There is a slit at the top of the tonsils called the slit (Sinus Tourtual), which is easy to infect and spreads downwards. Sometimes, infections in the base of the tongue also cause inflammation around the tonsils

Diagnose

Implementing the quadrants

Fever 38-39 0 C, tired people, infected face.

Clear sore throat, often pain spread to the ears, increased pain when opening the mouth, when swallowing, the patient has stagnant saliva in the mouth, bad breath. Especially only on one side of the throat.

Jaw enlarged and painful in one or both sides.

Examination of the throat: red throat mucosa, redness and swelling of the throat wall Depending on the location of the pustule there are:

The anterior upper body: most commonly, the pus in the upper anterior region around the tonsils makes the pharynx and a third on the anterior pillar swollen, stretch, soft, encroach into the throat. The tongue is also heavy, stiff, and pushed to the opposite side. The diseased side tonsils are large, pushed inward and downward, partially covered in the free face, and the rest have patches of pus or white pseudomembranous.

The posterior body: the pus in the back of the tonsils makes the posterior pillar swell, irritate and push into the throat. The tonsils are pushed forward, causing difficulty swallowing, painful swallowing, noticeably spreading to the ears.

The lower body: the pus is below the tonsils, often causing inflammation of the tonsils of the tongue, so in addition to the swelling, swelling on one side of the tonsils, we also see the base of the tongue, the vocal folds of the tongue are also red, the cartilage is down. partially filled the larynx. Patients often have markedly increased pain when swallowing, tongue movements, speechlessness and mild difficulty breathing.

Differential diagnosis

Stage II syphilis: red but painless swelling, BW (+).

Female tonsillar tonsil cancer damages the entire surface of the tonsils and invades the surrounding organization.

Developments

The purulent inflammation around the tonsils can rupture on their own, drain pus into the throat and leave hard, cramping scars. Pus can also pass through the throat wall into the anterior chamber or under the jaw, causing inflammation around the throat.

Causing complications of blood vessels such as septicaemia, thrombophlebitis or rupture of blood vessels in the tonsils (very rare).

The purulent inflammation around the tonsils often recurs, sometimes as soon as a few weeks, especially in people with weakened atopic.

To solve

When inflammation is not a pus sac: simple treatment with high-dose antibiotics, at the same time with nebulizer, throat.

When pus bags have formed: need to inject pus: local anaesthesia with Xylocaine 6% or 1% Lidocaine.

Use a small, sharp knife to poke at the bulge, pull it down along a parallel line with a 1-cm long tonsil pillar, then use a Lubet-Barbon clamp to deepen, spread the edges for pus to drain or suck. You can let a piece of wick or rubber drain from the pus out of your throat.

After pus removal, high doses of antibiotics should be given for 10 days and monitored. If the pus is tight and swollen, it is necessary to re-ball to remove the pus.

To avoid relapse, tonsillectomy should be performed after a few weeks when the purulent inflammation has stabilized.