Pharyngitis chronic

Pharyngitis chronic

Chronic pharyngitis (CP) is a chronic inflammation of the pharyngeal mucosa that develops as a result of acute inflammation with inadequate treatment and unresolved etiological factors. Classification by pathomorphological changes

• • Catarrhal CP (simple) – persistent diffuse venous hyperemia, mucosal edema, dilation and stasis of small veins, dilation of excretory ducts and hypersecretion of mucous glands
  • Hypertrophic CP is the replacement of the cylindrical ciliated epithelium with a cubic or flat one, the epithelium is desquamated, forms outgrowths, cystic expansions and depressions, resembling tonsil lacunae. Vessels of small caliber are dilated, perivascular cellular infiltration. The submucosal layer is thickened, infiltrated
  • Atrophic CP – more often occurs as a manifestation of atrophic rhinitis and is characterized by a sharp thinning of the pharyngeal mucosa, desquamation of the epithelial cover with the transformation of the cylindrical epithelium into a multi-layered squamous and a decrease in the number of mucous glands, obliteration of their channels, hyposecretion.

Risk factors

• • Smoking, alcoholism, gas pollution, dusty air (morbidity in urban areas is higher than in rural areas), incl. in production
  • Foci of chronic infection in the nasal cavity, within the sinuses, pharynx, oral cavity, nasal breathing disorders
  • Diseases of the cardiovascular and genitourinary systems, gastrointestinal tract, metabolic disorders, hypovitaminosis.

Clinical picture

• • Dryness, itching, sensation of a foreign body in the throat, cough
  • lacrimation
  • Passing viscous secretions, especially in the morning
  • It is not often that complaints do not correspond to the pharyngoscopic picture – they may be insignificant or absent with pronounced changes in the pharyngeal mucosa and vice versa.

Pharyngoscopy

• • Catarrhal HF – hyperemia, slight swelling and thickening of the mucous membrane of the pharynx, in some places the surface of its posterior wall is covered with transparent or cloudy mucus
  • Hypertrophic HF – the mucous membrane is hyperemic, thickened, the soft palate and palatine uvula are edematous, pronounced congestion (superficial branching veins are traced), mucus on the back of the pharynx
  • Lateral HF – hypertrophy of lymphadenoid tissue in the lateral folds of the pharynx, behind the palatopharyngeal arches, not often the palatine and lingual tonsils are inflamed (the focus of chronic inflammation is an etiological factor)
  • Granular HF is characterized by the presence of round or oblong red lymphadenoid formations 1–5 mm in size in the form of red granules on the posterior pharyngeal wall.
  • Atrophic HF – thinning and dryness of the mucous membrane: it can be pale pink or shiny lacquer, sometimes covered with a viscous purulent secret or crusts. Laboratory studies – see Acute pharyngitis.

Treatment: outpatient

• • non-irritating food
  • Alkaline, oil, herbal inhalations
  • Cauterization of granules and lateral ridges of the pharynx (with hypertrophic HF)
  • Drug method – silver nitrate 10-20% solution, trichloroacetic acid
  • Physical method – galvanocaustics and cryotherapy
  • Alkaline water-glycerin rinses of the pharynx and massage of its back wall with Lugol’s solution in glycerin in atrophic form
  • Local injection of biostimulants into the lateral folds of the pharynx
  • Physiotherapy: electrophoresis with nicotinic acid on the submandibular region, inductothermy, magnetotherapy and low-energy laser, mud applications in the form of a collar
  • Inhalation of proteolytic enzymes
  • Sanatorium treatment in a humid climate with the presence of mud and hydrogen sulfide resources.

See also Angina, Acute Pharyngitis Reduction. HF – chronic pharyngitis of the ICD. J31.2 Chronic pharyngitis