Treatment Of Chronic Tonsillitis Research Articles

Disturbance of intracardiac hemodynamics in children with chronic rheumatic cardiac disease.

By means of Doppler echocardiography there have been studied disturbances of intracardiac hemodynamics in 44 children aged 8-17 years with chronic rheumatic cardiac disease and developed mitral aortal and combined heart defects, as well as in chronic rheumatic cardiac disease without developed valvar defect. Differential approach has been defined to administration of inhibitors of angiotensin-converting factor in rheumatic heart defects: developed insufficiency of mitral and/or aortal valves II-III stage leads to remodeling of the left heart portions with developing chronic insufficiency of blood circulation, being an index for prolonged, not less than a year usage of the angiotensin-converting factor. In the presence of isolated mitral regurgitation, I stage in children with chronic rheumatic cardiac disease usage of the angiotensin-converting factor may be cancelled due to insignificant disturbances of valvar hemodynamics and a small risk of developing blood circulation insufficiency. Timely sanation of chronic infection foci in nasopharynx (conservative and surgical treatment of chronic tonsillitis, adenoid vegetations, therapy of hemolytic streptococcus presence) decreases risk of developing rheumatic heart defect in children suffered acute rheumatic fever.

N-acetyl-β-hexosaminidase in chronic tonsillitis and tonsillar hypertrophy

Background: The concentration and specific activity of N-acetyl-β-hexosaminidase (HEX) in palatine tonsils with chronic tonsillitis and tonsillar hypertrophy give insight in tonsillar tissue remodeling and constitute a potential marker for diagnosis and treatment of chronic tonsillitis and tonsillar hypertrophy. Aim: Determining the concentration and specific activity of N-acetyl-β-hexosaminidase in palatine tonsils with hypertrophy and chronic tonsillitis. Methods: HEX activity was analyzed by the method of Marciniak et al. with p-nitrophenyl N-acetyl-β-glucosaminepyranoside as a substrate. Results: The concentration and specific activity of HEX in palatine tonsils in patients with tonsillar hypertrophy and chronic tonsillitis both in childhood and adulthood significantly increase in comparison to healthy individuals. Conclusions: Our data demonstrate the presence of HEX in palatine tonsils and indicate on significant increase of its concentration and specific activity. Based on content and specific HEX activity we suggest that tonsils with hypertrophy and chronic tonsillitis should be treated as identical unit irrespectively of age.

Bacterial identification and antibiotic susceptibility patterns of Staphyloccocus aureus isolates from patients undergoing tonsillectomy in Malaysian University Hospital

Diagnosis and treatment of chronic tonsillitis (CT) and recurrent tonsillitis (RT) are common problems seen in any otolaryngology clinic. Antibiotic therapy usually fails to prevent the recurrences of these infections leaving the patient with no choice but surgery (tonsillectomy). This study aims to identify the bacteriology of both tonsillar swabs and biopsies specimens among children and adult patients diagnosed with CT and RT (infected tonsils). In addition to obstructive sleep apnea (OSA) and tonsillar hypertrophy (TH) (non-infected tonsils) all undergoing elective tonsillectomy and to characterize the antibiotic susceptibility patterns of the most common isolate. A total number of 138 surgically removed palatine tonsils were collected from 72 patients. Six types of antibiotics were selected to test the susceptibility of Staphylococcus aureus isolates which are methicillin, gentamicin, erythromycin, cotrimoxazole, clindamycin and fusidic acid. The most common isolate was S. aureus (190 isolatre) followed by Haemophilus influenza (83), Streptococcus Group B (61), Haemophilus parainfluenza (33), Klebsiella pneumoniae (32), Streptococcus Group G (29), Streptococcus Group F (14), Streptococcus Group C (12), Pseudomonas aeruginosae (10) and Streptococcus Group A (9) and Streptococcus Group A (9). The number of S. aurues isolates in infected tonsils (RT and CT) was 145 (76.3%) while in noninfected tonsils (OSA and TH) was 45 (23.6%). Three susceptibility patterns were found among S. aureus isolates in all cases, (89.4%) susceptible to all the selected antibiotics, (10.6%) resistant to fusidic acid only, whereas 0.5% resistant to both methicillin and fusidic acid. There was a 30.5% difference in the type of bacterial isolates between tonsillar swab and biopsies. The high prevalence of S. aureus in patients with both infected and non-infected tonsils suggests that this bacterium might not be the aetiological agent of chronic and recurrent tonsillitis. In addition, the high susceptibility rate of methicilin among S. aurues isolates could be due to the fact that S. aurues represents part of the oropharynx normal flora. The increased rate of resistance 10.6% to fusidic acid among methicillinsusceptible S. aureus (MSSA) isolates makes this antibiotic a less potential drug of choice for patients with chronic and recurrent tonsillitis.

Expression of cyclooxygenase-1 and 2 in chronic tonsillitis

Prostaglandins are critical mediators of inflammation and affect both humoral and cell-mediated immune responses. Recent findings show that T and B cells express COX-2 upon activation. The purpose of this study is to investigate the potential occurrence of COX-1 and COX-2 immunoreactivity in cases of chronic tonsillitis and to determine the sites of their expression. In addition, their expression in adult patients is compared with that in child patients. Immunohistochemical techniques were used to evaluate the expression of the enzymes COX-1 and COX-2, in chronic tonsillitis tissue specimens from adults (n = 15) and children (n = 15). There was no staining in surface epithelium or reticulated crypt epithelium. COX-1 and COX-2 expressions were observed mainly in the intraepithelial lymphoid cells in reticulated crypt epithelium and subepithelial cells. Also, COX-1 and COX-2 stained cells were found in the germinal center. There was no difference of the expressions of COX-1 and COX-2 among adults and children. The only significant difference noted between the adults and children was that, the adults had rich subepithelial plasma cells. Activated B and T cells express COX-1 and COX-2 in paraffin-embedded tissue sections of chronic tonsillitis. Further studies need to be performed to elucidate expression of COX enzymes and their immunologic role in tonsil diseases. They will play an important role in the treatment of chronic tonsillitis. Additional studies are warranted to study the effects of NSAIDs and selective COX-2 inhibitors in chronic tonsillitis.

Modification of a semi-surgical method for the treatment of chronic tonsillitis

It is known that in chronic tonsillitis caseous plugs are formed mainly in the lacunae of the first order, in their wide part, closer to the exit. The reason for the formation of stagnant pathological secretions and plugs in the lacunae is the difficulty of evacuation from them due to the narrowness of the mouth or its deformation after repeated inflammatory processes.

Radiological Treatment of Chronic Tonsillitis

Radiological Treatment of Chronic Tonsillitis