Lesions of the oropharynx. Diseases of the oropharynx: diphtheria, candidiasis, leptotrichosis of the oropharynx. A new format for developing leaders in the dental industry

The functions performed by the pharynx are quite diverse: it is involved in the process of digestion (swallowing food), breathing and voice formation. Therefore, any inflammatory processes that affect the throat affect the functioning of the entire body as a whole. Not to mention the significant discomfort that the patient experiences when the pharynx is inflamed. What are the types of pharyngitis and how to properly treat the disease to prevent the development of complications?

Pharyngitis: classification

Pharyngitis is one of the most common diseases of the pharynx, manifested in inflammation of the mucous membranes of the pharynx and its lymphatic tissues. Patients often confuse the manifestations of a sore throat with pharyngitis and begin to treat a completely different ailment. However, you should know that with angina, the inflammatory process spreads to the tonsils, and pharyngitis affects the mucous membrane.

Despite the fact that the pathology has only two forms of development, there are quite a lot of varieties of this disease. In most cases, the disease develops along with other diseases, so the causes of its occurrence must be identified among them: injuries, colds, caries, sinusitis, rhinitis, etc.

Classification of pharyngitis

There are two forms of pharyngitis: acute And chronic. The acute type develops as an independent pathology, however, sometimes it can be accompanied by an infectious disease (chickenpox, measles, etc.) or ARVI. This type of pharyngitis occurs after eating spicy or hot food, hypothermia, and also as a result of the fact that a person has inhaled dust or vapors. The classification of acute pharyngitis is determined by the type of pathogen.

There are the following types of illness:

The course of chronic pharyngitis is less acute; there are no signs such as a feeling of weakness, fatigue, or fever. Mucus formed in the larynx interferes with normal coughing, resulting in a person constantly coughing.

If chronic pharyngitis is not treated for a long time, the disease develops into one of three forms: catarrhal, atrophic or hypertrophic.

Catarrhal form is the most common type of pharyngitis. Its appearance is caused by the penetration of pathogenic bacteria and viruses into the pharynx.

The main cause of pharyngitis, both acute and chronic, is infection. According to statistics, in 70% of cases the main pathogens are viruses. A pathogenic virus, as a rule, is associated not only with the respiratory system. In fact, the source of infection may be in the stomach, intestines and other organs. For example, in adults the infection is often localized in the genitourinary system. Therefore, among the causative agents of pharyngitis there are gonorrheal, chlamydial and candidal types of harmful microorganisms. The initially emerging viral factor subsequently provokes the development of bacterial damage.

Hypertrophic form is caused by a secondary growth of the mucous membrane on old areas, as a result of which the doctor identifies granules or ridges on the back wall of the pharynx.

At atrophic form areas of the mucous membrane atrophy, and the whole process is accompanied by a feeling of soreness and dryness in the throat. With timely treatment, the symptoms of the disease intensify.

Causes of the disease

Typically, pharyngitis develops as a result of exposure to the following factors:

• development of inflammatory and cold processes;
• excessive consumption of ice cream;
• hypothermia;
• viral or fungal infection;
• hormonal imbalances;
• decreased immunity;
• endocrine disorders.

Chronic pharyngitis, as a rule, affects people employed in hazardous work, as well as heavy smokers.

In addition, the development of the disease can be triggered by the following factors:

• caries;
• regular consumption of spicy, salty and spicy foods;
• chronic stomach diseases, causing belching, heartburn;
• absence of tonsils or their inflammation;
• inflammatory processes of a purulent nature in the sinuses;
• prolonged use of vasoconstrictor drugs.

All of the above reasons for the development of pharyngitis are typical mainly for the adult population. Children from 0 to 5 years old have very weak immune defenses, so the main culprits in the development of the disease in them are viruses and bacterial infections. In addition, a child may develop pharyngitis due to advanced forms of tonsillitis, rhinitis, laryngitis and other chronic diseases of the nasopharynx.

Pharyngitis: symptoms and treatment

Acute pharyngitis is manifested by the following symptoms:

For chronic pharyngitis Body temperature, as a rule, does not increase. Patients report the following symptoms:

• dry throat;
• soreness;
• burning, scratching, or tickling sensation in the throat;
• cough;
• pain when swallowing;
• the need to constantly cough up viscous mucus.

Symptoms atrophic type pharyngitis manifested by severe dry throat. The mucous membrane of the pharynx is thinned, in some cases it is covered with dried mucus. Sometimes injected vessels can be seen on the mucous membrane. With hypertrophic pharyngitis, foci of hyperplastic lymphoid tissue are observed on the posterior wall of the pharynx. It is also possible that the tubopharyngeal ridges may become enlarged. In case of exacerbation of the disease, the above symptoms are accompanied by swelling of the mucous membrane and hyperemia.

In children, in addition to a constant dry cough with chronic pharyngitis, there is a symptom such as wheezing. Therefore, when making a diagnosis, a specialist must accurately differentiate this condition from bronchial asthma. The treatment method is determined by the cause of the disease, so you should not self-medicate.

Signs of pharyngitis in children

In children, the course of pharyngitis is very severe, especially for children under one year old. Sometimes in babies with acute pharyngitis body temperature rises to critical levels(40 degrees). Due to severe pain in the affected throat, the child refuses to eat. Swelling of the mucous membrane can cause an attack of suffocation. Often, an inflammatory process in the pharynx in a child can lead to the development otitis media in acute form.

Under no circumstances try to treat your baby yourself, as this can lead to serious consequences. At the first symptoms of acute pharyngitis, the child must be urgently hospitalized.

Possible complications

Although pharyngitis is not considered a dangerous disease, in the absence of timely and adequate treatment, quite serious complications may develop, among which the following can be noted:

• Chronical bronchitis;
• laryngitis;
• acute articular rheumatism;
• perintosillar abscess, the development of which is caused by streptococcal pharyngitis;
• tracheitis.

With chronic pharyngitis, the timbre of the voice changes. In addition, a person’s quality of life decreases, since he is deprived of the opportunity to communicate for a long time due to the appearance of symptoms such as sore throat and dry throat.

Treatment

When treating pharyngitis, medications are first prescribed, the action of which is aimed at relieving the symptoms of an exacerbation of the disease. Today, the pharmacological industry has an extensive list of medications that can cope with the disease on an outpatient basis.

Treatment with medications should be started only after an examination by an ENT doctor, who will make an accurate diagnosis and prescribe appropriate therapy.

Principles of disease treatment

The method of treating the disease is determined by the type and stage of pharyngitis.

For mild forms of the disease complex therapy is not required. It is only necessary to carry out local treatment and take preventive measures.

Preventive measures in this case consist of eliminating external provoking factors. Equally important is giving up bad habits, eating a balanced diet, and limiting exposure to the cold.

In later stages of pharyngitis An integrated approach is required, which consists of antibacterial or antiviral therapy. In addition, the following actions are carried out:

• strengthening the immune system and tissue restoration;
• symptomatic therapy (painkillers, anti-inflammatory and other medications);
• exclusion of possible relapses of exacerbation;
• disease prevention.

Therapeutic measures include physiotherapy, local therapy (solutions, compresses, lozenges, medicinal sprays, etc.), drug therapy (tablets, injections), and restorative measures.

Drug therapy for inflammation of the pharynx

In advanced forms of the disease, drug therapy is used, the effect of which is aimed at eliminating the pathogen and resolving purulent formations. The most effective method was shown by a complex method with the simultaneous use of the following types of drugs:

• vitamin complexes;
• sulfonamides;
• antibiotics that act on a specific type of pathogen.

The following medications are used to suppress streptococci:

In combination with these antibiotics, tablets with antihistamine properties are prescribed: Diazolin, Suprastin. And also antifungal agents: Nystatin, Livolin, Ketoconazole. To restore immunity - Cycloferon, Levamisole, Immunal.

