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Chronic Diseases of The Pharynx PowerPoint Presentation

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Description : Check out this medical PowerPoint presentation titled "Chronic diseases of the pharynx" by Nikiforova G.N., MD.

This medical PowerPoint presentation is about the chronic diseases that can affect the pharynx, which is the muscular tube that connects the nasal cavity and mouth to the esophagus and larynx. Some of the common chronic diseases of the pharynx include:

Pharyngitis: This is a condition where the pharynx becomes inflamed, leading to sore throat, difficulty swallowing, and sometimes fever. Chronic pharyngitis can result from repeated infections or irritation.
Tonsillitis: This is a condition where the tonsils, which are located in the pharynx, become inflamed and swollen. Chronic tonsillitis can result in frequent sore throat, bad breath, and difficulty swallowing.
Laryngopharyngeal reflux (LPR): This is a condition where stomach acid backs up into the pharynx and larynx, leading to irritation and inflammation. Chronic LPR can result in hoarseness, throat clearing, and chronic cough.
Pharyngeal cancer: This is a type of cancer that develops in the pharynx. Chronic irritation from smoking, alcohol use, or viral infections can increase the risk of developing pharyngeal cancer.
Obstructive sleep apnea (OSA): This is a condition where the airway becomes blocked during sleep, leading to pauses in breathing and disrupted sleep. Chronic OSA can result in fatigue, daytime sleepiness, and other health complications.

It is important to seek medical attention if you have chronic symptoms related to the pharynx, as some of these conditions can lead to serious complications if left untreated.

Tags : Chronic diseases of the pharynx, nasal cavity, esophagus, larynx, Pharyngitis, Tonsillitis, Laryngopharyngeal reflux, Pharyngeal cancer, Obstructive sleep apnea

Published on : Jun 23, 2023 | Views : 885 | Downloads : 4

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Slide 1-

1. Chronic diseases of the pharynx Department of Ear, Throat and Nose Diseases Sechenov University Moscow, Russia Lecturer Nikiforova G.N., MD, professor
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1.1. Part 1 Сhronic pharynx diseases Department of Ear, Throat and Nose Diseases Sechenov University Moscow, Russia Lecturer Nikiforova G.N., MD, professor
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Classification of chronic pharyngitis based on the nature of changes in the pharyngeal mucosa Types of Pharyngitis: catarrhal or simple chronic pharyngitis; atrophic (subatrophic) pharyngitis; hypertrophic (diffuse and limited - granular, lateral) pharyngitis; mixed form of the disease (a combination of morphological changes in the pharynx of a different nature)
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Chronic pharyngitis Possible reasons Relapsing Acute Pharyngitis Chronic foci of infection (chronic tonsillitis, sinusitis, dental caries) Prolonged difficulty in nasal breathing, postnasal syndrome Tonsillectomy previously Gastroesophageal Reflux Disease Common diseases (metabolic disorders, diabetes mellitus, chronic renal failure) Smoking, adverse environmental and climatic factors, nutrition, the use of topical corticosteroids
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Chronic catarrhal pharyngitis Complaints With exacerbation - sore throat when swallowing (more - with an "empty" pharynx), a feeling of rawness, soreness, coma, foreign body, discomfort in the pharynx, increased salivation During remission, as a rule, there are no complaints or there are transient discomfort, perspiration myslide.ru Edema, hyperemia and thickening of the mucous membrane of the pharynx Pharyngoscopic picture in chronic catarrhal pharyngitis:
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Pharyngoscopic picture with diffuse hypertrophic pharyngitis: hypertrophy and edema of the mucous membrane znaiu.ru Complaints: With exacerbation - sore throat when swallowing (more - with "empty" pharynx), more intense than with chronic catarrhal pharyngitis, sensation of soreness, soreness, lump, foreign body, discomfort in the pharynx, increased salivation During remission, there is transient discomfort, perspiration, accumulation of viscous mucus in the throat, or there are no complaints Hypertrophic pharyngitis
