Tonsillitis is one of the most common diseases of the pharynx (from Latin tonsila – tonsil, -itis – inflammation); it is a long-term or acute inflammation of tonsils.
This condition indicates that the human immune system can not cope with its functions. Palatine tonsils are the organs of the immune protection, which form a kind of a ring (the lymphoepithelial ring of Pirogov) together with the nasopharyngeal tonsils (adenoids), and lingual tonsils. This ring is a powerful barrier that stands in the way of the inhaled air and the incoming food. Tonsils are the first line of the immune system defense, which detects harmful bacteria and viruses in the air and food and triggers an immune response, i.e. the synthesis of antibodies, and cells – killers. That’s why, the tonsils have a very heavy workload.
If you look closely at the tonsils, you can see the holes and crypts on its surface. These holes extend to narrow winding passages, deep into the tonsils, the so-called tonsillar lacunae. Such a structure greatly increases the surface area.
While eating, food gets into the lacunae and is stored there for some time. The immune cells on the lacuna surface analyze its particles and trigger the immune response in case of danger. Then, on swallowing the food with the exfoliated epithelium is “squeezed out” of the lacunae in the form of whitish plugs and the process is repeated.
Why does chronic tonsillitis occur?
Chronic tonsillitis occurs when the process of the evacuation of the lacunae is disturbed.
This usually happens in cases of:
- narrowing of the lacuna mouth by scars that remain on the surface of the tonsils,
- food injury,
- independent extrusion of the plugs and washing out of the lacunae.
The lacuna content can not get through the narrowed “neck” resulting in its congestion.
Microorganisms (generally Streptococcus pathogens) develop in the lumen, which damage the tonsils, causing their inflammation. Waste products of the microorganisms cause intoxication.
Thus, the disease manifests itself by
- sore throat,
- weakness, possible long-term elevation in the body temperature up to 37-37.5° C.
Chronic streptococcal infection is the starting point of rheumatic autoimmune inflammation of the connective tissue that is manifested by damaged joints, heart valves and kidneys.
Chronic tonsillitis requires surgery. The effectiveness of conservative treatment is very controversial. Any garglings, washing out of the lacunae by the syringe provide relief at first, but injure the mucous membrane and later on the situation becomes aggravated.
In presence of signs of rheumatism it is advisable to remove the tonsils completely, which are the reservoir of dangerous infection in this case.
Preparation to the surgery.
The kind of planned surgery is determined only after laboratory and clinical examination of the patient and consultation of the physician.
In absence of signs of rheumatism and electrocardiogram changes laser lacunotomy is a method of choice.
The operation is non-traumatic. Modern laser equipment used in the clinic Virtus, allows to effect precisely the necessary parts, while maintaining the valuable function of the mucous membrane and lymphoid tissue of the pharynx organs.
The purpose of surgical treatment is the laser evaporation of the narrowed lacuna neck, resulting in restoring its drainage. The tonsils are not removed (if it is not needed).
The operation is very gentle, however, for the comfort of the patient it is performed under general anesthesia.
Hospital stay is not required. Laser lacunotomy is mostly tolerated by the patients easily. There are no particular limitations postoperatively. However, we recommend to refuse visits to sauna, bath and drinking during the first 1-2 days after surgery.