Acute pharyngitis requires the use of medications that help reduce inflammatory activity and relieve pain. For this purpose, drugs such as Naproxen, Ibuprofen or Paracetamol are prescribed.

Local therapy

Particular attention in the treatment of pharyngitis is paid to local therapy, which uses medications in the form of lozenges, lozenges, aerosols, inhalations and gargles. The composition of the medicinal products includes sulfonamides, antibiotics (Framycetin, Fusafyungin), vitamins (ascorbic acid), anesthetic components (menthol, tetracaine, lidocaine), essential oils, antiseptics (alcohols, iodine-containing compounds, benzidamine, Thymol, Chlorhexidine, Ambazol).

Recently, products based on plant extracts, bacterial lysates (Imudon), and synthesized components that provide protection to the mucous membrane (Interferon, Lysozyme) have been widely used. Sprays (aerosols) are also widely used in the local treatment of pharyngitis. Such drugs have local analgesic, antiseptic and anti-inflammatory properties. The aerosol composition must be kept in the mouth until swallowed with saliva for at least three minutes.

• Inhalipt. A product based on thymol, sulfonamide, mint and eucalyptus oils.
• Theraflu Lar based on benzoxonium chloride and lidocoine.
• Tantum Verde. The drug is based on benzydamine hydrochloride. The product is available in the form of aerosols and lozenges. Particularly effective against viral pathogens.
• Cameton. The drug contains eucalyptus oil, levomenthol, camphor and chlorobutanol.
• Hexoral spray. The active ingredient is hexethidine.
• Stopangin. Contains essential oils of plant origin, Hexetidine, Levomenthol.

Local preparations in the form of lozenges, lozenges and lozenges are very convenient to use. Their composition and effectiveness are similar to sprays.

Inhalations and gargling

Inhalations and gargling solutions, which contain antibiotics together with antiseptic and anti-inflammatory substances, have shown a good therapeutic effect.

Among the most popular compositions are the following:

• Eucalymin. A solution based on eucalyptus extract. Used for inhalation.
• Bioparox. A solution based on fusafyngine. Used for inhalation.
• Rotacan and Vokadin - rinsing solutions.

Timely treatment of pharyngitis and compliance with all doctor’s recommendations will allow you to quickly cope with the disease and avoid possible complications.

Papilloma- a formation with a grayish tint, uneven edges and a granular surface, mobile, since most often it has a thin base (pedicle). The mucous membrane around the papilloma is not changed.
The final diagnosis is made based on the results of histological examination.

Frequent tumor of the oropharynx - hemangioma. It has many varieties, but in the middle part of the pharynx cavernous diffuse and deep capillary hemangiomas predominate. Branched venous or arterial vascular tumors can be found much less frequently.
Hemangioma in the middle part of the pharynx is somewhat less common than papilloma.
Deep capillary hemangioma is covered with unchanged mucous membrane, its contours are unclear.
In appearance, the tumor is difficult to distinguish from neuromas and other neoplasms localized in the thickness of the tissue. Cavernous and venous hemangiomas are most often located superficially. They are bluish, the surface of these tumors is lumpy, and the consistency is soft. Encapsulated cavernous
hemangiomas have clear boundaries. Branched arterial hemangioma, as a rule, pulsates, and this pulsation is noticeable during pharyngoscopy. The surface of the tumor may be lumpy. Arterial hemangioma must be differentiated primarily from an aneurysm (using angiography).
The boundaries of a hemangioma are difficult to determine. This is due to the fact that the tumor spreads not only over the surface, but also deep into the tissues, often reaching the neurovascular bundle of the neck, filling the jaw area or appearing as a swelling, often anterior to the sternocleidomastoid muscle.

Mixed tumor found in the middle part of the pharynx as often as hemangioma. It develops from the minor salivary glands. In terms of frequency of occurrence, this neoplasm is second only to papilloma. Due to its large polymorphism, it is usually called a mixed tumor or polymorphic adenoma. In the oropharynx, a mixed tumor can be localized in the thickness of the soft palate, on the lateral and, less commonly, on the posterior wall of the middle part of the pharynx. Since the tumor arises and develops deep in the tissues, on the surface of the walls of the pharynx it looks like a well-defined swelling of dense consistency, painless on palpation, with an uneven surface. The mucous membrane over the tumor is not changed. By appearance, it is not possible to distinguish a mixed tumor from other neoplasms of this localization (neurinoma, neurofibroma, adenoma). The final diagnosis is made based on the results of histological examination.

Tumors such as lipoma, lymphangioma etc., are rare in the middle part of the pharynx. Of these tumors, only osteoma can be diagnosed without histological examination. It is radiopaque, but the final diagnosis is still established based on the results of a histological examination, which makes it possible to determine the morphological structure of the tumor focus.

Clinical picture

Diagnostics

Instrumental studies

Malignant tumors

Clinical picture

Among malignant tumors of the oropharynx, neoplasms of epithelial origin predominate. Epithelial exophytically growing tumors have a wide base, their surface is bumpy, in places with foci of decay; pink color with a grayish tint. There is an inflammatory infiltrate around the tumor. The tumor bleeds easily when touched.

A tumor ulcer is quite often localized on the palatine tonsil. The affected tonsil is enlarged compared to the healthy one. A deep ulcer with uneven edges, the bottom of which is covered with a dirty gray coating, is surrounded by an inflammatory infiltrate.

Diagnostics

Laboratory research

Instrumental studies

Differential diagnosis

Treatment of patients with oropharyngeal tumors

There are many diseases that can affect the oropharynx area, but most of us are faced with only the most common of them - sore throat, laryngitis, pharyngitis, etc. However, there are also rarer diseases that, nevertheless, people encounter from time to time and are diagnosed by specialists in a wide variety of segments of the population. And it is important to know about them. Therefore, we will consider some of these diseases of the oropharynx - diphtheria, candidiasis, leptotrichosis of the oropharynx and talk about the features of these pathological conditions in a little more detail.

Diphtheria

This infectious disease develops as a result of an attack on the human body by a rod-shaped bacterium. The defeat of a person leads to the production of a particularly dangerous diphtheria toxin, which explains the pathogenic nature of this disease.
You can become infected with diphtheria from the same patient, or from a carrier of a toxigenic strain. In general, doctors distinguish several varieties of this disease, depending on the location of the pathological processes. In this case, diphtheria of the oropharynx is especially common. The patient experiences a sharp increase in temperature, his general condition worsens, and pain in the throat develops when swallowing. A fibrinous plaque of a grayish color appears on the surface of the tonsils, which becomes dense and smooth over time.

Rarely does plaque spread to other areas of the oral mucosa. In especially severe cases, the disease occurs in a toxic form, in which case the patient’s condition is extremely serious - his temperature increases greatly, headaches, vomiting, euphoria, delirium, etc. occur. Diphtheria films in this case spread throughout all parts of the oropharynx and can last up to two weeks. This type of disease is fraught with various kinds of complications and is difficult to treat.

Treatment of diphtheria involves the introduction of a special anti-diphtheria serum and detoxification therapy. All patients and people suspected of developing this disease should be taken to the infectious diseases department. The main feature of diphtheria is the absence of sore throat and, most often, a relatively low temperature.

Candidiasis

This disease is familiar to many as a common female disease. However, its pathogens - fungi - can affect not only the genitals, but also the oral cavity. Doctors say that such pathological processes always occur as a result of reduced immunity - with various forms of immunodeficiency, cancer and chronic diseases, prolonged use of antibiotics, and diseases of the endocrine system. Quite often, oral candidiasis is diagnosed with the so-called natural immunodeficiency, which is observed in newborns, pregnant women, and the elderly.

