Treatment of chronic tonsillitis in children
The content of the article:
- Features of the development and course of the disease
- Symptoms of chronic tonsillitis in children
-
How to treat chronic tonsillitis in children
- Medication and physiotherapy
- Surgical intervention
- Folk remedies
- Video
Chronic tonsillitis in children most often develops between the ages of 5 and 10 years, it can recur several times a year. The disease is an infectious-allergic inflammatory process that affects the lymphoid tissue of the tonsils. They are located on either side of the back of the throat and filter germs that, if inhaled, provoke infection. The antibodies produced by the tonsils prevent the development of inflammation, but when bacteria or viruses attack, they become inflamed and enlarged - tonsillitis occurs.
If symptoms of the disease appear, you should consult an ENT or pediatrician
The disease can occur in two forms - acute and chronic. In the first case, the tissues of the oropharynx are affected, in which the focus of inflammation is formed. Often it appears after an acute respiratory viral infection, when the protective function of the tonsils is reduced. The child complains of pain when swallowing or yawning, he has intoxication and a high body temperature.
Features of the development and course of the disease
Children with a hereditary predisposition or immunodeficiency are at risk for chronic tonsillitis. The most common causes of pathology are bacteria and viruses, namely:
- streptococci;
- Epstein-Barr virus;
- adenoviruses;
- influenza and parainfluenza virus;
- enteroviruses;
- herpes simplex virus.
Most often, the disease is caused by bacteria and viruses, in particular the influenza virus
The chronic form develops after relapses, when acute inflammation in previous times has not been completely stopped. The reasons in this case may be:
- histological and anatomical and topographic features of the tonsils;
- the presence of vegetation conditions in microflora crypts;
- chronic diseases in the nasal cavity, mouth and paranasal sinuses (sinusitis, dental caries and others).
According to Dr. Komarovsky, with the development of the disease in children, especially 2–3 years old, first of all, it is worth paying attention to the factors that led to a decrease in local immunity at such an early age: where the child constantly encounters viral infections, they are so adequately treated what are the air conditions in the room where he most often spends his time (humidity, temperature, dust).
Timely begun therapy aimed at eliminating the cause of the inflammatory process, usually completely stops its manifestations within 1 week. Incorrectly selected treatment or its absence can lead to the development of complications in the form of otitis media, sinusitis, rheumatism, glomerulonephritis, and weight gain.
The code for chronic tonsillitis according to ICD-10 in children, as in adults, is J35.0 (class X - respiratory diseases, rubric - other diseases of the upper respiratory tract).
To clarify the diagnosis at the first signs of pathology, you should contact an otolaryngologist or pediatrician. The doctor, if tonsillitis is suspected, examines the patient's anamnesis, conducts an examination, palpation of the cervical lymph nodes and pharyngoscopy, which allows you to visually examine the pharyngeal mucosa. If necessary, he takes a photo of the throat.
To make a diagnosis, the doctor conducts an examination and pharyngoscopy
To distinguish the disease from similar ones - tuberculosis of the tonsils and chronic pharyngitis, differential diagnosis is carried out.
In addition, the doctor may prescribe tuberculin tests, blood cultures for sterility, X-ray of the paranasal sinuses, ultrasound of the kidneys, echocardiography and electrocardiography.
Symptoms of chronic tonsillitis in children
The main symptoms of chronic tonsillitis are:
- frequent exacerbations of pathology in the form of angina (3-5 times a year) with hypothermia, overwork, starvation, viral or bacterial infection;
- dryness of the mucous membrane of the pharynx;
- foreign body sensation in the throat and pain when swallowing;
- a periodic increase in body temperature to subfebrile values (37.1–38.0 ° C);
- bad breath;
- soreness and enlargement of the mandibular lymph nodes;
- headache, rapid fatigue, decreased body resistance;
- hyperemia, thickening, swelling of the palatine arches and tonsils, in some cases - the presence of lacunar plugs.
An exacerbation is indicated by the appearance of tonsillitis, which is accompanied by a sharp increase in body temperature, intoxication, sore throat, severe swelling and redness of both the tonsils and palatine arches. Depending on the individual characteristics of the patient, the etiology of the disease and the treatment used, the symptoms of exacerbation of chronic tonsillitis may vary.
How to treat chronic tonsillitis in children
First of all, the doctor prescribes the child to bed rest, a sparing diet with the exclusion of fatty and spicy foods, as well as an abundant warm drink. With insufficient fluid intake, it is possible to add signs of dehydration in the form of headaches, exhaustion of the body and fatigue. Parents are advised to maintain the required level of humidity in the children's room and exclude smoking in the vicinity of the child.
In the children's room, you need to maintain optimal humidity and temperature
If the doctor has prescribed medications, it is important to strictly follow his instructions and not change the dosage regimen on your own. This is especially true for antibacterial drugs, which are used only in the most severe cases with bacterial etiology of the disease. Inpatient therapy is only required for children who have not been helped by oral antibiotics.
