Throat
Discuss Throat Condition
Tonsillitis
A discussion of throat conditions: Tonsillitis and Quinsy
Tonsillitis and Tonsillectomy: Overview
The tonsils are described as being “…part of a ring of lymphoid tissue (Waldeyer’s ring) that encircles the entrance to the food and air passages in the throat.” (Jacoby and Youngson, 2005, p. 2235) The tonsils grow rapidly but regress to a great degree after puberty. They function as part of the human immune system. As such they are an integral part of the body’s defense system against disease. “They are ideally situated to monitor ingested material and to react to those materials that could pose a threat to the well-being of the body.” (Jacoby & Youngson, 2005, p. 2236) The tonsils also produce antibodies that combat local infection.
Tonsillitis is a fairly common infection of the throat which sometimes results from a dangerous bacterium, streptococcus which infects the tonsil. (Jacoby & Youngson, 2005, p. 2236) While the bacterium is the cause, this condition can also be precipitated by other factors such as stress.”Stressors of various kinds often seem to precipitate the disease of tonsillitis in the individual.” (Asen, Tomson, Young & Tomson, 2003, p. 4)
It is important to understand the difference between a common sore throat and tonsillitis. A sore throat can be caused by many factors and refers to the inflammation of the tissues of the throat in varying degrees of severity. Tonsillitis on the other hand refers specifically to the inflammation of the tonsils. (Jacoby & Youngson, 2005, p. 2010)
The difference between a simple, ordinary sore throat and tonsillitis is also the length of time that the latter persists. With tonsillitis the throat condition can last for more than one week. This infection of the tonsils can result in the tonsil becoming enlarged and inflamed. Pus may also exude from the surfaces of the infection.
(Jacoby & Youngson, 2005, p. 2236) Consequently, “Infections which start with a sore throat or pharyngitis often spread to nearby tissues and involve them too. The most commonly affected neighboring organ is the tonsil.” (Jacoby & Youngson, 2005, p. 2011) With Tonsillitis the sore throat becomes more severe and swallowing is almost impossible. The tonsil once infected usually becomes red and swollen. It is also very painful, with an accompanying high temperature. If this condition is not treated it can lead to a more severe condition which is known as Quinsy or a peritonsillar abscess.
The usual symptoms of tonsillitis include the following.
Discomfort of the pharynx
Pain experienced while swallowing
This pain may also extend to the ears
Some patients also experience discomfort on turning their head because of swelling of the glands in this region
Malaise and vomiting may occur, especially in children
A fever almost always accompanies the infection, but it varies in degree.
(Jacoby & Youngson, 2005, p. 2011)
1.1. Occurrence
This infection is most commonly found in the younger age demographic, usually in children between the ages of four and six as well as in puberty. (Jacoby & Youngson, 2005, p. 2236) There is also a pattern of reoccurrence with this disease in that if the tonsils are infected they become more prone to infection later on.
1.2. Treatment
Tonsilitus responds to antibiotics and “… improvement can be expected within 36-48 hours.” (Jacoby & Youngson, 2005, p. 2236) Symptomatic relief is provided by the absorption of liquids as well as from painkillers such as aspirin that reduce the temperature caused by the infection.
2. Tonsillectomy
Recurrent infections may necessitate the removal of the tonsils in a process known as tonsillectomy. As one study notes; “A stage is reached when removal of the tonsils is the only sensible way of controlling the illness.” (Jacoby & Youngson, 2005, p. 2236) This occurs when local inflammation due to the infection of tonsils becomes extreme, sometimes causing swallowing to be difficult. This in turn makes antibiotics ineffective. This in turn makes antibiotics ineffective. The removal of the tonsils takes place under general anesthesia and the procedure is known as a tonsillectomy.