With the development of the acute form of the disease, the surfaces of the mucous membranes of the oral cavity, larynx and lips become covered with a whitish coating. It can be easily eliminated, and underneath is smooth, inflamed mucosa. In some cases, plaque is difficult to remove, and the surfaces underneath are damaged and painful. If candidiasis proceeds according to the atrophic type, the mucous membranes are painted in bright red fiery tones, and the white coating may be completely absent. At the same time, patients complain of pain. The chronic type of the disease is accompanied by the appearance of a white or yellowish coating, which is extremely difficult to separate, and bleeding surfaces are observed underneath it.

Pathological processes lead to burning and pain in the mouth; patients also complain of severe discomfort and constant dryness. Therapy is carried out using antifungal compounds, as well as by taking measures to increase immunity. Patients are also advised to adhere to dietary nutrition and not self-medicate.

Leptotrichosis of the oropharynx

This pathological condition is quite often diagnosed in children in the absence of proper hygienic care for the oral cavity. The disease develops due to an attack of the body by special iron-containing bacteria. In most cases, the disease is provoked by a decrease in the overall resistance of the body. Pathological processes lead to the active proliferation of leptotrichia, which causes the appearance of massive white deposits on the root of the tongue, as well as on the tonsils. Patients may complain of pain, a burning sensation, and patients often refuse food. In certain cases, leptotrichosis may be accompanied by candidiasis, which we already discussed above. Sometimes the disease does not make itself felt at all and is discovered only during a routine examination.

As for the treatment of such a disease, it is often difficult. In a certain percentage of patients, leptotrichosis goes away on its own, but it is often characterized by a persistent course and requires intensive care. Maximum effectiveness can be achieved by washing the lacunae with a solution of quinosol, as well as a solution of decaris and using such compositions for rinsing. A good result can also be achieved by performing cryotherapy - freezing individual affected areas. Many doctors also advise using different physiotherapeutic methods.

If you suspect the development of one of the ailments described above, you should consult a doctor.

Throat diseases are common in children and adults, since the larynx is the first filter after the nasopharynx through which all pathogenic microorganisms pass. Most pathologies have a similar clinical picture, but a different etiology. Treatment includes taking medications, using folk remedies and correcting nutrition.

The human throat is often affected by pathogenic microorganisms

List of throat diseases

The cause of a sore throat can be various pathogenic microorganisms, neoplasms, and mechanical damage. Often unpleasant sensations occur with a cold, flu, or acute respiratory viral infection.

The main causes of throat diseases:

• viral infections - rotaviruses, adenoviruses, enteroviruses provoke the development of pharyngitis, acute laryngitis;
• bacterial pathologies - develop against the background of active reproduction of streptococci, staphylococci, sore throat and tonsillitis are considered childhood diseases, most often these diseases are diagnosed at the age of 5–15 years;
• fungal diseases;
• various types of neoplasms - malignant tumors, papillomas, polyps, metastases in the pharynx;
• mechanical damage.

All infectious diseases of the throat, in addition to obvious pain when swallowing, are accompanied by other accompanying symptoms - body hyperthermia, loss of strength, muscle pain, migraine, rhinitis, swollen lymph nodes, increased salivation, the pharyngeal mucosa becomes red and loose.

A sore throat often develops in a child as a complication of colds and flu. You can see in the photo what a healthy throat and mucous membrane looks like in various forms of pathology. The ICD-10 code is J03, for the chronic form – J35.

Healthy human throat

Types of sore throat:

With phlegmonous sore throat, accumulations of pus appear

Tonsillitis

Inflammation of the palatine tonsils is a consequence of frequent sore throats and can occur in acute and chronic forms. Measles, scarlet fever, and diphtheria can provoke the development of the disease. The ICD-10 code is J03.

With tonsillitis, the tonsils become inflamed

Tonsillitis most often occurs without an increase in temperature, is accompanied by atrophy of the lymphoid tissue of the tonsils, and breathing problems occur against the background of hypertrophy.

The inflammatory process is localized in the mucous membrane of the larynx and occurs in acute and chronic forms. The disease develops from hypothermia, inhalation of cold or polluted air, or tobacco smoke. The ICD-10 code is J04.

Acute laryngitis is most often one of the symptoms of ARVI, influenza, whooping cough, scarlet fever, and develops with hypothermia, prolonged stay in a room with dusty air, against the background of addictions. The disease is characterized by a barking cough, but after a while sputum begins to be discharged, the person complains of a dry throat, the voice becomes hoarse and may disappear completely, and the temperature rises slightly.

Forms and symptoms of chronic laryngitis:

1. Catarrhal - accompanied by diffuse damage to the laryngeal mucosa. The main signs are hoarseness, weakness, a feeling of narrowing of the throat, and a wet cough periodically appears.
2. Hypertrophic - against the background of prolonged inflammation, the epithelium grows into other layers of the epidermis. The disease is accompanied by aphonia, burning in the throat, and cough.
3. Atrophic - the inner lining of the larynx atrophies and becomes thin. Symptoms: decreased voice tone, sore throat, dry cough; during a severe attack, crusts streaked with blood may come off.

With hypertrophic laryngitis, it is sometimes necessary to remove areas with hyperplasia surgically.

Pharyngitis

Acute or chronic inflammatory process in the mucous membrane of the pharynx. The ICD-10 code is J02.

The acute form of the pathology develops against the background of infectious diseases of the upper respiratory tract. Pharyngitis can occur with prolonged inhalation of frosty air through the mouth, against the background of smoking and alcohol abuse, after eating very hot or cold food. The sore throat intensifies when swallowing saliva, the disease is accompanied by a low-grade fever, a sore throat occurs, but in general the person feels normal.

Throat with pharyngitis

Chronic pharyngitis develops against the background of sinusitis, tonsillitis, caries, metabolic disorders, heart and lung diseases. The pathology is combined with atrophy of the nasal mucosa, accompanied by severe scratching in the throat, dry barking cough, swelling of the tongue, purulent discharge, and low-grade fever.

The acute form of laryngitis is a dangerous disease for children under two years of age, often accompanied by severe catarrhal rhinitis, swelling and inflammation of the nasopharyngeal mucosa, which causes a significant deterioration in nasal breathing.

Adenoiditis

Inflammation of the pharyngeal tonsil is often viral in nature, manifests itself in the form of severe headache, dry choking cough, attacks of shortness of breath and suffocation, and is diagnosed in children aged 3–15 years. The ICD-10 code is J35.

The disease develops against a background of weakened immunity, vitamin D deficiency, hypothermia, a history of chronic rhinitis or upper respiratory tract diseases.

Adenoiditis - inflammation of the pharyngeal tonsil

Malignant and benign neoplasms

Laryngeal cancer is difficult to diagnose in the early stages because the disease can occur for a long time without pronounced symptoms, so tumors are often diagnosed when they reach a large size. The ICD-10 code is C32.

Possible signs of oncology:

• sensation of a foreign body in the throat, soreness, discomfort when swallowing;
• labored breathing;
• the presence of bloody inclusions in the mucus from the throat and nose;
• increased salivation;
• frequent ear congestion without obvious signs of inflammation;
• toothache, while the dentist cannot detect the cause of the discomfort;
• hoarseness of voice.

Blood clots in saliva may indicate the development of tumors in the throat

Benign neoplasms are less dangerous, but also require immediate treatment, since if they are frequently injured, serious complications can arise. Polyps and vocal nodules appear on the larynx due to constant tension of the ligaments, smoking, and chronic inflammatory processes. The reason for the formation of papillomas is the activation of HPV, growths appear on the trachea and vocal cords. All non-cancerous tumors have an ICD-10 code of D10.