Medication and physiotherapy
To alleviate the symptoms of the disease, in most cases, prescribes local drug treatment, namely:
- washing the tonsils with antiseptics - Chlorophyllipt, Iodinol;
- lubrication of the tonsils and the posterior pharyngeal wall with Lugol's or Fukortsin's solution;
- rinsing with saline solutions;
- cold inhalation with a nebulizer;
- throat irrigation with Ingalipt antiseptic aerosol;
- resorption of tablets with antimicrobial action - Septolete, Faringosept.
Cold inhalation with a nebulizer is effective for tonsillitis
For the effective treatment of chronic tonsillitis, physiotherapy methods are widely used:
- ultra-high-frequency therapy (UHF): the effect is directed at the tissues and lymph nodes surrounding the tonsils, which leads to a decrease in inflammation;
- ultrasound therapy: promotes relief of inflammation in the tonsil area, activation of reactions in the tissues of the tonsils and the synthesis of immunoglobulins;
- ultraviolet radiation: therapy is aimed at sanitizing the tonsils; usually performed in combination with UHF therapy;
- laser irradiation: affects directly the tonsils, sanitizing them; thanks to therapy, the blood supply to the surrounding tissues improves, their swelling decreases.
Surgical intervention
Since the tonsils protect the body from the penetration of infections, viruses and bacteria into the lower parts of the respiratory system, only in extreme cases they resort to their removal - tonsillectomy. It is justified for a child if:
- conservative treatment was ineffective;
- relapses of pathology are noted from 5 times a year;
- symptoms recur throughout the year;
- the development of complications is recorded from the side of internal organs.
If the treatment is ineffective, surgery may be prescribed
Traditionally, tonsillectomy is performed under general anesthesia for 30–45 minutes using a scalpel. However, there are other methods for removing tonsils, namely:
- extracapsular tonsillectomy: performed with surgical blades to cut the tonsil. This method allows you to remove them together with the capsule and open paratonsillar purulent foci;
- diathermy: the tonsils are removed by radio frequency energy and the tissue around them is destroyed. This method can be performed in addition to extracapsular tonsillectomy;
- ablation: unlike diathermy, less painful surgery. It is carried out using a low temperature;
- excision of the tonsils with laser beams: allows you to minimize tissue swelling and reduce the likelihood of bleeding;
- excision of the tonsils using ultrasound waves: a method similar to laser excision. It is characterized by low blood loss and minimal damage to the tissues surrounding the tonsils;
- bipolar radiofrequency ablation: an ionized layer is formed through radiofrequency bipolar energy, which separates molecular bonds without heat. The level of tissue trauma, recovery period and possible complications are minimal.
Which of these methods to use, the surgeon decides on an individual basis. The average recovery period after surgery is 10 to 14 days. Pain relievers are used during the first week. To prevent re-infection with the infection during this period, it is recommended to exclude the child from visiting crowded places.
Folk remedies
According to the appointment of an otolaryngologist, alternative medicine recipes can be used for the treatment of pathology in children.
Beet broth can be used to treat pathology.
Recipes for folk remedies for the treatment of chronic tonsillitis:
- propolis syrup: 3 tbsp. tablespoons of crushed natural propolis are mixed with 3 tbsp. tablespoons of butter and melted in a water bath. The resulting liquid is thoroughly mixed, cooled to body temperature and add 1 tbsp. a spoonful of honey. The finished composition is transferred to glassware and stored in the refrigerator. After thorough rinsing of the oral cavity from mucus and food residues, the child is allowed to dissolve ½ teaspoon of the product 3 times a day. According to reviews, the product tastes good and effectively relieves inflammation;
- garlic drops: 2.5 tbsp tablespoons of finely chopped garlic are mixed in a glass container with the same amount of refined vegetable oil, tightly closed with a lid and rolled for 5 days in a cool dark place. Next, the product is filtered and the oil is carefully squeezed out of the garlic cake. Add 1 tbsp to the resulting liquid. a spoonful of lemon juice. In finished form, the composition is taken orally, 10 drops, 2 times a day;
- beet broth: 300 g of thoroughly washed beets are finely chopped together with the peel, pour 800 ml of water and simmer under a lid for 1 hour. The resulting broth is filtered and used for gargling after each meal;
- myrtle tincture: 200 g of fresh myrtle leaves are ground in a mortar and mixed in a glass container with 400 ml of ethyl alcohol. The container is closed with a lid and placed in a dark, cool place for 8 days. Rinse the throat with tincture, before using in children, 1 teaspoon of the product is diluted in 1 glass of water. The procedure is carried out 2 times a day for 30 days (no more).
If no improvement is observed within one month of using folk remedies, it is recommended to consult a doctor for other methods of treatment.
Video
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Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
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