Chronic tonsillitis

Chronic tonsillitis is an illness that the medical profession often finds with young adults. Its development is latent and is often preceded by repeated sore throats or one that has healed badly. It can happen spontaneously.

Contributing factors:

  • Allergy
  • Poor mouth hygiene
  • Tobacco
  • Nasal infections or repeated sinusitis


SYMPTOMS

The symptoms are subtle and often overlooked by doctors. The patient can have problems swallowing, a tingling sensation, the feeling that there is a foreign body, all of which can cause pain.Twice or three times a year when there is retention or the temperature increases dysphagia becomes clearer. Some patients complain of a dry cough ( irritation of the superior laryngeal nerve) or cephalgia with a headache.

In most cases  it is the patient who notices the presence of small white concretions in the tonsil area: This can be evacuated but causes bad breath.

 

CLINICAL EXAMINATION AND DIAGNOSTIC.

It is often evident, one finds various sized tonsils of cryptal surface i.e. Covered by small cavities in which caseum grains get stuck. These can easily be taken out and the fetid character confirms this.

The  caseum  is made up of cellular debris, bacteria, food and fibrin fragments.
Sometimes the diagnostic of tonsillitis is more difficult, and the use of  a foam rubber instrument is necessary to push back the front part  of the tonsil.
If tonsillitis is doubtful a little pressure can be applied with a protected finger to raise the caseum or even  the pus which means that real intra-tonsilluar abcesses are present.
Finally but more rarely, one can find cysts around the tonsils due to the occlusion of a tinsillar crypt with with caseum coated with an odd nauseus liquid.
Its clinical appearance is one of a yellowish mark or translucent stain around the tonsil.

The rest of the laryngology examination is normal as are supplementary examinations.

EVOLUTION

This is done using several methods.
Sometimes easily endured, there are often some various unforeseen pharyngeal incidents which are painful such as throat clearing or aphonia, all continuous with seasonal upsurges.

General disorders such as headaches and tiredness may occur.

Digestive troubles (regurgitation and stomach pains).

Finally chronic tonsillitis can be the origin of an infection of a heart valve.

TREATMENT

The treatment of tonsillitis that I recommend is CO2 laser treatment which is carried out under local anesthetic in my doctor's office.. Several sessions are necessary. It is possible to reduce the size of the tonsil in two or three sessions.  This volumetric reduction is often enough to solve the problem.

                                                    
LASER TREATMENT OF CHRONICE TONSILLITIS

This is a technique I have used for over 20 years.
The CO2 laser seems to me to be the most efficient tool to cure tonsillitis. Hemostasis and the method of healing means there is no risk of hemorrage.

Using a laser beam eliminates the need to put an instrument in the mouth which means there will be no nausea and reduces patient anxiety;

TECHNIQUE

Using the CO2 laser technique for tonsillectomy is simple because it is performed under local anesthetic and in my doctor's office. The session lasts about fifteen minutes and as the patient can works afterwards there is no leave from work.

During the session the entire tonsil area is vaporized which is possible due to the precision of the laser beam so as to achieve progressive peeling of the tonsil session after session. The idea is to obtain a sufficient volumetric reduction of the tonsils.
Three or four sessions are required depending on the size of the tonsils. The sessions will be spaced over three weeks.

After the last session there should be no trace of the tonsil; just  a bit of fibrosis tissue.

The sessions themselves are not painful but there is slight pain after the first session.  There is no comparison with the pain felt had the tonsils been removed by classical surgery. In any case efficient anti-inflammatory pills and pain killers are prescribed.

In the days following the session the tonsil area is covered with a white fibrin coating which disappears in a week.

One is advised not to take aspirin before or after the session.
Finally this technique can be extended  for the treatment of recurrent angina to patients who refuse surgery or who are allergic to anesthetics.