Atrophic pharyngitis: treatment, causes, symptoms
The content of the article:
- Development reasons
- Symptoms of atrophic pharyngitis
-
Diagnostics
Differential diagnosis
- Treatment of atrophic rhinitis
- Video
Atrophic pharyngitis is a chronic inflammatory disease of the pharyngeal mucosa. The prevalence in adults is 5% of all pathologies of the ENT organs. Therefore, an important task is to find and eliminate the causes of the disease.
The disease is manifested primarily by dryness, sore throat and sore throat.
The development of dystrophic changes in the mucous membrane of the pharynx is associated with endogenous and exogenous causes. Pharyngitis can be not only an independent disease, but also develop as a consequence of diseases of the gastrointestinal tract: chronic atrophic gastritis, cholecystitis, pancreatitis, gastric ulcer and duodenal ulcer. Pharyngitis is often caused by gastroesophageal reflux, in which the acidic contents of the stomach pass into the esophagus and pharynx.
Development reasons
The main factors contributing to the development of atrophic pharyngitis:
- anatomical features of the structure of the mucous membrane of the pharynx and gastrointestinal tract;
- long-term exposure to various environmental factors: dust, smoke, hot and dry air, chemicals;
- mouth breathing due to difficulty breathing through the nose;
- long-term use of vasoconstrictor drops that drain from the nasal cavity into the pharynx and have an anemic effect;
- injury or burns to the throat;
- foci of chronic infection in the nasal cavity, paranasal sinuses, oral cavity;
- foreign bodies of the upper respiratory tract;
- alcohol abuse;
- the presence of allergies;
- avitaminosis;
- endocrine system pathology;
- diabetes;
- heart, pulmonary and renal failure.
Smoking and tonsillectomy often lead to atrophic changes in the pharyngeal mucosa. Also, a decrease in local and general immunity plays an important role.
The development of dystrophic changes in the mucous membrane of the pharynx may be associated with its injuries or burns
Morphologically, the disease is characterized by the following changes:
- the number of epithelial layers decreases;
- the layer of stratified squamous non-keratinizing epithelium becomes thinner;
- the size and number of glands decreases;
- desquamation (desquamation) of the epithelial layer occurs;
- collagen fibers thicken, the space between them decreases.
Symptoms of atrophic pharyngitis
The symptoms of the disease are:
- dryness, perspiration, burning and sore throat;
- feeling of a lump in the throat, which provokes a persistent dry cough;
- bad breath;
- change the timbre of the voice.
The disease is characterized by a feeling of a lump in the throat, which leads to the appearance of a persistent dry cough
The mucus on the back wall forces you to swallow often, which causes constant discomfort in the throat. When coughing, mucus and crusts may separate.
For chronic atrophic pharyngitis, an increase in body temperature is not typical. The general condition of the patient is usually not affected, but symptoms can interfere with daily life and interfere with sleep.
Diagnostics
To diagnose the atrophic form of pharyngitis, a comprehensive examination is necessary, including instrumental and laboratory research methods.
In order to assess the state of microcirculation of the mucous membrane of the posterior pharyngeal wall, laser Doppler flowmetry is used
With pharyngoscopy, pathology is characterized by the following signs:
- thinning and dryness of the pharyngeal mucosa;
- change in the surface of the mucous membrane, it becomes pale pink, shiny, injected by vessels;
- the presence of crusts that form when the mucus that covers the walls of the larynx dries.
During pharyngoscopy, you can take a photo for further comparison and tracking the dynamics of recovery.
Cytological examination reveals inflammatory and degenerative changes in the mucous membrane of the posterior pharyngeal wall. At the 1st degree of dystrophy, focal accumulations of lymphocytes and plasma cells are a characteristic feature. Histiocytes and tissue neutrophilic leukocytes accumulate around the vessels. At II and III degrees of dystrophy, sclerotic changes in the lamina propria of the pharyngeal mucosa increase, the number of fibroblasts decreases, the vessels are unevenly located. In comparison with healthy tissues, the blood circulation in the vessels decreases during the atrophic process.