Most often, laryngeal cancer is diagnosed in men aged 55–65 years, heavy smokers. Mycoses of the larynx

Fungal infections develop against a background of weakened immunity and can have an acute or chronic form. They manifest themselves in the form of redness of the throat and tonsils, pain when swallowing, white plaque, ulcers and erosions in the mouth, sores in the corners of the mouth, dry cough, fever, swelling and tenderness of the cervical and submandibular lymph nodes. The ICD-10 code is B37.

Fungal infection of the throat

The main types of fungal pathologies of the oral cavity:

• pseudomembranous candidiasis - most often diagnosed in children and the elderly;
• mycosis – develops against the background of diabetes mellitus;
• erythematous chronic itching.

Pain and burning when swallowing can be caused by reflux disease - the acidic contents of the stomach penetrate the upper esophagus, throat, irritating the mucous membranes.

Other throat diseases

A sore throat may be a sign of other diseases that are not related to ENT pathologies.

What diseases can cause a sore throat:

1. Laryngospasm - most often occurs in children with rickets, hydrocephalus, and formula feeding. Symptoms are a decrease in the diameter of the pupil, strong closure of the vocal cords, convulsions, fainting, noisy breathing. In adults, the skin becomes red or bluish and a hacking cough appears. ICD-10 code – 5.
2. Swelling of the larynx - develops against the background of allergies, injuries of the larynx, pathologies of the heart and blood vessels, purulent processes in the pharynx. The person experiences pain when swallowing and has difficulty breathing. The ICD-10 code is J4.
3. Laryngeal stenosis - the lumen of the respiratory tract is completely or partially closed due to swelling of the larynx, insect bites, injuries, the cause may be syphilis, diphtheria, neoplasms of various origins. Signs: profuse cold sweat, breathing problems, shortness of breath, hoarse voice, mucous membranes and skin acquire a blue tint, possible loss of consciousness, respiratory arrest. ICD-10 code – 6.

Laryngeal stenosis - closure of the airway due to swelling

Mechanical damage to the larynx is often diagnosed in young children, since they may accidentally swallow a foreign object. In adults, pathology can occur when swallowing a fish bone; singers and lecturers are susceptible to the disease due to constant increased stress on the ligaments.

Which doctor should I contact?

If you have a sore throat, you should consult a therapist or pediatrician; after examination and preliminary diagnosis, he will give a referral to an otolaryngologist.

Additionally, consultation with an infectious disease specialist, oncologist, endocrinologist, gynecologist, or gastroenterologist may be required.

If the illness is psychosomatic in nature, the patient will be seen by a psychologist or psychotherapist. A doctor from one of these areas will be able to make an accurate diagnosis based on the test results.

Diagnosis of throat diseases

The patient is examined using special instruments - laryngoscopy and pharyngoscopy make it possible to identify in which part of the throat the mucous membrane is most hyperemic and swollen, to assess the condition of the vocal cords and the posterior wall of the larynx, and to detect lumps of pus.

Basic diagnostic methods:

• clinical blood and urine analysis;
• throat swab, sputum culture;
• MRI, histological examination of the tumor - allows you to determine the origin of the tumors;
• Ultrasound of the larynx.

Since throat diseases are often of bacterial origin, before prescribing therapy, sputum is tested for sensitivity to antibacterial drugs.

Ultrasound of the larynx shows the cause of the disease

Treatment methods for throat diseases

To eliminate unpleasant symptoms and prevent the development of complications in the treatment of throat diseases, medications and diet therapy are used, and alternative medicine recipes will help speed up the healing process.

Medicines

To treat throat diseases, I use medications in tablet form, topical agents, the choice of drugs depends on the type of pathogen.

Main groups of drugs:

• antibiotics – Amoxicillin, Augmentin;
• antiviral drugs - Remantadine, Tamiflu;
• antifungal agents – Fluconazole, Levorin;
• antihistamines – Ebastine, Cetirizine;
• antipyretics – Paracetamol, Nurofen;
• mucolytics – ACC, Prospan, Ambroxol;
• local antiseptics - Tantum Verde, Ingalipt, Lizobakt, Miramistin;
• streptococcal and staphylococcal bacteriophages.

Recently, doctors are increasingly resorting to surgery to remove tonsils in the throat, since the tonsils are organs of the immune system and prevent infection from entering the bronchi, trachea, and lungs.

Amoxicillin - an antibiotic drug

Folk remedies

When treating throat diseases, it is necessary to maintain bed rest, drink more warm drinks, milk, tea with raspberries or black currants, rosehip decoction, alkaline mineral waters without gas are good for pain and soreness.

How you can treat throat diseases at home:

• honey is one of the best remedies for treating sore throat; it can be lubricated on the tonsils, consumed in its pure form, or prepared as a gargle;
• inhalations with essential oils of eucalyptus, fir, pine, tea tree;
• a regular heat or alcohol compress on the neck, hot foot baths with mustard;
• Gargling is an effective method of combating throat diseases. For procedures, you can use a decoction of chamomile, sage, linden, oak bark, St. John's wort;
• You can take diluted tincture of propolis, garlic, and calendula internally;
• you can treat inflamed tonsils with a mixture of juice from aloe, kalanchoe and propolis tincture; sea buckthorn oil softens the throat well and eliminates purulent processes.

Gargling with chamomile decoction helps to cope with sore throats.

Honey should not be added to hot drinks - under the influence of high temperatures the product acquires carcinogenic properties. Boiling water destroys vitamin C in lemon, raspberries, and black currants.

Any thermal procedures can be carried out only at normal temperatures. Nutritional Features

To reduce inflammation, pain, swelling of the mucous membrane, and not injure the irritated throat, you must adhere to a special diet.

Nutrition principles:

• It is necessary to exclude hot, sour, spicy, salty foods from the diet, give up heavy fatty and sweet dishes, and junk food;
• all dishes must have a comfortable temperature and soft consistency;
• the menu should contain a lot of vegetables and fruits, especially those high in vitamin C and iodine - greens, bell peppers, carrots, seaweed;
• Every day you need to consume 10–15 ml of olive or corn oil;
• Fermented milk products will help speed up recovery and prevent the development of dysbiosis when taking antibiotics;
• Smoking and drinking alcohol are strictly prohibited.

Garlic, onions, ginger, cinnamon, and star anise effectively fight viruses.

If you have a sore throat, you should not eat spicy food.

Possible complications

Without proper and timely treatment, acute inflammatory processes in the throat turn into chronic diseases, which is fraught with constant relapses at the slightest hypothermia and weakened immunity.

What are the dangers of throat diseases?

• tonsillitis often causes complications in the heart, joints, kidneys - rheumatism, infectious polyarthritis, paratonsillitis, nephritis develop;
• with chronic tonsillitis, vasculitis and skin dermatoses often develop;
• hypotonic dysphonia – the functioning of the vocal cords and laryngeal muscles worsens;
• jaw spasm;
• retropharyngeal abscess;
• chronic bronchitis, sinusitis, sinusitis, otitis;
• severe eye pathologies;
• hepatitis A, B.

If streptococci from the tissues of the throat penetrate into the blood, sepsis will begin to rapidly develop.

If your throat is not treated, chronic sinusitis may develop.

Prevention

To prevent the development of throat diseases, you need to follow simple rules of prevention and strengthen the immune system.

How to avoid a sore throat:

• take daily walks in the fresh air;
• stop smoking;
• maintain optimal temperature and humidity in the room;
• eat food at a comfortable temperature;
• the diet should contain a sufficient amount of vitamins and microelements;
• avoid hypothermia.

Stop smoking to avoid throat diseases

To avoid catching an infection, you must follow the rules of hygiene, do not touch your face with dirty hands, take antiviral drugs during epidemics of acute respiratory viral infections and influenza, and lubricate your nose with oxolinic ointment when leaving the house.

