Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

Tonsillitis

47,512 views

Published on

Published in: Health & Medicine
  • My partner says the difference is incredible! My partner has probably punched me a hundred times to get me to roll over and stop snoring. I have been using your techniques recently and now my partner has told me that the difference is incredible. But what has amazed me the most is how much better and more energetic I now feel after a good night's sleep! Thank you so much! ♥♥♥ http://t.cn/AigiCT7Q
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • Who Else Wants To Permanently Cure Their Uterine Fibroids and Achieve LASTING Freedom From PCOS Related Symptoms? learn more... ➤➤ https://tinyurl.com/rbqozdv
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • Discover How to Cure uterine fibroids and PCOS At Any Age, Even If You’ve Tried Everything And Nothing Has Ever Worked For You Before ♥♥♥ http://t.cn/Aig7bySW
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • DOWNLOAD FULL BOOKS, INTO AVAILABLE FORMAT ......................................................................................................................... ......................................................................................................................... ,DOWNLOAD FULL. PDF EBOOK here { https://tinyurl.com/yyxo9sk7 } ......................................................................................................................... ,DOWNLOAD FULL. EPUB Ebook here { https://tinyurl.com/yyxo9sk7 } ......................................................................................................................... ,DOWNLOAD FULL. doc Ebook here { https://tinyurl.com/yyxo9sk7 } ......................................................................................................................... ,DOWNLOAD FULL. PDF EBOOK here { https://tinyurl.com/yyxo9sk7 } ......................................................................................................................... ,DOWNLOAD FULL. EPUB Ebook here { https://tinyurl.com/yyxo9sk7 } ......................................................................................................................... ,DOWNLOAD FULL. doc Ebook here { https://tinyurl.com/yyxo9sk7 } ......................................................................................................................... ......................................................................................................................... ......................................................................................................................... .............. Browse by Genre Available eBooks ......................................................................................................................... Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult,
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • Unique Acne System, How to get lasting acne freedom clear skin e-book reveals all ▲▲▲ https://tinyurl.com/ybbtmvh8
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here

Tonsillitis

  1. 1. TONSILLITISDEPT OF OTORHINOLARYNGOLOGY JJM M C DAVANAGERE
  2. 2. ANATOMY OF PALATINE TONSIL Paired structures situated in lateral wall of oropharynx between anterior and posterior pillars Consists of two surfaces (medial and lateral) and two poles (upper and lower) Medial surface is covered by non keratinizing stratified squamous epithelium There are 12-15 crypts on the medial surface Largest crypt is called crypta magna or intratonsillar cleft
  3. 3. ANATOMY OF PALATINE TONSIL Lateral surface of tonsil presents a well defined fibrous capsule Loose areolar tissue lies between the tonsillar bed and the capsule, it is the site for collection of pus in peritonsillar abscess (Quinsy) Upper pole of tonsil extends into soft palate, its medial surface is covered by semilunar fold plica semilunaris Lower pole of tonsil is attached to the tongue, triangular fold of mucous membrane extends from anterior pillar to antero-inferior part of tonsil enclosing plica triangularis Tonsil is seperated from the tongue by tonsilo- lingual sulcus
  4. 4. ANATOMY OF PALATINE TONSIL
  5. 5. TONSILLAR BED Formed by Loose areolar tissue containing paratonsillar vein Pharyngo-basilar fascia Superior constrictor muscle Bucco-pharyngeal fascia Styloglossus Medial pterygoid muscle Glossopharyngeal nerve Facial artery
  6. 6. BLOOD SUPPLY OF TONSIL
  7. 7. LYMPHATIC DRAINAGE Lymphatics pierce the superior constrictor and drain into upper deep cervical (jugulo- digastric) node
  8. 8. FUNCTIONS OF TONSIL It is the component of inner waldeyer’s ring It has a protective role and acts as a sentinal at portal of air and food passage Crypts increase the surface area for contact with foreign substances
  9. 9. ACUTE TONSILLITIS Mostly affects children in the age group of 5-15 years, may also affect adults Organisms  beta-hemolytic streptococci (most common), staphylococci, pneumococci, H.influenzae Symptoms: sore throat, difficulty in swallowing, fever, ear ache, constitutional symptoms
  10. 10. ACUTE TONSILLITIS-TYPES Acute catarrhal/superficial  here tonsillitis is a part of generalized pharyngitis, mostly seen in viral infections Acute follicular  infection spread into the crypts with purulent material, presenting at the opening of crypts as yellow spots Acute parenchymatous  tonsil in uniformly enlarged and congested Acute membranous  follows stage of acute follicular tonsillitis where exudates coalesce to form membrane on the surface
  11. 11. Acute catarrhal/superficial
  12. 12. Acute follicular
  13. 13. Acute membranous
  14. 14. SIGNS Halitosis Coated tongue Congestion of pillars, soft palate and uvula Jugulo-digastric nodes enlarged and tender Tonsils are congested and enlarged depending on type of acute tonsillitis
  15. 15. TREATMENT Bed rest Plenty of oral fluids Analgesics Antimicrobial therapy penicillin In case of penicillin sensitivity macrolides are given
  16. 16. COMPLICATIONS chronic tonsillitis peritonsillar abscess parapharyngeal abscess cervical abscess acute otitis media rheumatic fever acute glomerulo nephritis sub acute bacterial endocarditis
  17. 17. DIFFERENTIAL DIAGNOSIS OF MEMBRANE OVER THE TONSIL Membranous tonsillitis Diphtheria Vincents angina Infectious mononucleosis Agranulocytosis Leukaemia Traumatic ulcer Aphthous ulcer malignancy
  18. 18. CHRONIC TONSILLITIS Aetiology: Complication of acute tonsillitis Sub clinical infection of tonsil Chronic sinusitis or dental sepsis Mostly affects children and young adults
  19. 19. TYPES OF CHRONIC TONSILLITIS Chronic follicular tonsillitis Chronic parenchymatous tonsillitis : tonsils are very much enlarged uniformly and may interfere with speech, deglutition and respiration, long standing cases may develop pulmonary hypertension Chronic fibroid tonsillitis
  20. 20. CLINICAL FEATURES recurrent attacks of sore throat chronic irritation in throat with cough halitosis dysphagia odynophagia thick speech
  21. 21. SIGNS Tonsil may show varying degree of enlargement depending on the type Irwin-moore sign pressure on the anterior pillar expresses frank pus or cheesy material  mainly seen in fibroid type Flushing of the anterior pillar compared to rest of the pharyngeal mucosa Enlargement of the jugulo-digastric node  soft non tender
  22. 22. TREATMENT conservative management tonsillectomy
  23. 23. COMPLICATIONS Peritonsillar abscess Parapharyngeal abscess Retro pharyngeal abscess Intra tonsillar abscess Tonsillar cyst Tonsillolith Focus of infection for RF, AGN
  24. 24. Peritonsillar abscess
  25. 25. STYALGIA (EAGLE’S SYNDROME) Due to elongated styloid process or calcification of stylohyoid ligament Patient complains of pain in tonsillar fossa and upper neck which radiates to ipsilateral ear It gets aggravated on swallowing Diagnosis is by transoral palpation in tonsillar fossa X-ray Townes view is helpful in diagnosis Treatment is by excision of styloid process by transoral or cervical approach

×