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Hypertrophic pharyngitis 03online.com en.ppt-online.org Pharyngoscopic picture with granulosa pharyngitis and lateral pharyngitis 1- hypertrophy of the pharyngeal granules 2- hypertrophy of the lateral pharyngeal rollers Complaints: With exacerbation - sore throat when swallowing (more - with "empty" pharynx), more intense than with chronic catarrhal pharyngitis, inherent in sadinas, perspiration, lump, foreign body, discomfort in the pharynx, increased salivation During remission, there is transient discomfort, perspiration, accumulation of viscous mucus in the throat, an almost constant desire to cough or there are no complaints 2 1
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Atrophic pharyngitis Thinning and dryness of the pharyngeal mucosa. The mucous membrane is pale pink, has a "varnished" look 03online.com Complaints: With exacerbation - sore throat when swallowing (more - with "empty" pharynx), more intense than with chronic catarrhal pharyngitis, sensation of soreness, soreness, lump, foreign body, discomfort in the pharynx, increased salivation During remission, dryness in the throat, pain against dryness, almost constant discomfort, soreness, often - the formation of mucous membranes or crusts in the throat Pharyngoscopic picture
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Mixed form of chronic pharyngitis Pharyngoscopic picture Thinning and dryness of the pharyngeal mucosa. The mucous membrane is pale pink, has a “varnished" appearance, hyperplasia of the lateral pharyngeal ridges 03online.com
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Therapeutic measures for chronic pharyngitis in remission Elimination of causative factors, treatment of concomitant somatic diseases and pathology of ENT organs Exposure to hypertrophic areas of lymphoid tissue and pharyngeal mucosa (high-energy laser exposure, cryodestruction, radio wave destruction) In atrophic processes - irrigation of the pharyngeal mucosa with isotonic seawater, the use of artificial saliva, courses of moisturizing inhalations, lubrication of the pharyngeal mucosa with Lugol's solution In atrophic processes - novocaine blockade of the posterior pharyngeal wall with a solution of proserin or aloe, vitamin therapy (insufficient evidence base)
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1.2. Part 2 Сhronic pharynx diseases Department of Ear, Throat and Nose Diseases Sechenov University Moscow, Russia Lecturer Nikiforova G.N., MD, professor
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Chronic tonsillitis general infectious-allergic (?) disease with local manifestations in the form of persistent chronic inflammation of the palatine tonsils, characterized by a relapsing course Epidemiology One of the most common diseases in all regions of Russia. Among the adult population, the prevalence is 4–37%, and in childhood - 15–63%.
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Types of formation of chronic tonsillitis The development of chronic tonsillitis is preceded by a transferred sore throat (when the patient can accurately indicate the time of onset of the disease) The disease develops imperceptibly (non-angina form of chronic tonsillitis) masked by frequent SARS, adenoiditis, stomatitis, periodontitis. Palatine tonsils are involved in the inflammatory process a second time
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Chronic tonsillitis Complaints: Discomfort in the throat, a sense of unpleasant odor, the formation of “jams” in the gaps of the tonsils; Pain in the throat during remission is usually due to concomitant pharyngitis; acute tonsillitis previously; Tonsillogenic intoxication (low-grade fever, weakness, malaise, fatigue, periodic joint pain, heart pain without objective impairment
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Signs of chronic tonsillitis No pathognomonic symptom A diagnosis requires a combination of several features. Sign of Zach - swelling in the upper corner formed by the front and rear arches Sign of Preobrazhensky - hyperplasia and infiltration of the edges of the upper palatine arches Sign of Giza - hyperemia of the anterior palatine arches Pathological contents in the gaps - caseous-purulent detritus Maxillary lymphadenitis Fusion and adhesion of palatine arches with tonsil lxuafv.cn.triagung86.wordpress.com Pharyngosopic picture with chronic tonsillitis
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Classification (according to I. Soldatov) 1. Compensated form: local signs of chronic inflammation of the tonsils without a pronounced general reaction recurrent tonsillitis in the anamnesis (not more often than 1 tonsillitis in 1-2 years), or non-anginal course of inflammation 2. Decompensated form:(more often than 1 tonsillitis in 1-2 years) a history of paratonsillitis and paratonsillar abscesses the presence of conjugate (metatonsillar diseases)
