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Paratonsillar abscess (paratonsillitis)

This disease is also called phlegmonous tonsillitis. Between the capsule of the tonsil and the pharyngeal fascia, the distance between which is normally 0.5-1 cm, there is paratonsillar tissue, and behind the pharyngeal fascia, laterally, there is fiber of the parapharyngeal space. These spaces are made of fiber, the inflammation of which, and in the final stage, and abscess formation, determines the clinic of the named disease (Fig. 3.6). An abscess is most often caused by a non-specific flora as a result of the tonsillogenic spread of the infection, although abscesses from carious teeth and more distant foci of inflammation are described. The disease begins acutely with the appearance of pain when swallowing more often on the one hand, a unilateral abscess is 100 times more often than a bilateral one. Typically, a paratonsillar abscess occurs after a sore throat during the recovery period and the appearance of pain should alert the doctor. When examining the pharynx, there is a sharp swelling and hyperemia of the tissues around the tonsil (arches, soft palate, tongue, protrusion of the tonsil from the niche, shift to the midline. An abscess forms on average about two days. General symptoms, weakness, fever, enlargement of the cervical lymph nodes on the side of the abscess The classical triad of paratonsillar abscess was noted: profuse salivation, trismus of the masticatory muscles and open nasal, the latter as a result of paralysis of the muscles of the palatine curtain. Combined treatment of abscesses: intramuscular antibiotics taking into account pain when swallowing and forced starvation, aspirin, analgesics, a half-alcohol compress on the side of the neck (on the abscess side), antihistamines. Surgical treatment is carried out at the same time. Abscesses are distinguished: anteroposterior (most often), when pus accumulates behind the anterior arch and a soft palate near the upper pole of the tonsil, posterior - with accumulation of pus in the posterior arch, external - accumulation of pus between the capsule of the tonsil and pharyngeal fascia. Anesthesia is usually local - lubrication of the mucosa with 5% cocaine solution or 2% dicaine solution.
They are wound on a scalpel so that the tip protrudes no more than 2 cm, otherwise the main vessels of the carotid pool can be injured. The incision is made with the front abscess strictly in the sagittal plane at the middle of the distance from the posterior molar to the tongue, then a blunt probe or hemostatic clamp (Holsted) is inserted into the incision and the edges of the incision are bred for better emptying of the abscess (Fig. 3.7). With the removal of pus, the patient's condition usually improves significantly, but therapy should be continued. After a day, the edges of the incision are again bred with a clamp to remove accumulated pus. It is not always possible to obtain pus during an incision, and this is not a mistake in treatment, since it is difficult to determine the exact stage of abscess formation, and an incision with paratonsillitis (before abscess) has a resolving effect, reducing edema, infiltration, and pain. Opening the posterior abscess through the posterior arch is also performed. It is more difficult and dangerous to open the external abscess, which lies deeper (up to 2.5 cm) and requires more caution in view of the danger of injury to blood vessels. Preliminary puncture with a syringe with a long needle can help in this case, if, in case of detection of pus, the incision is made in the direction of the puncture. After any cut in the throat, rinsing with furatsillin is performed. A pharyngeal abscess is very rare - an accumulation of pus in the region of the posterior pharyngeal wall. In children, this is due to the presence of lymph nodes in the retropharyngeal space, in adults - as a continuation of the external paratonsillar abscess. Requires opening through the back wall as described above (Fig. 3.8). It is necessary to distinguish paratonsillitis from Ludwig's sore throat or abscess in the diaphragm of the bottom of the oral cavity, where there is also loose fiber. In this case, there is a sharp swelling in the submandibular region, difficulties and pain when protruding the tongue. Treatment of Ludwig's sore throat is performed by the maxillofacial surgeon.
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Paratonsillar abscess (paratonsillitis)

  1. Paratonsillar abscess
    The clinical picture appears as a further development of paratonsillitis due to purulent fusion of paratonsillar infiltrate. It may be complicated by bleeding, the development of mediastinitis and tonsillogenic sepsis. Sore throat is worse when swallowing and opening the mouth. Eating is difficult. Body temperature rises sharply. Maxillary lymph nodes enlarge, become
  2. Pharyngeal and paratonsillar abscesses
    A pharyngeal abscess develops as a result of a purulent lesion of deep pharyngeal lymph nodes and loose tissue located in the pharyngeal space. These lymph nodes are regional for the posterior sections of the nasal cavity, paranasal sinuses, auditory tube, middle ear, nasal pharynx and palatine tonsils. A pharyngeal abscess may occur in newborns, but
  3. Paratonsillar abscesses. Types, Technique and features of surgical treatment
    A paratoillar abscess is an acute inflammation of the paratonsillar tissue and surrounding tissues as a result of infection from lacunae or suppurative tonsils follicles. Usually it is a complication of angina. Types of paratonsillar abscesses 1. Upper (anteroposterior) paratonsillar abscess. It is observed most often. It is formed between the anteroposterior
  4. Paratonsillitis
    The clinical picture of Paratonsillitis is a complication of acute primary tonsillitis - catarrhal, lacunar and follicular tonsillitis. It occurs due to the spread of the inflammatory process to paratonsillar fiber. Symptoms: sore throat, the intensity of which increases rapidly, fever up to 39-40 ° C, chills. Maxillary lymph nodes are enlarged, painful.
