chronic tonsillitis palatine tonsils

1. CHRONIC TONSILLITIS

2. Aetiology
 Complication of acute sinusitis
Subclinical infection of tonsils
Chronic infection of sinuses or teeth
 Mostly affects children and young adults ,
rarely occurs after 50yrs

3. TYPES
1.Chronic follicular tonsillitis – Tonsillar crypts
are full of infected cheesy material, shows
yellowish spots on surface

4. 2.Chronic parenchymatous tonsillitis
Hyperplasia of lymphoid tissue
Tonsils are very much enlarged,may
interfere with speech,deglutition and
respiration
Long standing cases develop features
of cor pulmonale

5. 3.Chronic fibroid tonsillitis
Tonsils are small but infected,with history
of repeated sore throats

6. CLINICAL FEATURES
• Recurrent attack of sore throat or acute
tonsillitis
• Chronic irritation in throat with cough
• Bad taste in mouth and foul breath(halitosis)
• Difficulty in swallowing and choking spells at
night

7. EXAMINATION
• Tonsils may show varying degree of
enlargement
• There may be yellowish beads of pus on
medial surface of tonsil
• Tonsils are small but pressure on anterior
pillar expresses frank pus or cheesy
material

8. • Flushing of anterior pillars compared to
rest of the pharyngeal mucosa
• Enlargement of jugulodigastric
lymphnodes

9. TREATMENT
• Conservative treatment - attention to
general health,diet,treatment of
coexistent inefction of teeth,nose and
sinuses
• Tonsillectomy - tonsils interfere with
speech,
deglutition and respiration

10. COMPLICATIONS
1.Peritonsillar abscess
2.Parapharyngeal abscess
3.Intratonsillar abscess
4.Tonsilloliths
5.Tonsillar cysts

11. TONSILLOLITHS(calculus of the tonsil)
• Seen in c/c tonsillitis
• when crypt is blocked with retention of
debris
• Inorganic salts of Ca and Mg are then
deposited  stone formation
• Gradually and then ulcerate through tonsil

12. • It give rise to local discomfort or
foreignbody sensation
• Diagnosed by palpation or gritty feeling
on probbing
• Treatment- simple removal of stone or
tonsillectomy

13. INTRATONSILLAR ABSCESS
• Accumulation of pus within the substance of
tonsil
• It usually follows blocking of crypt opening in
Acute follicular tonsillitis
• There is marked local pain and dysphagia
• Treatment – Antibiotics,drainage of abscess

14. TONSILLAR CYST
• It is due to blockage of tonsillar crypt and
appraer as a yellowish swelling over the
tonsil
• Usally symptomless

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