What happens to the tonsils
The tonsils are penetrated by deep passages - lacunae. Normally they clean themselves. With chronic inflammation, the lacunae expand, dead cells, food debris and bacteria accumulate in them - the same caseous plugs are formed. The tonsil tissue is gradually replaced by scar tissue, and the organ ceases to perform a protective function.
Over time, the outbreak begins to affect the entire body: waste products of streptococcus and immune complexes affect the heart, joints and kidneys.
Symptoms
- Periodic or constant pain and sore throat, foreign body sensation
- White or yellowish plugs that come out on their own, with a strong unpleasant odor
- Bad breath that cannot be eliminated by hygiene
- Frequent sore throats - 2–3 or more times a year
- Permanently enlarged submandibular lymph nodes
- Fatigue, low-grade fever, decreased performance
Simple and toxic-allergic form
- Simple form: only local signs - pain, traffic jams, redness of the arches, enlarged lymph nodes. There is no general effect on the body. Treated conservatively
- Toxic-allergic form of the 1st degree: weakness, low-grade fever, joint pain, functional changes on the ECG
- Toxic-allergic form of degree II: persistent changes in the heart, joints, kidneys; associated diseases - rheumatism, glomerulonephritis, endocarditis
It is the shape, and not the size of the tonsils or the number of plugs, that determines the tactics. In grade II, the tonsils must be removed because they are already causing harm.
Survey
- Осмотр ЛОР-врача: оценка дужек, содержимого лакун, спаянности миндалин.
- Мазок of зева на флору и чувствительность к антибиотикам.
- Анализ крови: общий, СРБ, АСЛО (антистрептолизин-О), ревматоидный фактор.
- ЭКГ, при показаниях — эхокардиография.
- Общий анализ мочи для оценки состояния почек.
- Консультация ревматолога и кардиолога при подозрении на сопряжённые заболевания.
Conservative treatment
- Rinsing the lacunae of the tonsils in courses - washes out the contents; performed by a doctor using a syringe or vacuum method
- Local antiseptics and painkillers during exacerbations
- Physiotherapy: ultrasound, laser, ultraviolet irradiation as prescribed
- Sanitation of the oral cavity: treatment of caries and gum disease is a mandatory step
- Elimination of difficult nasal breathing: adenoids, deviated septum, chronic sinusitis
- Courses are usually held 2 times a year
When to remove tonsils
Tonsillectomy is not “removal of an immune organ,” as is commonly thought. In case of chronic inflammation of the second degree, tonsils no longer protect, but harm. The indications are quite specific:
- Toxic-allergic form of degree II
- Associated diseases: rheumatism, glomerulonephritis, infective endocarditis, psoriasis, vasculitis
- Frequent sore throats (7 times a year, or 5 times a year for two years in a row, or 3 times a year for three years in a row)
- Previous peritonsillar abscess
- Lack of effect from two or three courses of conservative treatment
- Marked enlargement of the tonsils with difficulty breathing and swallowing
Once removed, adults usually recover within 10–14 days. Immunity does not suffer: the function is taken over by the remaining elements of the lymphoid ring of the pharynx.