3. Quinsy
Quinsy is a medical term that refers to a complication of tonsillitis when a peritonsillar abscess develops. In this case, after the tonsil becomes infected, an abscess forms between the tonsil and the tissue of the soft palette of the mouth. Furthermore, “The infection may spread, before it abscesses, into a fairly large area of the soft palate, and when the abscess finally forms, it may include a good portion of that side of the soft palate.” ( Schvey, 1989) An important consideration is that the abscess may in fact cause the displacement of the tonsil, which will lead to pain and a high temperature, as well as difficulty in swallowing. ( Schvey, 1989)
The process of developing quinsy is described as follows. It begins with a simple case of sore throat and tonsillitis. This condition seems to improve at first. However, after a short period of time, usually a few days, the pain increases and the patient usually experiences difficulty in swallowing. Pain also extends to the ears. Other indications of the development of a peritonsillar abscess are that “… It becomes difficult to open the mouth because of spasm of the chewing muscles, and the speech becomes thick and indistinct.” ( Schvey, 1989)
The condition of the patient worsens with a concomitant increase in pain, to the extent that he or she cannot eat. There is also in many cases pressure to the neck which causes the head to be tilted. Other symptoms include excessive salivation and bad breath and an increase of temperature to 38 degrees Celsius and extreme illness. (Jacoby & Youngson, 2005, p. 2012)
3.1. Complications
There are a number of complications that may occur if a peritonsillar abscess occurs with tonsillitis. These include “…infection of the tissue between the lungs or the lining covering the heart.” ( Schvey, 1989) There is also the chance that if the infection and inflammation becomes very severe, then this condition could lead to death. This may occur if the”… resultant inflammation is severe enough to push the tongue upward and cause strangulation.” ( Schvey, 1989) In most cases tonsillectomy is the preferred treatment to deal with extreme cases of quinsy.
3.1 Treatment
There are a number of problems in the treatment of this condition. A central difficulty is that if the abscess is allowed to become fully developed then normal antibiotics will have no effect in curtailing the advancement of the infection. This is due to the fact that “…the center of an abscess is cut off from the general blood supply and no antibiotics can get to the germs.” (Jacoby & Youngson, 2005, p. 2012)
It is however also clear that if tonsillitis is treated at an early stage with antibiotics then it is relatively easy to avoid a disease like quinsy. Other forms of treatment for this disease include various painkillers; an ice pack is applied to the neck, mouthwashes and a cold liquid or semisolid diet. (Jacoby & Youngson, 2005, p. 2012) Surgery and the draining of the abscess is the most appropriate treatment outcome for quinsy.
4. Conclusion
The above study of throat conditions like tonsillitis and quinsy refer to a number of pertinent facts. While tonsillitis is still a prevalent ailment especially among young children, it can be relatively easily treated with modern antibiotics. What is also clear from the above is that a complication like quinsy can be avoided if the tonsillitis is treated at early stage. While quinsy is a serious condition, prevention and the user of modern medicine can successfully prevent the prevalence of this condition.
References
Asen, E Tomson, D Young, V & Tomson, P 2003, Ten Minutes for the Family: Systemic Interventions in Primary Care, Routledge, New York.
Bradley, E 1994, A Patient’s Guide to Surgery, University of Pennsylvania Press. Philadelphia:
Harold C ( Ed.) 2005, Professional Guide to Diseases, Lippincott Williams & Wilkins, N.Y.
Hecht, A 1985, Whatever the Cause, a Sore Throat Is Hard to Swallow. FDA Consumer,” volume 19, pp.18+.
Jacoby, D and Youngson, R 2005, Encyclopedia of Family Health (3rd ed.) (Vol. 14), Marshall Cavendish, New York.
Jacoby, D and Youngson, R 2005, Encyclopedia of Family Health (3rd ed.) (Vol. 16), Marshall Cavendish, New York.
Schvey, M 1989, “Peritonsillar abscess (quinsy). (The Pharynx) (Diseases of the Ear, Nose and Throat),” The Columbia Univ. Coll. Of Physicians & Surgeons Complete Home Medical Guide, Lowenstein Associates, Inc. viewed 18 Feb. 2011, .