The list and symptoms of throat diseases are quite large, so if you experience discomfort when swallowing or hoarseness, you should consult a doctor. Correct diagnosis and adequate therapy will help avoid the development of severe, sometimes fatal, complications.

Most often the reason oropharyngeal diseases are various infections. Their most popular consequences are tonsillitis (more scientifically - acute tonsillitis, laryngitis and pharyngitis. The article contains recommendations from doctors on how not to harm yourself with these diseases, but, on the contrary, to help the body get healthier faster.

Sore throat causes inflammation of the tonsils. In addition to a sore throat, she is accompanied by aches throughout the body, weakness and a high temperature of 38 degrees.

A person wakes up in the morning relatively cheerful, but by the evening he usually “loses.” The disease has many varieties: catarrhal (red throat), follicular (purulent follicles on the tonsils), lacunar (pus in the lacunae), aphthous (rash on the tonsils in the form of white or pinkish ulcers), herpetic (rash on the tonsils in the form of blisters).

Laryngitis is inflammation of the laryngeal mucosa. Symptoms are soreness and redness, a slightly elevated (about 37.5° C) temperature and - a distinctive feature - hoarse, heavy breathing and a hoarse voice. The patient's condition is worse in the morning, immediately after waking up.

Pharyngitis is inflammation of the mucous membrane of the pharynx. It is accompanied by redness, soreness, the same as with laryngitis, a slightly elevated temperature, and often a dry, painful cough.

Treatment is prescribed by a doctor. Warm rinses and grandma's recipes will not help. Untreated diseases can lead to all sorts of complications. But standard recommendations for diseases of the oropharynx are the same for everyone.

At inflammation of the oropharynx it is forbidden:
1. Strain your throat.
That is, talk long and loudly. Communication should be kept to a minimum. Listen more. Shorten your answers. As the signalmen say, switch to information receiving mode.

2. Eat salty, chocolate, spicy and even healthy citrus fruits. All of these foods irritate the oropharynx. You should also avoid hard foods: crackers, cookies. It is best to eat porridge, light broths, and baked vegetables.

3. Drink excessively hot drinks.
They will not warm the throat, but will only further injure the mucous membrane.

4. At elevated temperatures, drink a lot of milk.
Protein dishes in such a situation can increase intoxication of the body.

5. Gargle with water, baking soda and iodine.
This disinfectant solution will only be beneficial for purulent sore throat. In other cases, it will only irritate the throat mucosa.

6. Walk.
Inflammation of the oropharynx requires bed rest and, ideally, cessation of communication for 5 to 10 days.

7. Self-prescribe antibiotics.
8. Postpone calling a doctor if your sore throat is accompanied by a headache, high fever, vomiting or rash.

For inflammation of the oropharynx, you can and should:
1. Relieve pain using local remedies - special lozenges or sprays.
2. Take complex vitamins to strengthen your immune system.
3. Ventilate the room. This will help you fall asleep faster and sleep better at night.
4. Drink warm drinks with vitamin C and honey as often as possible (if you are not allergic to the latter).
It has a healing and disinfecting effect. It will be useful to include extracts of hawthorn and rose hips in the composition of such drinks.

Diseases of the throat and larynx are heterogeneous groups of pathologies that develop for a variety of reasons, but are united by a common localization.

All diseases can be divided as follows:

• Infectious pathologies. They are usually provoked by bacteria and viruses.
• Fungal pathologies. They are relatively rare, but such situations still occur.
• Benign neoplastic processes in the pharynx and larynx.
• Malignant tumors in the structures of the upper respiratory tract.
• Other conditions and pathological processes in the pharynx.

Below we will look at each of these groups in more detail.

Infectious pathologies

They are also heterogeneous in composition, but there is one point that absolutely all infectious diseases of the throat have in common - these are the reasons for their development.

According to research, all pathogenic processes in the pharynx develop for three groups of reasons. The first group of factors concerns the penetration of dangerous microorganisms and viruses into the body.

Among them:

Staphylococci. Cause severe damage to the pharyngeal organs. Usually pyogenic (pyogenic) type. They provoke massive exudation and complex symptoms and are difficult to treat. The most dangerous type of microorganism is Staphylococcus aureus.

Streptococci. Especially alpha and beta hemolytic. Cause blood problems, as well as suppuration of the throat and upper respiratory tract. Read more about the diseases they can cause here.

Atypical microorganisms, such as chlamydia, gonococci, ureaplasma, mycoplasma, trichomonas and others. They provoke difficult to cure, but sluggish forms of infectious diseases of the pharynx.

Herpes viruses. Especially strains of the fourth and fifth types (Epstein-Barr virus and cytomegalovirus). Diseases caused by this type of viral agents are extremely difficult to cure. You can only transfer the disease into the latent phase.

Human papillomaviruses. In total there are more than 500 types. Many are oncogenic. These are serious opponents that promote the formation of cancer cells.

In what ways do they enter the body?

Primarily airborne. With particles of mucus, saliva when coughing, sneezing and even just breathing.

To become a carrier of a virus or bacteria yourself, it is enough to be near an infected person for some time. Since almost everyone is infected (98% or more), the probability of “getting” the agent is extremely high.

• Household or contact path. When in contact with dirty household items, during non-sexual interactions with infected people (handshakes, kisses).
• Sexual route of transportation. Namely oral-genital. There are many dangerous bacteria living on the genitals. Unprotected sex can be dangerous. It is recommended to protect yourself.
• Perinatal path. A child may encounter harsh environmental conditions while still in the womb, as viruses and bacteria easily cross the placental barrier.
• Transmission path. With insect bites.
• Blood transfusion.
• Passage through the mother's birth canal.
• The infection can enter the throat and pharynx through the descending (from the nasopharynx) or ascending (from the lower respiratory structures) routes.
• Throughout the body itself, pathogenic agents are transported through the blood or lymphatic fluid.

However, becoming a carrier of uninvited “guests” is not enough, and does not at all mean that a person will get sick.

The next significant factor that increases the likelihood of developing pathologies is a decrease in immunity.

For what reasons can a security system fail?

• Alcohol abuse.
• Smoking. Women who smoke are especially at risk because their bodies are less able to tolerate the harmful substances contained in cigarettes.
• Use of antibiotics without sufficient reason.
• Incorrect feeding of the child (early weaning, late attachment to the mammary glands, transfer to dry formula).

And other factors, of which there are more than twenty. The third group of reasons are trigger factors. They vary from disease to disease, so you need to consider each pathology separately.

Angina

It is an inflammation of the oropharynx and, in particular, the tonsils. Another name for sore throat is tonsillitis. The disease is better known under this name.

The reasons for the development of sore throat, in addition to those already mentioned, are:

• Traumatic lesions of the pharynx. For example, during diagnostic or therapeutic procedures.
• Consumption of contaminated food. The nutritional factor plays a role.
• The symptoms of the disease are quite specific:
• Sore throat when swallowing, breathing, eating. They get worse when trying to speak.
• Formation of purulent plugs. These are small yellowish lumps localized in the lacunae and come out when squeezed with the tongue.
• Purulent exudation. Discharge of a large amount of pus from the lacunae due to an infectious lesion.
• Formation of a whitish coating in the throat and soft palate.
• Hyperemia of the pharynx. It can be determined even by self-examination of the pharynx. In other words, redness of the throat.
• Loose soft tissue structure upon examination.
• Increased body temperature.

Treatment is required immediately. Sore throat tends to cause complications on the heart, kidneys and lungs. It is necessary to use specialized drugs: non-steroidal anti-inflammatory drugs, antibiotics, analgesics, local antiseptics and antipyretics for general symptoms.