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Classification (according to Preobrazhensky B.S. and Palchun V.T.) Simple form – only local signs, sore throats - less than 1r per year; Toxic Allergic Form I (TAF I) - history of periodic sore throats, local signs in combination with general toxico-allergic effects (periodically subfebrile temperature, manifestation of tonsillogenic intoxication with weakness, malaise, fatigue, periodic joint pain, heart pain during exacerbation without objective disturbances on the ECG); Toxic – allergic form II (TAF II) - more pronounced signs of TAF I in the kidneys, liver, vascular system, joints, registered in the laboratory) and associated diseases that have common etiopathogenetic factors with chronic tonsillitis: local (paratonsillar abscess, parapharyngitis) and general.
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Metatonsillar (conjugate) diseases Diseases of distant organs and systems in chronic tonsillitis are diverse and widespread. Collagen diseases (rheumatism, systemic lupus erythematosus, periarteritis nodosa, scleroderma, dermatomyositis) Rheumatic and non-rheumatic carditis Focal or diffuse glomerulonephritis Thyroiditis, thyrotoxicosis Skin diseases (psoriasis, eczema, erythema multiforme exudative) Thrombocytopenic purpura, hemorrhagic vasculitis Recurrent erysipelas
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Conservative; Organ preserving surgery Radical surgical (tonsillectomy) Methods of treating patients with chronic tonsillitis
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Treatment of chronic tonsillitis Indications Compensated form of chronic tonsillitis Decompensated form of chronic tonsillitis in the presence of contraindications for surgical treatment For diagnostic purposes - to confirm the metatonsillar nature of lesions of distant organs in the case of temporary positive dynamics during treatment Conservative
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Protocol for the Conservative Treatment of Chronic Tonsillitis Local treatment: Washing of gaps of palatine tonsils (syringe, hardware); «Tonsilor»; Physiotherapy; Immunomodulators, bacterial lysates Remediation of regional foci of infection Systemic treatment: Adaptogens, antioxidants, immunomodulators Phytotherapy Homeopathic remedies
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Washing the gaps of the palatine tonsils ppt-online.org
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Criteria for the effectiveness of conservative treatment of chronic tonsillitis The absence of pathological contents in the gaps of the tonsils Reducing the severity of local signs of chronic tonsillitis Decrease in frequency or absence of acute tonsillitis General improvement
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Surgical treatment of chronic tonsillitis Indications: Decompensated form of chronic tonsillitis (the presence of confirmed metatonsillar diseases, a history of paratonsillar abscess, tonsillitis more often 1-2 times a year). Inefficiency of two or more courses of conservative treatment with a compensated form of chronic tonsillitis. Tonsillectomy
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Tonsil niches 2 days after tonsillectomy (fibrinous plaque) Archive of the First MGMU. I.M.Sechenov
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Surgical treatment of chronic tonsillitis Partial tonsil removal using laser radiation or shaver, cryodestruction of lymphoid tissue Lacunotomy (dissection of the walls of the gaps to improve their drainage) Organ conservation operations
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Treatment of chronic tonsillitis Lacunotomy - an operation first proposed in 1909 by N.P. Simanovsky (dissection of the walls of lacunae with a sickle-shaped scalpel; later they started using an electrocautery). Modern varieties of lacunotomy Laser lacunotomy Intralacunar exposure to a high-energy laser beam Organ conservation operations
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Surgical treatment of chronic tonsillitis indications: Inefficiency of conservative treatment in the compensated form of chronic tonsillitis; Contraindications to tonsillectomy in the decompensated form of chronic tonsillitis Trial treatment with relative indications for tonsillectomy Organ conservation operations
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Intralacunar exposure to a high-energy laser beam Archive of the First MGMU them. I.M.Sechenov