  5. Paratonsillar abscess. U-36
    {foto33} Treatment outcome: Clinical criteria for improving the patient's condition: 1. Normalization of temperature. 2. Normalization of laboratory parameters. 3. Improving the clinical symptoms of the disease (pain, difficulty swallowing, purulent discharge from
  6. Epidural Abscess
    Epidural abscess - an infectious process that develops between the bones of the skull and the outer leaf of the dura mater, may be accompanied by osteomyelitis. Due to the fact that the pathogen easily penetrates through the dura mater along the emissary veins, the epidural abscess is often accompanied by subdural empyema. Major causative agents The most common cause of
  7. Abscess
    Abscess (abscessus), abscess, abscess - a limited cavity filled with pus, formed as a result of focal purulent fusion of tissues. Etiology. The cause of abscesses is the penetration of microorganisms into tissues with damage to the skin and mucous membrane and when foreign bodies enter the tissue. They can be introduced during medical manipulations (injections, subcutaneous infusions) made
  8. Abscess
    Physical blockage An abscess is a collection of pus in one place. Distinguish between hot and cold abscesses. With a hot abscess (it occurs much more often), pus accumulates very quickly and all four signs of inflammation appear: swelling, redness, temperature, and pain. A cold abscess is characterized by a slow accumulation of fluid in one place with no signs of inflammation. Emotional
  9. ABSCESS
    An abscess is a limited inflammation in tissues or organs, characterized by an accumulation of pus in a newly formed cavity under a dense membrane. An abscess most often occurs after any mechanical damage to the skin (for example, due to a splinter), through which pyogenic microbes (staphylococci, streptococci, Pseudomonas aeruginosa, cryptococcus fungi, etc.) penetrate the skin.
  10. Pharyngeal abscess
    Clinical picture The pharyngeal abscess is a purulent fusion of the lymph nodes and loose tissue of the pharyngeal space. It is especially common in debilitated children under the age of 2-3 years, rarely in adults. In childhood, usually occurs after infectious diseases, acute respiratory viral infections, measles, scarlet fever. In adults, pharyngeal abscesses
  11. Abscess of the larynx
    An abscess of the larynx may be the final stage of phlegmonous laryngitis, but more often it is caused by a body injury (fish bone, etc.). An abscess occurs mainly on the lingual surface of the epiglottis or in the area of ​​one of the arytenoid cartilages, and usually develops gradually against the background of the general inflammatory reaction of the body. Complaints boil down to pain when swallowing. 2-3 days after injury
  12. Brain Abscess
    Clinic. An abscess of the brain is a limited abscess in the brain tissue - intracerebral, or epidural, subdural. Caused by streptococci, staphylococci, pneumococci, etc. Contact (otogenically determined), metastatic (pneumonia, lung abscess), bronchiectatic abscesses and abscesses occurring during open craniocerebral injuries are pathogenetically distinguished.
  13. Otogenic intracranial abscesses
    An extradural abscess is the accumulation of pus between the dura and the bone. It occurs as a result of the spread of the inflammatory process from the mastoid process and tympanum to the cranial cavity and is localized in the middle or posterior cranial fossae. An extradural abscess is usually a complication of chronic suppurative otitis media; often observed
  14. Extradural abscess
    An extradural abscess usually has a contact mechanism of occurrence. In most cases, the source of infection is osteoperiostitis, a carious process located in the wall of the paranasal sinus, which can occur with their chronic inflammation (frontitis, ethmoiditis, sphenoiditis). The onset of the disease is characterized by the appearance of a limited focus of inflammation in the dura mater
  15. Pelvic abscesses
    Abscesses of the pelvic cavity are a delimited accumulation of pus in the cystic-uterine or rectal-uterine space. Such abscesses can form with purulent-inflammatory saccular masses in the appendages, as well as in the postoperative period. In this case, the resulting adhesions delimit the accumulation of pus from the free parts of the abdominal cavity. In the beginning, an inflammatory
  16. ABCESS EASY
    Lung abscess is a pathological process characterized by the formation of a limited cavity in the lung tissue as a result of its necrosis and purulent fusion. The main pathogens The development of lung abscess is primarily associated with the anaerobic flora - Bacteroides spp., F.nucleatum, Peptostreptococcus spp., P.niger - often in combination with enterobacteria (due to aspiration of the contents
  17. Brain Abscess
    A brain abscess is a capsule-limited accumulation of brain detritus, white blood cells, pus, and bacteria. The main causative agents The etiological cause of brain abscess can be bacteria, fungi, protozoa and helminths. Of the bacterial pathogens, the most common are vermin streptococci (S. anginosus, S. constellatus and S. intermedius), which occur in 70% of cases. IN
  18. Causes of the development of brain abscess
    An abscess of the brain is a local accumulation of pus located in the tissue of the brain. Usually, an abscess of the brain occurs as a secondary disease, provided that there is an infectious focus located outside the central nervous system. Mandatory is the penetration of an infectious agent into the brain. At the same time, not one but several abscesses may exist.
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