Pharyngitis

Inflammatory lesion of the oropharynx. The disease is very widespread. Trigger factors are specific:

• Hypothermia. Drinking cold water and inhaling frosty air are especially dangerous during the hot season.
• Long-term use of vasoconstrictor drops.
• Chronic diseases of the upper respiratory tract. Sinusitis of various types (sinusitis and others) is especially dangerous.
• Thermal, chemical damage to the pharynx. Burns of various etiologies.

Symptoms include:

• Intense pain syndrome of a burning, stabbing nature. Localized in the pharynx and soft palate. With a long course of the pathology, diffuse discomfort is possible. The unpleasant sensation increases when talking, eating food, drinking water, or breathing.

• Bad breath. Caused by the activity of pathogenic microorganisms.
• Change in voice character. The inability to speak normally develops (hoarseness, weakness, nasal voice), complete loss of the ability to speak.
• Increased body temperature.
• Headache and symptoms of general intoxication.
• Cough with a small amount of sputum.
• Sore throat.

The treatment is specific. As in the case of sore throat, the following groups of medications are prescribed:

• Anti-inflammatory non-steroidal origin.
• Steroid drugs (glucocorticoids).
• Broad-spectrum antiseptics.
• Antibacterial drugs (only after studying the sensitivity of the flora to drugs).

Lack of therapy leads to chronicity of the process and many complications.

Laryngitis

Laryngitis is an inflammation of the mucous membranes of the larynx. The disease develops relatively often - the prevalence of the pathological process is approximately 8% of clinical cases (statistics are based on recorded situations).

Causes of the disease:

• Traumatic lesions of the larynx. Most often as a result of diagnostic measures for other probable diseases. So, laryngoscopy is especially dangerous.
• Inhalation of pathogenic substances. Smoke, dust, pollen (in this case they speak of an allergic form of laryngitis).
• Mechanical lesions of the larynx. For example, as a result of damage to the delicate mucous membrane from a fish bone, stale bread, accidental inhalation of crumbs, etc.

Otherwise the reasons are identical.

Characteristic manifestations:

1. Pain in the throat and neck. It is impossible to determine the exact localization of discomfort. The feelings are diffuse, which makes it difficult to formulate complaints.
2. Cough. The hallmark of laryngitis is an intense barking reflex. Cannot be removed with classical drugs. No sputum is produced, which is typical for this disease.

The treatment uses antitussives of general action (to suppress the reflex at the central level), antitussives of peripheral action, and anti-inflammatory drugs of non-steroidal origin. Glucocorticoid medications may also be needed. Thinning agents and mucolytics are not required. They are useless and even dangerous in this case.

Scleroma

It is a disease of mixed origin (immune and at the same time infectious). It is characterized by spontaneous proliferation of the walls of the larynx and the formation of special nodular inclusions, granulomas.

Contrary to what you might think, these are not neoplasms. Granulomas are considered to be the result of proliferation, but not of a tumor nature. Therefore, scleroma is classified as an infection.

The causes of the disease are multiple. The most common are:

• Mechanical damage to the walls of the larynx. Usually as a result of diagnostic or therapeutic measures. As already mentioned, laryngoscopy is the most traumatic.
• Chemical and thermal injuries of a long-term nature. The longer pathological factors affect the pharynx, the higher the likelihood of developing the disease.
• Long-term infectious lesions. Affected by the manifestation of scleroma.

Symptoms:

1. Breathing disorders (shortness of breath, and later suffocation).
2. Change in voice of different types (may become higher or lower).
3. Sore throat, other unpleasant sensations in the throat area.
4. Nasal congestion, nasal breathing disorders.

Treatment is conservative, in most cases, with the use of anti-inflammatory drugs. If the airway is obstructed, surgical intervention is required.

Fungal diseases (pharyngomycosis)

Diseases of the throat and larynx are not limited to viral and bacterial lesions. Fungal infestations are possible. The most common is the so-called pharyngomycosis.

At its core, it is the same pharyngitis, however, of a fungal nature. According to research, in almost 100% of clinical cases the culprit is fungus of the genus candida.

The main causes of the development of the disease are diabetes mellitus and other endocrine pathologies. They cause a general and local decrease in immunity.

Less commonly, predisposing factors are injuries to the throat and pharynx in general. For example, when anatomical structures are exposed to hot steam, excessively dry air, or chemical reagents. Mechanical damage is also possible, which opens the way for fungal agents.

Symptoms of pharyngomycosis:

• Intense sore throat. It is burning, cutting. It intensifies at night, when eating, drinking liquid.
• Unpleasant, sour odor from the mouth.
• Formation of a white cheesy coating in the throat.
• Redness of the pharynx and the entire soft palate.
• Clogging cough and sore throat.

Treatment requires special attention. The following groups of drugs are used:

• Non-steroidal anti-inflammatory drugs (NSAIDs).
• Broad-spectrum antifungals and antibiotics to prevent secondary damage.

Benign tumors

Benign tumors are non-infiltrative growing neoplasms. They are not prone to metastasize. However, due to the development of mass effect, breathing problems and other unpleasant and life-threatening conditions are possible.

Adenoiditis

Strictly speaking, it is not a benign tumor. Adenoiditis is an inflammation of the adenoids: the enlarged palatine tonsil. Most often have infectious causes.

In almost 100% of cases it affects children under 10 years of age. In adults, the disease occurs as exceptions. This is casuistry.

Symptoms of adenoiditis:

1. Nasal breathing disorders. The patient cannot breathe normally due to the overlap of the choanae and vomer.
2. Rise in body temperature to subfebrile-febrile levels.
3. Symptoms of general intoxication of the body.

Treatment in most cases is surgical. It is necessary to remove the adenoids and thereby the problem will be solved radically.

Other neoplasms

There is also the following list of benign tumors of the larynx and throat:

Fibroids. Consist of fibrous tissue. They develop mainly in the area of ​​the vocal cords. They have an oval or spherical regular shape. They are not prone to metastasis and grow extremely slowly. Lead to voice changes and breathing problems. Large sizes pose a danger to life and health.

Lipomas. Also called wen. Develop from adipose tissue. They have a spherical shape. May have a leg. Formation occurs at the entrance to the larynx in most cases.

Polyps. A type of fibroids. Unlike the former, they have a tendency to malignant degeneration. They need to be removed in any case. This is an axiom.

Chondromas. Tumors of the larynx from cartilaginous tissue. Over time, they can transform into cancer (chondrosarcoma).

Papillomas. They're warts. They are provoked by the human papillomavirus. Many strains are oncogenic, therefore mandatory histological examination and PCR diagnostics are required.

Cystic formations. Fluid structures surrounded by a fibrous capsule. Not prone to growth.

Angiomas. Vascular tumors. Difficult to remove. They are often congenital.

In all cases, the reasons for the development of tumors lie in a violation of cell differentiation (the process of transforming unspecialized embryonic cells into specialized cells of tissues and organs) and an increase in their proliferation (the process of cell reproduction).

Treatment is surgical. However, you shouldn’t rush to extremes right away.

The best option would be dynamic monitoring of the tumor. If it grows, it needs to be removed. It is also important to determine the histological structure of the neoplasm (benign or malignant). Only after this do they decide on treatment tactics.

Malignant tumors

Cancers of this location are relatively rare. However, they are extremely dangerous. In a similar arrangement, carcinomas and sarcomas are distinguished.

Carcinoma

Develops from epithelial tissues. Cell differentiation is practically absent, proliferation is maximum.

The reasons for the development of an oncological tumor are as follows:

• Tobacco abuse. The more a person smokes, the greater the risk of developing carcinoma. When consuming tobacco products a pack a day or more, the likelihood of developing cancer increases by 70%. A person drives himself into harsh conditions.
• Excessive consumption of alcoholic beverages. Burns of the mucous membranes form. As a result, the risks increase significantly.
• Occupational hazards. This includes dangerous work at chemical plants, in hot industries, etc.
• Drinking hot liquids on a regular basis.

