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Pembahasan mengenai tonsilitis serta penyakit-penyakit yang dapat terjadi pada adenoid secara lebih lanjut
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The Nasopharyngeal Tonsil
• It is a mass of sub-epithelial lymphoid tissue present at the junction between the roof & posterior wall of the nasopharynx
• The free surface has 6 folds• It has no capsule• It is covered by pseudo-
stratified columner epithelium
• It drains to the Retropharyngeal lymph nodes Upper Deep Cervical Lymph Nodes
The palatine tonsil has a capsuleon its lateral surface
which separate the lateral wall
from the bed The palatine tonsil
is covered by stratified columner epithelium
The palatine tonsil drains to The Jagulodigastric lymph nodes below the angle of the mandible
Adenoid
• Hypertrophy of the nasopharyngeal onsil sufficiently to produce symtoms
Definition Age Causes of enlargement
2 -12 years
• Physiological enlargement : at 3-7 years• Pathological: recurrent upper respiratory
tract infection
Symptoms
- Bilateral Nasal Obstruction
- Mouth Breathing- Snoring & OSA- Speech hyponasality- Difficult suckling
• Bilateral Nasal discharge- Mucoid or mucopurulent
discharge WHY? Due to blockage of the choanae
- Excoriation of the nasal vestibule & upper lip
- Post nasal discharge causing frequent nocturnal cough
Rhinolalia clausa(speech hyponasality)
الباء مثل الميم ينطق
تفرز األنف أن تعلم هلمن ونصف لتر الي لتر حوالييوميا المخاطي السائل
لألنف الخلفي االنسداد حالة في يحدث ماذمن للنزول تتحول الكمية هذه كل
لألنف االمامية الفتحة
Signs
• Posterior Rhinoscopy difficult• Digital palpation not pleasant • Endoscopic examination the best
Investigations
• Lateral soft tisue X ray of the nasopharynx
It is not the size of the
nasopharyngeal tonsil which is
important but the size of the
mass in relation to the
nasopharyngeal space
Complications
1- OSAS:- During Sleep:- During day time2- Descending infection3- ِ Adenoid Facies Morning headache
Impaired concentrationExcessive day-time sleepiness
Recurrent OMPharyngitis, Laryngitis, bronchitis
Restless sleep, Night mare, كوابيسNocturnal eneuresis
الارادي تبول
Idiot lookPinched nostrilShort upper lipProminent incisorHigh arched palate
وكل • وبيشخر فمه فاتح نايم الليل طول الطفلتاني وينام نفسه يأخد ويصحي يتوقف تنفسه شويه
قليل • وتركيزه نفسه علي نايم دايما وبالنهارالارادي • تبول وعنده
Treatment
Adenoidectomy operation
Acute tonillitisAcue inflammation of the palatine tonsils
Age: Any age but common in
children Etiology :- Beta hemolyic streptococci
- Streptococcus pneumonia
- Hemophylus influenza
Mode of transmissiondroplet infection
SymptomsRapid onset of - Fever, Headache, Anorrhexia, Malaise- Severe sore throat ± referred otagia- Halitosis
SignsGeneral :High Fever with flushed face
PharyngealAcute follicular tonsillitisAcute membranous tonsillitisAcute parynchymatous tonsillitis
CervicalEnlarged tender jugulo-digastric
lymph nodesThe crypts of the tonsils are full of purulent exudateGiving yellow spots on the tonsils
The yellow spots may Coalease to form a Yellow membrane
Marked hyperemia and enlargement of the tonsils
Acute follicular T. Acute membranous T Acute parynchymatous T
Complications
Local:- Peritonsillar abscess- Parapharyngeal abscess- Retropharyngeal abscess
Systemic- Rheumatic fever (carditis
and arthritis)- Acute glomerulonephritis
Quinzy
Treatment
Antibiotics: 10 dayes
Rest
Ample fluid intake
Cold compresses
Analgesic Antipyretics
Gargles
Chronic TonsillitisChronic inflammation of the palatine tonsils
Etiology :
Repeated attacks of acute tonsillitis
Symptoms: one or more of the following
- History of repeated attacks of AT- Irritation in the throat- Foetor oris
If hypertrophic- Difficult swallowing- Obsrtuctive sleep apnea
Signs:Pharyngeal - Asymmetry of the size of
the tonsils- Hypertrophy of the tonsils- The crypts ooze pus on
pressure by tongue depressor
- Hyperaemia of the anterior pillars
Cervical Persistent enlargement of
jagulodigastric lymph nodes
Treatment of Chronic Tonsillitis
Surgical By
Tonsillectomy operation