Inflammation of the oropharynx. Diseases of the throat and larynx. Malignant and benign neoplasms

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.
Of the benign tumors, papillomas are the most common. They are often localized on the palatine arches, tonsils, mucous membrane of the soft palate and rarely on the posterior wall of the pharynx. Pharyngeal papillomas are single formations, the diameter of which rarely exceeds 1 cm.
Papilloma among benign tumors of the pharynx is quite common. Squamous cell papillomas of the palatine arches, tonsils, uvula and free edge of the soft palate are usually single.

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

In most patients with oropharyngeal tumors, the first signs of the disease are the sensation of a foreign body in the pharynx, soreness or other paresthesia. Patients often complain of dryness in the throat, and sometimes of mild pain in the morning when swallowing saliva (“empty throat”).
Neoplasms such as papillomas, fibromas, cysts localized on the palatine arches or tonsils may not cause any symptoms for years; Only when the tumor reaches a large size (1.5-2 cm in diameter) does a sensation of a foreign body in the pharynx occur. Dysphagia is more typical for tumors of the soft palate. Violation of the tightness of the nasopharynx during a swallow leads to a disorder in the act of swallowing, and liquid food entering the nose. Such patients sometimes make nasal noises. The sensation of a foreign body in the pharynx and other paresthesias appear very early with neoplasms of the root of the tongue and vallecules. These tumors can cause difficulty swallowing, including choking on liquid foods.
Pain is not typical for benign neoplasms of the oropharynx. Pain when swallowing or regardless of swallowing can occur with neuromas, neurofibromas, and very rarely with ulcerated vascular tumors.
Bleeding and the admixture of blood in sputum and saliva are characteristic only of hemangiomas, as well as ulcerated disintegrating malignant tumors.

Diagnostics

Instrumental studies

The main method of examining the pharynx is pharyngoscopy. It allows you to determine the location of the tumor focus, the appearance of the tumor, and the mobility of individual fragments of the pharynx.
Angiography, radionuclide studies and CT can be used as auxiliary research methods for hemangiomas. The most informative is angiography, which allows you to determine the vessels from which the tumor receives blood. In the capillary phase of angiography, the contours of capillary hemangiomas are clearly visible. Cavernous and venous hemangiomas are better visible in the venous phase, and branched arterial hemangiomas are better visible in the arterial phase of angiography. The diagnosis of hemangiomas is usually made without histological examination, since a biopsy can cause intense bleeding. The histological structure of the tumor is most often determined after surgery.

Malignant tumors

Clinical picture

Malignant tumors of the middle part of the pharynx grow quickly. They may remain unnoticed for some time, usually several weeks, much less often months. The first symptoms of malignant tumors depend on their primary location. Subsequently, as the tumor grows, the number of symptoms increases rapidly.
One of the early signs of a tumor is the sensation of a foreign body in the throat. Soon it is accompanied by pain in the throat, which, like the sensation of a foreign body, is strictly localized. Epithelial tumors are prone to ulceration and decay, as a result of which the patient develops bad breath and blood in the saliva and sputum. When the tumor process spreads to the soft palate, its mobility is impaired and a nasal sound develops; liquid food may get into the nose. Since swallowing disorders occur quite early and the passage of food is disrupted, patients begin to lose weight early. In addition to local symptoms, due to intoxication and inflammation accompanying the tumor, general symptoms also develop, such as malaise, weakness, and headache. When the lateral wall of the pharynx is affected, the tumor quickly penetrates deep into the tissues towards the neurovascular bundle of the neck, and therefore there is a danger of profuse bleeding.

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

Cytological examination of smears-imprints or reprints. The final diagnosis of a tumor, determining its type, is established by studying its histological structure.