Symptoms of throat cancer are as follows:

• Headaches in the back of the head.
• Pain in the jaws, radiating to the teeth.
• Problems with vision and hearing.
• Frequent otitis of unknown origin.
• Voice disorders.
• Bad breath.

Treatment is exclusively surgical. In later stages, radiation and chemotherapy will be required. The choice of treatment tactics is chosen only by the oncologist.

Sarcoma

A much more aggressive tumor. It develops for the same reasons. Characterized by intense cellular atypia and high proliferation rate.

Symptoms are similar to carcinoma and include the following manifestations:

• Toothache.
• Pain in the jaw area on the affected side.
• Voice problems. It becomes weak, hoarse or too low.
• Visual and hearing impairments.
• Frequent otitis.

Treatment, as in the previous case, is surgical. Excision of tissue is required, as radical as possible. This way you can avoid relapses.

Radiation and chemotherapy are prescribed based on the stage of the pathological process.

Dangerous conditions

Acute laryngeal stenosis is manifested by a significant narrowing of the airways.

• Penetration of foreign objects into the respiratory tract.
• Infectious pathologies such as measles, malaria, typhoid and other diseases.
• Carrying out various types of medical procedures.
• Inflammatory processes of the respiratory system.

Characteristic symptoms include: breathing problems, acute asphyxia, sore throat. Surgical treatment consists of expanding the lumen of the larynx.

Laryngeal edema

In most cases it develops as a result of an allergic reaction. The symptoms are identical. Asphyxia and death are possible. Treatment is specific: urgent administration of antihistamines and artificial ventilation (if the condition is severe) is necessary.

Laryngospasm

The condition is generally identical to stenosis. The manifestations and methods of treatment are similar. The essence of the pathological process is the development of spasm of the laryngeal muscles.

In all described cases, treatment should be carried out immediately. The patient's life is at stake. An ambulance is required. There is nothing you can do on your own.

Problems of this kind are the most common. The diseases are similar in manifestations, therefore mandatory differential diagnosis is required.

Treatment is selected based on the situation. For the most part it is conservative. The main thing is to contact a treating specialist in time.

The oropharynx connects the pharynx (from the soft palate) and the larynx. At this site the respiratory and digestive tracts intersect. It is the soft palate that separates the oropharynx from the nasopharynx.

A malignant neoplasm characterized by a high growth rate is oropharyngeal cancer. The aggressiveness of the tumor is confirmed by histological analysis and clinical features in the form of rapid metastasis to regional lymph nodes and distant organs.

Oncological process, in most cases, is registered after the age of 40 years. Mostly, the neoplasm is located on the palatine tonsils (73%), but damage to the posterior pharyngeal wall (16%) and soft palate (11%) occurs. Due to the hidden initial period, the disease is often diagnosed at stages 3–4, and in half of the cases metastases are detected in the lymph nodes.

Causes of oropharyngeal cancer

The occurrence of a malignant focus in the oropharynx can be a primary process or secondary, as a result of malignancy of a benign formation. Malignancy of cells can be observed due to the influence of provoking factors, for example:

• smoking, chewing tobacco;
• alcohol abuse;
• low-quality, inconveniently installed dentures.

In addition, it is worth noting the conditions and background pathology that increase the risk of tissue degeneration into malignant ones:

• inflammatory processes (sinusitis, tonsillitis, pharyngitis);
• leukoplakia, erythroplakia of the pharynx;
• papillomas;
• immunodeficiency.

Symptoms

The initial period (1-3 months) does not have any noticeable symptoms. The tumor grows over time, begins to feel like a foreign body, and pain occurs when swallowing and choking.

Depending on the location of the tumor, a nasal voice is disturbing, liquid food is thrown into the nasopharynx and appetite decreases. When the surface of the tumor is injured by a food bolus, an admixture of blood is noted in the saliva.

The tumor can grow into the lumen of the oropharynx or deep into the tissues.

Signs of oropharyngeal cancer by stage

The classification of malignant diseases (TNM) into stages is based on criteria such as tumor size (T), involvement of surrounding lymph nodes (N) and the presence of distant metastases (M). According to this division, the volume of surgical intervention and the rationality of prescribing courses of radiation and chemotherapy are determined.

At the first stage, oropharyngeal cancer may not appear at all, since the lesion is small in size and there is no damage to the lymph nodes and other organs.

In the second stage, a person may feel a sore throat, as if something is “itching” on the back of the throat or on the soft palate. Lymph nodes may be enlarged in size or undergo malignancy on one side.

As for the third stage, a person is bothered by the feeling of a lump in the throat, difficulty swallowing, choking, nasal voice and pain. In addition, there is oncological involvement of regional lymph nodes on both sides. They enlarge, become painful when palpated and adhere to the surrounding tissues.

Common symptoms of cancer intoxication include headache, weakness, loss of appetite and body weight. At this stage, cancer may grow deep into the tissues, involving the neurovascular bundle and possible bleeding.

At the fourth stage, the malignant focus spreads both to neighboring tissues and organs and to distant structures. When the nasopharynx is affected, germination into the Eustachian tube is noted with the development of acute, possibly purulent, otitis, as a result of which hearing loss develops.

By disrupting ventilation in the paranasal sinuses, the tumor provokes the development of sinusitis. If the cancer process spreads to the cranial cavity, symptoms of a brain tumor are observed. In addition, at the fourth stage, the neoplasm undergoes decay, which predisposes to bleeding. In addition to local damage, metastasis occurs with the formation of distant malignant foci.

Diagnostics

Sometimes oropharyngeal cancer is discovered during an examination by an ENT doctor or at a dentist's appointment. To confirm the malignant origin, a histological examination is performed under pharyngoscopy control.

To assess the extent of the process, rhinoscopy, otoscopy, laryngoscopy, tomography and lymph node biopsy are performed.

Treatment of oropharyngeal cancer

The main method of treatment is surgical removal of the tumor. If cancer grows into the larynx, partial removal of the pharynx and complete removal of the larynx are performed, followed by the formation of a tracheostomy, esophagostomy and orthostomy. After 3 months, pharynx plastic surgery is performed and the natural passage of food is restored.

At stages 1-2, only surgical treatment is used. Starting from stage 3, a combination with radiation and chemotherapy is recommended, including if the tumor is inoperable.

Prognosis and survival

At stages 1-2, the prognosis is relatively favorable and patient survival reaches 70-95% (depending on age and the presence of concomitant diseases). If oropharyngeal cancer diagnosed at stages 3-4, survival rate ranges from 20% to 60% when combined treatment is taken into account.

mouth Back in 1655, a wealthy Dutch shopkeeper from Delft decided that he had enough time and money to do what he loved - create microscopes and study the microworld with their help. Antonio Leeuwenhoek - that was the name of the Delft merchant - is considered the founder of microscopy. It was he who discovered the slipper ciliates, and it was he who first described blood cells and the variety of forms of bacteria.

But then, back in the 17th century, he was incredibly surprised when he first discovered microscopic “little animals” in a decoction of pepper. And he was completely shocked by the discovery that hundreds of such animals lived in his mouth.

Since the time of Antonio Leeuwenhoek, science has made a colossal leap forward, including microbiology. Now it is difficult to surprise someone with the message that thousands of microorganisms live in their mouth. But does every patient think about the harm these microorganisms bring to health?

Meanwhile, we know that infectious and inflammatory diseases of the oral cavity and pharynx (pharyngitis, glossitis, stomatitis and gingivitis) are among the most common reasons for patients to visit local physicians, family doctors and otolaryngologists, which indicates the widespread prevalence of this problem.

The main cause of the development of inflammatory processes in the upper respiratory tract (pharyngitis, rhinitis, tonsillitis, etc.) is a viral infection (rhinovirus, adenovirus, coronavirus, parainfluenza, influenza, etc.).