Laser Doppler flowmetry is used to assess the state of microcirculation of the mucous membrane of the posterior pharyngeal wall at different degrees of pharyngeal dystrophy.
Differential diagnosis
With persistent sore throat that does not respond to therapy, it is necessary to carry out differential diagnostics with some systemic diseases and pathologies of the nervous system:
- Plummer-Vinson syndrome, or sideropenic dysphagia: occurs against the background of iron deficiency anemia;
- Sjogren's syndrome: an autoimmune disease accompanied by dryness of the mucous membrane of the gastrointestinal tract and an increase in the salivary glands;
- Stilalgia syndrome: characterized by one-sided pain in the throat as a result of lengthening of the styloid process of the temporal bone;
- neuralgia of the glossopharyngeal or vagus nerve.
Treatment of atrophic rhinitis
Therapy should be aimed at eliminating the causes of the disease, improving blood flow in tissues and increasing local immunity.
One of the methods of therapy is inhalation with mineral water, decoctions of medicinal herbs
Drinks and foods that irritate mucous membranes are excluded from the diet: cold, hot, spicy, salty and sour foods.
Treatment of concomitant somatic diseases, such as pathologies of the gastrointestinal tract, is carried out. This requires the consultation of related specialists.
Alkaline and oil rinses, inhalations with mineral water are prescribed. Mucus and crusts can be washed off daily with isotonic sodium chloride solution. With a large number of crusts, inhalations with proteolytic enzymes are used. Inhalation and gargling with a solution of sea salt, warm infusions of chamomile, calendula, sage, eucalyptus are considered useful. To do this, you can use a nebulizer - an apparatus that converts a medicinal solution into an aerosol.
It is recommended to lubricate the back of the pharynx with Lugol's solution, and also to use emollient ointments and oil drops in the nose: Retinol, Pinosol, olive, peach oil.
To eliminate severe symptoms of burning, dryness, paresthesia, novocaine blockade is prescribed in the lateral parts of the posterior pharyngeal wall, often in combination with the introduction of aloe.
In order to restore the mucous membrane, the following are recommended: Solcoseryl, Actovegin, vitamins A and E, iron preparations.
To activate local immunity, use Lizobakt, IRS-19, Imudon. Bacterial lysates, which are part of these agents, increase the protective properties of the pharyngeal mucosa. To increase general immunity and during an exacerbation of inflammation, it is advisable to use systemic immunomodulators: Likopid, Galavit.
Achieve long-term remission in the treatment of all degrees of degeneration of the pharyngeal mucosa allows the drug Dalargin, which is a synthetic neuropeptide. After application anesthesia with 10% Lidocaine solution, 1 ml of 0.001% Dalargin aqueous solution is injected into the submucosal layer. The procedure promotes tissue repair and improves microcirculation.
It is possible to use platelet-rich plasma. The method is aimed at activating the regeneration of the pharyngeal mucosa under the influence of growth factors and other biologically active substances contained in platelet alpha granules, which stimulate the formation of new vessels. Platelet-rich plasma is injected into the submucosa of the upper and lower posterior pharyngeal wall.
Physiotherapeutic methods of treatment play an important role:
- electrophoresis of potassium iodide or nicotinic acid in the submandibular region;
- exposure to infrared laser.
Hardening is one of the effective methods of disease prevention
Preventive measures include:
- timely detection and treatment of chronic foci of infections and somatic diseases;
- rejection of bad habits;
- increasing immunity by hardening and playing sports;
- improving working conditions when exposed to harmful factors;
- use of air purifiers and humidifiers.
Video
We offer for viewing a video on the topic of the article.
Alina Ervasova Obstetrician-gynecologist, consultant About the author
Education: First Moscow State Medical University. THEM. Sechenov.
Work experience: 4 years of work in private practice.
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