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Intralacunar exposure to a high-energy laser beam Archive of the First MGMU them. I.M.Sechenov
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Expansion and straightening of the gap, the disappearance of narrowing and branching that impede drainage Partial coagulation of lymphoid tissue Strengthening the histohematological barrier due to the development of fibrous tissue in the perilacunar zone, at the site of coagulation necrosis. Helps reduce the absorption of toxins and antigens from the lacunae Intralacunar exposure to a high-energy laser beam Archive of the First MGMU them. I.M.Sechenov
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1.3. Part 3 Аcute and chronic diseases of the pharynx Department of Ear, Throat and Nose Diseases Sechenov University Moscow, Russia Lecturer Nikiforova G.N., MD, professor
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Adenoids Adenoids (adenoid growths, adenoid vegetation) -Pathologically enlarged pharyngeal (nasopharyngeal) tonsil. -An increase in the pharyngeal tonsil is due to hyperplasia of its lymphoid tissue. gorlor.com Arrow - adenoid vegetation
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Adenoids Adenoids - a widespread disease among children from 1 year to 14-15 years, most often from 3 to 7 years Recently, there has been a tendency to identify adenoids in children of an earlier age and after 15 years. uz.denemetr.com tonsillit.ru Endophoto. 1- adenoids, 2- pharyngeal orifice of the auditory tube, 3- posterior edge of the opener 1 2 3
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Adenoids Adenoid vegetation in terms of growth can be of three degrees: - I degree - adenoid vegetation covers only the upper third of the opener - II degree - adenoid vegetation covers 2/3 of the coulter - III degree - adenoid vegetation covers the opener completely, reaching the level of the posterior end of the n / nasal concha Adenoid vegetation II degree gorlor.com
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Adenoids Difficulty in nasal breathing, especially in sleep, snoring, obstructive sleep apnea syndrome Closed nasal Chronic rhinitis Recurrent exudative otitis media Lag in the mental and mental development of a child as a result of chronic hypoxia Lag in the mental and mental development of a child as a result of chronic hypoxia Changes in the development of the facial skeleton (adenoid face) Changes in the development of the facial skeleton (adenoid face) Violation of the formation of the chest ("chicken breast") Bed-wetting Symptoms ppt-online.org
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Anterior and posterior rhinoscopy Endoscopy of the nasopharynx (gold standard) Radiation diagnostics (x-ray of the nasopharynx in lateral projection, computed tomography, magnetic resonance imaging) Finger examination of the nasopharynx Diagnostics Back rhinoscopy 1- tongue of soft palate 2- nasopharyngeal mirror 3- language nasmork-rinit.com Adenoids 1 2 3
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Differential diagnosis
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X-ray of the nasopharynx loronline.ru radiomed.ru Adenoids Blue arrows – adenoids Red arrows - pharyngeal cavity
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Adenoids Blue arrows – adenoids MRI of the nasopharynx studfiles.net
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ADENOIDS Treatment tactics
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Chronic adenoiditis Chronic infectious allergic process: Catarrhal, exudative-serous, mucopurulent Symptoms : Difficulty in nasal breathing, closed nasal, snoring Drainage of mucus on the back of the pharynx Intrusive wet cough in the morning Low-grade fever Manifestations of intoxication and hypoxia (distraction, increased irritability, pallor of the skin, enuresis and others)
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Methods of conservative treatment of adenoiditis local and, according to indications, systemic antimicrobial therapy (taking into account the identification of the pathogen and its sensitivity to etiotropic drugs) inhaled glucocorticosteroids (no recorded indications are prescribed for the treatment of concomitant pathology) non-specific hypersensitizing therapy irrigation therapy (nasal douche, drug transfer method, retronasal douche) physiotherapy, laser therapy фармакологическая иммунокоррекция homeopathic remedies Climatotherapy astringents (1-2% protargolum solution, etc.)