When the oropharynx is affected, adenovirus and rhinovirus infections are most common. The body reacts to the introduction of an infectious agent and disruption of the integrity of the mucous membranes by developing an inflammatory process, which involves a number of protective mechanisms: changes in the permeability of the vascular wall, increased blood flow, increased activity of macrophages and polymorphonuclear cellular elements, release of inflammatory mediators, free oxygen radicals. Macrophages play a major role in the defense mechanism by causing an increase in T-lymphocyte levels through the release of cytokines. Various diseases accompanied by a decrease in local and general body resistance (primary and acquired immunodeficiency conditions, cystic fibrosis, endocrine diseases, etc.). A decrease in local immunity can be caused by local hypothermia of the oropharynx with cold food, drinks or cold air, as well as exposure to various irritating agents (tobacco or other smoke with systematic exposure, dust in the air, the presence of irritating chemicals in the air). When the paranasal sinuses become inflamed, infected secretions can enter the pharynx and stimulate infectious inflammatory processes in it.

With a decrease in immunity, the so-called “transit flora” can acquire the status of “pathogenic”. The “transit flora” includes streptococci, staphylococci, pneumococci, gram-negative diplococci and other microflora that are usually sown normally in a healthy person.

Pharyngitis

Pharyngitis is divided into acute and chronic. Acute pharyngitis is an infectious inflammation of the mucous membrane of the oropharynx and palatine tonsils. With favorable development, acute pharyngitis may resolve spontaneously, without medical intervention. But most often acute pharyngitis is accompanied by the development of inflammatory and sometimes purulent processes in adjacent tissues. The main complaints of patients with acute damage to the mucous membrane of the oropharynx are unpleasant sensations - burning, tingling, dryness, pain when swallowing; headache localized in the occipital region. Children often experience difficulty breathing and nasal sounds. In adults, this disease occurs without a sharp deterioration in the general condition, and in children it can occur with a sharp increase in temperature up to 39°C. Especially in cases where inflammation spreads to the larynx and trachea. Acute pharyngitis is characterized by enlargement and tenderness of the cervical and occipital lymph nodes. When examining the patient, hyperemia of the posterior wall of the pharynx and palatine arches, individual inflamed lymphoid granules are detected, but there are no signs of inflammation of the tonsils characteristic of tonsillitis.

Chronic pharyngitis, unlike acute pharyngitis, is usually of a bacterial nature, less often fungal. This is a polyetiological disease characterized by the presence of inflammatory and degenerative changes in the pharyngeal mucosa. Chronic pharyngitis is characterized by complaints of dryness, soreness, soreness and the sensation of a foreign body in the throat, often a dry cough and the formation of viscous sputum, and fever. A significant deterioration in general condition is rare in patients with chronic pharyngitis. When making a diagnosis, the pharyngoscopy picture is taken into account. The development of chronic pharyngitis is associated with the harmful effects of irritating factors such as alcohol, nicotine, spicy foods, carbonated drinks, and various adverse industrial and climatic influences. The formation of the disease is facilitated by pathological conditions of the nasal cavity, leading to impaired nasal breathing - deviated nasal septum, vasomotor and hypertrophic rhinitis, nasal polyposis, adenoids. The cause of chronic pharyngitis can be recurrent respiratory tract infections, leading to persistent damage to the mucociliary barrier and significant inhibition of the mechanisms of local and general immunity. Atrophic pharyngitis is a consequence of progressive atrophy of the pharyngeal mucosa in elderly people.

Gingitis and periodontitis

An imbalance in the oral defense system can cause inflammation of the gum mucosa - gingivitis. When inflammation spreads from the gum margin to the tissue surrounding the teeth, gingivitis turns into periodontitis, which can subsequently lead to inflammation of the bone tissue, loosening and tooth loss. In patients over 15 years of age, in 50% of cases, the cause of tooth loss is periodontopathies. With gingivitis, the gums become inflamed, swelling occurs, and its contour changes. Due to swelling, the gingival groove between the teeth deepens, and a so-called gingival pocket is formed. As a result, redness of the gingival margin, swelling and bleeding of the gums occur, it becomes sensitive and painful, and there are difficulties in chewing and swallowing. Gingivitis can be either acute or chronic. Chronic gingivitis is more common in adults.

Stomatitis

Infectious and inflammatory diseases of the oral cavity include stomatitis - inflammation of the oral mucosa. According to clinical manifestation, stomatitis is divided into catarrhal, ulcerative and aphthous. The most common cause of stomatitis is poor oral hygiene, dental disease, dental plaque, oral dysbacteriosis, as well as gastrointestinal diseases (gastritis, duodenitis, colitis, etc.). Aphthous stomatitis is characterized by a connection with allergic reactions, viral infections, and rheumatism. Depending on the severity and form of the disease, patients complain of pain in the oral cavity and pharynx, severe pain when chewing, and swallowing articulation. Sometimes there is an increase in body temperature up to 37.5°C, an increase in regional lymph nodes, malaise, and headache. Upon examination, defects in the mucous membrane of the oral cavity and tongue are determined.

Treatment: general principles

Therapeutic tactics for infectious and inflammatory diseases of the mucous membrane of the oral cavity and pharynx include the prescription of drugs with anti-inflammatory, analgesic, immunocorrective effects, local antiseptics, decongestants and hyposensitizing drugs. In the complex of therapeutic measures, an important role is played by drugs that have a combined effect.

What exactly is the treatment?

So, a specialist treating a patient with an inflammatory disease of the oral cavity and pharynx has the main mission: choosing the most effective drug. The speed and effectiveness of the therapy depends on this choice.

Scientific information

Causes of inflammatory processes in the oral cavity

1. Traumatic inflammation. Trauma can be mechanical, chemical or physical, acute or long-term.
2. Infectious inflammatory processes (viral, bacterial, fungal infections).
3. Allergic reactions accompanied by swelling and inflammation of the oral mucosa.
4. Inflammation of the mucous membrane in systemic diseases: hypo- and avitaminosis, endocrine diseases, diseases of the blood system, diseases of the gastrointestinal tract, etc.

HEXETIDINE

Broad-spectrum antiseptic against gram-positive and gram-negative microorganisms. Bactericide for anaerobic bacteria. Bacteriostatic for most bacterial strains at a concentration of 100 mg/ml. Fungicide against fungi of the genus Blastomycetes, Trichophyton, Histoplasma, Microsporum. Inhibits the growth and reproduction of more than 40 strains of fungi of the genus Candida. Weak analgesic.

An undeniable advantage of hexetidine, in addition to its wide spectrum of action, is a high degree of adhesion to the mucous membrane of the oropharynx. At the same time, in the absence of absorption, hexetidine has a long-lasting effect (active concentrations of hexetidine on the mucous membranes persist for 10-14 hours after a single use).

CHOLINE SALICYLATE

A powerful analgesic and antipyretic, a derivative of salicylic acid. It blocks the enzymes COX-1 and COX-2, inhibits the synthesis of prostaglandins, due to which it has a powerful anti-inflammatory effect. Inhibits the activation of macrophages and neutrophils, exhibiting an anti-edematous effect. It has antipyretic and analgesic effects. Indispensable in the treatment of diseases of the oropharynx, accompanied by an increase in local temperature, severe inflammation, swelling and pain. It is well absorbed from the mucous membrane and has a quick effect.

CHLOROBUTANOL

A fast-acting local anesthetic, a reliable tool in the arsenal of dentists and otolaryngologists. It has additional properties: antibacterial and antifungal effects. Helps enhance the analgesic effect in combination with hexetidine and choline salicylate.

An “ideal” product in composition should provide:

1. Antibacterial and antiviral effect.
2. Anti-inflammatory effect.
3. Analgesic effect.