Instrumental studies

Biopsy - excision of a piece of tissue for histological examination - is one of the important diagnostic methods in oncology. It is well known that a piece of tissue should be taken at the border of the tumor process, but it is not always possible to determine this border, especially with tumors of the ENT organs. Neoplasms of the palatine, pharyngeal and lingual tonsils, especially connective tissue ones, arise deep in the tonsil tissue. The amygdala enlarges. An enlarged tonsil should be alarming and requires targeted research, including a biopsy. In case of asymmetry of the palatine tonsils, if a tumor process is suspected, if there are no contraindications, it is necessary to perform a unilateral tonsillectomy or tonsillotomy as a biopsy. Sometimes such a tonsillectomy can be a radical surgical intervention in relation to the tumor.

Differential diagnosis

An ulcerated tumor of the tonsil must be differentiated from ulcerative membranous tonsillitis Simanovsky-Vincent, syphilis and Wegener's disease. For this purpose, it is necessary to examine smears taken from the edges of the ulcer and perform the Wasserman reaction.

Treatment of patients with oropharyngeal tumors

The main treatment method for patients with benign tumors of the middle part of the pharynx is surgical. The extent of surgical intervention depends on the extent, histological structure and location of the tumor. Limited tumors, such as palatine papilloma, can be removed in the clinic using a loop, scissors or forceps.
After its removal, the original site of the tumor is treated with galvanocauter or a laser beam. In a similar way, you can remove a pedunculated fibroma, a small, superficial cyst of the tonsil or palatine arch.
A small mixed tumor of the soft palate can be removed through the mouth under local anesthesia. More often, when removing tumors of the oropharynx, anesthesia is used, using a sublingual pharyngotomy as access, which is often supplemented by a lateral one. Wide external access allows you to completely remove the tumor and ensure good hemostasis.
External access is also required when removing vascular tumors of the pharynx. Before removing hemangiomas, the external carotid artery is first ligated or embolization of the afferent vessels is performed. Intervention for these tumors is always associated with the risk of severe intraoperative bleeding, which may require ligation of not only the external, but also the internal or common carotid artery to stop. Considering the possibility of intraoperative bleeding and the severity of the consequences of ligation of the internal or common carotid artery, in patients with parapharyngeal chemodectomas and hemangiomas, “training” of intracerebral anastomoses is carried out 2-3 weeks before surgery. It consists of pinching the common carotid artery on the side of the tumor localization with a finger 2-3 times a day for 1-2 minutes. Gradually, the duration of clamping is increased to 25-30 minutes. At the beginning of the “training” and then when the duration of clamping of the common carotid artery is increased, the patient feels dizzy. This sensation serves as the criterion by which the duration of clamping of the artery is determined, as well as the duration of the “training” course. If clamping the artery for 30 minutes does not cause a feeling of dizziness, then after repeated clamping for another 3-4 days, you can begin the operation.
Cryotherapy as an independent method of treating patients with benign tumors is indicated mainly for superficial (located under the mucous membrane) diffuse hemangiomas. It can be used in the treatment of deep hemangiomas in combination with surgery.
The main methods of treatment for malignant tumors of the oropharynx, as well as for neoplasms of other localizations, are surgical and radiation. The effectiveness of surgical treatment is higher than the effectiveness of radiation and combined treatment, the first stage of which is radiation.
Through the mouth, it is possible to remove only limited tumors that do not extend beyond one of the fragments of this area (soft palate, palatoglossal arch, palatine tonsil). In all other cases, external approaches are indicated - transhyoid or sublingual pharyngotomy in combination with a lateral one; sometimes, to gain wider access to the root of the tongue, in addition to pharyngotomy, resection of the lower jaw is performed.
Surgeries for malignant tumors are performed under anesthesia, after ligating the external carotid artery and performing a tracheotomy. Tracheotomy is performed under local anesthesia, and subsequent stages of the intervention are performed under intratracheal anesthesia (intubation through a tracheostomy).
If the palatine tonsil is affected by a tumor that does not extend beyond its limits, they are limited to removing the tonsil, palatine arches, paratonsillar tissue and part of the root of the tongue adjacent to the lower pole of the tonsil. The supply of unaffected tissue around the tumor focus should not be less than 1 cm. This rule is also followed when removing common tumors using external access.
Radiation treatment of patients with pharyngeal tumors should be carried out according to strict indications. This therapeutic effect can only be used for malignant tumors. As an independent method of treatment, irradiation can be recommended only in cases where surgery is contraindicated or the patient refuses surgery. We recommend combined treatment, the first stage of which is surgery, for patients with stage III tumors. In other cases, you can limit yourself only to surgery.
For tumors occupying the middle and lower parts of the pharynx, spreading to the larynx, a circular resection of the pharynx is performed with removal of the larynx. After such extensive intervention, an orostoma, tracheostomy and esophagostomy are formed. After 2-3 months, plastic surgery of the lateral and anterior walls of the pharynx is performed, thereby restoring the path of food passage.
The five-year survival rate of patients after surgical treatment is 65+10.9%, after combined treatment (surgery + radiation) - 64.7±11.9%, after radiation therapy - 23+4.2% [Nasyrov V.A., 1982 ].