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Indications for adenotomy persistent difficulty in nasal breathing with adenoid hypertrophy recurrent exudative otitis media frequent acute respiratory infections recurrent chronic infectious diseases of the ear, paranasal sinuses and other parts of the respiratory tract speech impairment, concomitant neuropsychiatric and reflex disorders deviations of the formation of the facial skeleton www.b17.ru
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Adenotomy Beckman Adenot Palchun V.T. M.Meditsina 2002
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Shaver adenotomy gutaclinic.ru
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Differential diagnosis of pharynx diseases vmede.org Leptotrichosis - a bacterial lesion of the pharynx It is characterized by the formation on the surface of the tonsils and less often on the mucous membrane of dense white spines - the result of increased proliferation of the epithelium and keratinization May be asymptomatic or with mild discomfort in the throat Pharyngoscopic picture with leptotrichosis
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Differential diagnosis of pharynx diseases Hairy Leukoplakia - An Absolute Sign of HIV Infection Mucosal growths on the lateral surfaces of the tongue, cheek mucosa Bull TR, “Geotar-honey”, 2004
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Differential diagnosis of pharynx diseases Candidiasis of the oral cavity and oropharynx (spreads to the entire mucous membrane, may be continuous or in the form of foci). It occurs with repeated courses of systemic antibiotic therapy, in AIDS patients, prolonged use of aerosol steroids. Bull TR, “Geotar-honey”, 2004 Pharyngoscopic picture with candidiasis
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Tonsil hypertrophy not a sign of chronic tonsillitis. In the absence of complaints, treatment is not required. Otherwise - tosillotomy Bull TR, “Geotar-honey”, 2004 Differential diagnosis of pharynx diseases Hypertrophy of the tongue (snoring and OSAS. An examination is necessary - polysomnography. Treatment is usually surgical) Bull TR, “Geotar-honey”, 2004
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Hyperkeratosis of the tonsils - formation of a pronounced whitish density (requires palpation with a probe to exclude exudate) Often an accidental find No treatment required in the absence of complaints and signs of chronic tonsillitis Differential diagnosis of pharynx diseases Pharyngoscopic picture with hyperkeratosis Bull TR, “Geotar-honey”, 2004
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Paratonsillar abscess Unilateral enlargement of the palatine tonsil without signs of inflammation - a sign of a tumor (lymphosarcoma) Palatine tonsil cancer (a type of dense ulcer). Ear pain may be one of the first complaints. Differential diagnosis of pharynx diseases - asymmetry of the soft palate and tonsils Bull TR, “Geotar-honey”, 2004
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Literature Clinical otorhinolaryngology / V.I. Babiyak, Ya.A. Nakatis - St. Petersburg: Hippocrates, 2005 - Part 4. Throat - p.412-445. Children's otorhinolaryngology, ed. Bogomilsky M.R., Chistyakova V.R., T. 2.-M.: OJSC "Medicine", 2005. - p. 375-318. Otorhinolaryngology: national leadership / ed. V.T. Palm tree. M .: GEOTAR-Media. - 2008 .-- 960 s. Chronic tonsillitis and tonsillitis. Immunological and clinical aspects. / Ed. S.A. Karpishchenko and V.M. Svistushkina. - SPb .: - Dialogue. - 2017 .-- 264s. Atlas of ENT diseases Bull T.R. Geotar-Med, 2004. - 266 p. Diseases of the nose, pharynx, larynx and ear. Ovchinnikov Yu.M., Lopatin A.S., Gamov V.P. Publisher: Medical News Agency, 2008. - p.133-160