Same signs and symptoms as acute Occurring in 4-7 separate episodes per year 5 episodes per year for 2 years 3 episodes per year for 3 years
Chronic tonsilitis
? Pathogen: recurrent acute tonsilitis ? Diagnosis: case history
Chronic Tonsillitis
Chronic sore throat Malodorous breath Presence of tonsilliths Peritonsillar erythema Persistent tender cervical lymphadenopathy Lasting at least 3 months
II. General
➢ chronic diseases…
Symptoms:
Sense as if there are foreign bodies in throat Itching throat Sense of dryness in throat Cough
Chronic simple pharyngitis chronic mucosal congestion
Acute Tonsillitis
Signs and symptoms:
– Fever – Sore throat – Tender cervical lymphadenopathy – Dysphagia – Erythematous tonsils with exudates
Recurrent Acute Tonsillitis
✓c test ✓ blocking test
Acute adenoiditis
Symptoms include:
– Purulent rhinorrhea – Nasal obstruction – Fever – Associated Otitis Media
Pharyngology
(EENT Hospital of Fudan University)
Anatomy of pharynx
Nasopharynx Oropharynx Laryngopharynx
Nasopharynx
top and posterior: adenoid
lateral: Eustachian tube
anterior bottom
Laryngopharynx
vallecula epiglottica pyriform sinus postericoid space
Laryngopharynx
Retropharyngeal and parapharyngeal space
Waldeyer’s ring
Pharyngitis
Acute Chronic Atrophic
Pathogen Pathology Symptoms Signs Diagnosis & differentiated diagnosis Complications Therapy
Pathogen(acute pharyngitis)
Inflammation
Treatment :
Antibiotics
Pathogen(chrnoic pharyngitis)
I. Regional
➢ recurrent acute pharyngitis ➢ chronic upper respiratory tract
infection ➢ physical & chemical stimulation ➢ occupational
Chronic hypertrophic pharyngitis chronic mucosal congestion + hyperplasia of lymphoid tissues
Treatment:
Remove of pathogeny Chinese medicine
Pathogen(atrophic pharyngitis)
rheumatism
Therapy: antibiotics
Acute Tonsilitis
Pathogen: --hemolytic streptococci
anaerobe mixed infection
Pathology: catarrhal
purulent (follicular+lacunar)
Chronic tonsilitis
? Pathologic mechanism that the infected tonsil becomes a focus
✓ Allergy Ⅲ
Chronic tonsilitis
? How to identify whether or not the infected tonsil is a focus?
I. Virus:
➢ Coxsackie …
II. Bacteria
➢ A --hemolytic streptococci…
III. Physical and chemical stimulation
Congestion Swelling Fever Sore throat Dysfunction
Atrophic rhinitis
Adenotonsillar disease
Major divisions are:
– Infection/inflammation – Obstructive – Neoplasm
Acute Tonsilitis
Symptoms: general+regional Signs: Complications: peritonsillar abscess…