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.

Inflammation of the pharynx and its symptoms are probably known to everyone. After all, every person in his life has had a sore throat at least once, pain when swallowing and sore throat. These are the symptoms that are characteristic of pharyngitis and we will talk about them below.

Doctors also call inflammation of the pharynx pharyngitis. This inflammatory process develops against the background of a viral or bacterial infection and is dangerous because it can spread to underlying structures, for example, the trachea, bronchi, and lungs. In this case, it will be necessary to talk about other diseases, such as tracheitis, bronchitis and pneumonia, respectively, but we should not forget that ordinary pharyngitis, if left untreated, can lead to the development of such serious and severe illnesses. That is why, when the first symptoms appear, indicating a possible inflammation of the pharynx, it is necessary to urgently contact an ENT doctor to take specific therapeutic measures.

Mesopharyngoscopy - examination of the oropharynx

Symptoms of inflammation of the pharynx

Symptoms of inflammation of the pharynx usually appear quite quickly and, without proper treatment, increase significantly. Symptoms of inflammation of the pharynx include:

  • Sore throat, discomfort in the throat;
  • Pain when swallowing, which in severe cases forces the patient to refuse food and liquid intake;
  • Enlargement and pain of regional lymph nodes (submandibular, cervical);
  • Dry, persistent cough;
  • Deterioration of general condition, increase in body temperature, weakness in the body, lethargy.

As we have already indicated above, in the absence of proper treatment for such an inflammatory process in the pharynx, complications such as tracheitis, bronchitis and, in the most severe cases, pneumonia can develop. With these ailments, the symptoms will be somewhat different and more pronounced. It should not be forgotten that if you have symptoms of inflammation of the pharynx, it is best to immediately contact an ENT doctor to receive quality treatment, rather than having to treat the complications of this disease for a long time.

Causes of inflammation of the pharynx

The causes of inflammation of the pharynx are varied. Reasons that provoke inflammation of the pharynx include:

  • Hypothermia, general (whole body) and local (drinking cold drinks);
  • Excessive physical activity, stressful conditions, which significantly reduces the defenses of the immune system;
  • The presence of chronic inflammatory foci in the body, from where pathogenic flora can migrate and cause inflammation in the pharynx;
  • Reduced immune defense of the body and local defenses in the oropharynx;
  • Damage to the mucous membrane of the pharynx as a result of a burn (eating too hot food or liquid) or injury.

Most often, inflammation in the pharynx occurs due to a viral or bacterial infection, however, this also occurs against the background of the above reasons. That is why, remember, you can always prevent inflammation of the pharynx. To do this, you must try to avoid exposure to damaging factors.

Deep vacuum ultrasonic sanitation of the palatine tonsils for inflammation of the pharynx

Treatment of inflammation of the pharynx

Treatment for inflammation of the pharynx often begins with the use of throat sprays, tablet medications, and sometimes antibiotics. Such treatment is not always effective and does not completely eliminate the inflammatory process, but only reduces it. This is dangerous because such pharyngitis can develop into a chronic form, and treatment of chronic inflammatory processes is always more severe and lengthy. That is why we offer unique methods for treating inflammation of the pharynx, which permanently eliminate the inflammatory process and prevent chronic inflammation and the development of complications.

All methods of treating inflammation of the pharynx used in our center are absolutely painless and highly effective.

Treatment of inflammation of the pharynx is carried out by the doctors of our clinic at the highest level. Before prescribing modern and unique techniques that quickly and reliably eliminate the inflammatory process in the pharynx, our specialists conduct a thorough diagnosis, which allows us to make the correct diagnosis.

The following methods are actively used as therapeutic measures to eliminate inflammation of the pharynx:

  • Mineral therapy - allows you to eliminate the effect of pathological microorganisms, eliminate signs of inflammation, restore the mucous membrane, and most importantly, quickly relieve pain. This method of treating inflammation in the pharynx is highly effective and irreplaceable in most cases;
  • Ozone therapy - this modern method of treating ENT pathologies is also actively used in our clinic. With the help of ozone therapy, it is possible to treat even chronic ENT diseases of an inflammatory nature, including chronic pharyngitis. This technique makes it possible to eliminate the infection not through the use of antibacterial therapy, but with the help of medical ozone, which has a positive effect in treatment and leads to the complete elimination of inflammation in the pharynx.

It is very important that in our clinic each treatment method is selected for the patient individually. This approach allows you to quickly and efficiently eliminate inflammation of the pharynx and achieve excellent treatment results. Remember, treatment in our clinic will always be as comfortable and high-quality as possible for you!

Inflammation of the pharynx or pharyngitis, a disease that in itself does not pose a great danger and goes away after several rinses. However, its consequences can be dire. If neglected or not fully treated, it can cause inflammation of the kidneys, rheumatism and lead to heart disease.

A feeling of sore throat, itching that makes you want to cough, and all this against the backdrop of an absolutely normal body temperature. This feeling is familiar to many people. After a couple of days they turn into a severe sore throat with a slight increase in temperature. Patients with such symptoms rarely go to the doctor and prefer to treat themselves.

Inflammation of the mucous membrane and lymphoid tissue of the pharynx, which appears due to the influence of aggressive external and internal factors on them, is called pharyngitis. The disease can occur in acute and chronic forms. Depending on the location of the source of the disease, there is nasopharyngitis, when the nasal mucosa of the nasopharynx is affected, and mesopharyngitis, if the lining of the oral part of the pharynx is inflamed. The second type of disease occurs most often.

Almost the entire population of the globe has suffered from this disease. There are few who would not imagine the unpleasant sensations caused by it. No one can be immune from pharyngitis, since it can develop equally from eating cold food and from drinking a glass of too hot tea. The disease can even be caused by cigarette smoke, which is inhaled when being in the same room as a smoker.

There are many diseases of the larynx that are confused with pharyngitis:

  • scleroma;
  • laryngospasm;
  • pharyngomycosis;
  • swelling, stenosis of the larynx;
  • sore throat or tonsillitis;
  • laryngitis.

Many of them are dangerous to humans and can be fatal if treatment is not started in a timely manner.

Causes of the disease

The throat is the most vulnerable part of the human body. Therefore, the inflammatory process can occur due to many reasons. In the autumn-spring period and winter, the cause of the disease can be cold air that enters the larynx directly, and not through the nose. With a viral infection, the pharynx will be irritated by bacteria that have entered the body and secretions from the paranasal sinuses flowing down it.

An organism weakened by any disease can easily become infected with various types of microbes (staphylococci, streptococci, pneumococci), viruses, and fungi. This group also includes people who abuse alcohol and smoking.

If there is a focus of infection in the oral cavity, this can also provoke inflammation of the posterior wall of the nasopharynx. For this, incompletely treated dental caries or stomatitis is sufficient.

For people who work in the service sector and, due to their profession, have contact with chemicals every day, this is what can cause illness. Air pollution has a great influence on the occurrence of pharyngitis. This is the reason that city residents complain of throat diseases more often than people living in rural areas.

Types of disease

First of all, it is necessary to determine what type of pharyngitis is bothering you: chronic, allergic or acute. Each of them has its own sources and provoking factors, which means that subsequent treatment should be different.

The acute form is caused by staphylococci and streptococci, and therefore often accompanies adenovirus and influenza. In addition, the disease can be activated by unfavorable factors:


The allergic form is often found among workers of large enterprises and among city residents. It can be triggered by polluted air and industrial emissions. Appearing dryness and soreness are caused by swelling of the back wall of the pharynx.

The chronic form can develop as a result of acute or untreated pharyngitis, appear in old or senile age, and be a consequence of serious diseases of the gastrointestinal tract, cardiovascular and urinary systems.

Chronic form

There are several types of chronic pharyngitis:

  • atrophic;
  • hypertrophic;
  • catarrhal;
  • combined form.

Atrophic farinitis is combined with degradation of the mucous membrane lining the nasal cavity. As a result of this atrophy, microbes freely enter the human body and primarily into the throat. The cause of this form may be infection of the throat by a fungus due to prolonged use of antibiotics.

The hypertrophic form is accompanied by nausea and vomiting due to mucus accumulating in a large volume. It also makes you want to constantly hawk and cough. In addition to mucus, pus periodically accumulates in the throat, which causes bad breath.

Catarrhal pharyngitis causes the sensation of a “lump” in the throat. The disease is accompanied by mild pain when swallowing with moderate tingling and an intermittent cough resulting from tickling.

The mixed form is characterized by the fact that in addition to a sore throat and cough, one or more forms of chronic pharyngitis can be added. Before treating a chronic disease, it is necessary to find out and eliminate all the factors that cause it. Otherwise, the treatment measures taken will not only not give a positive result, but will also cause irreparable damage to the patient’s health.

Symptoms of the disease

Irritation of the pharyngeal mucosa at the onset of the disease has no characteristic symptoms and is similar to all other throat diseases. Only a doctor can make an accurate diagnosis on the basis of which treatment will be prescribed after personally examining the patient and passing tests.

Signs characteristic of acute and chronic pharyngitis at the initial stage of the disease:

  • pain;
  • sore throat;
  • general condition is normal;
  • the temperature does not rise.

If the disease is caused by viruses, then be sure to do the following on day 2-3:

  • a runny nose appears;
  • a dry, sharp cough appears;
  • the voice becomes hoarse, becomes hoarse;
  • when coughing, light sputum is produced;
  • the temperature rises to 38°C and above.

A bacterial infection will cause slightly different symptoms:

  • enlarged lymph nodes;
  • the voice becomes hoarse or disappears;
  • sharp “barking” cough to the point of nausea;
  • body temperature ranges from 37°C to 38°C.

The chronic form causes approximately the same conditions in patients. The difference lies in the color of the sputum and its quantity.

This form is characterized by:


This form is also characterized by pain when eating salty, spicy foods, and a feeling of a lump in the throat.

Treatment of the disease

Self-medication is not advisable. How long it takes for treatment depends only on the form of the disease. This also affects the duration of the disease.

The acute form lasts from 4 days to 2 weeks. For treatment:

  • the throat is sprayed with medicines;
  • solutions with alkaline content are sprayed;
  • alcohol consumption and smoking are excluded;
  • spicy and salty foods are limited;
  • drugs are prescribed to fight bacteria;
  • fever-lowering agents.

In the chronic form of the disease, the source of inflammation in the body that caused the exacerbation of the disease is first blocked. For this:

  • crusts and mucus are removed, for this purpose inhalations and spraying are done;
  • treat the pharynx with solutions that reduce its swelling;
  • carry out treatment with ultrasonic phoresis;
  • antiseptic and anti-inflammatory drugs are prescribed.

Only after this is a course of treatment carried out, which can last about a year.