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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 festering tonsils. 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 part of the palatine arch and the tonsil, where the largest amount of loose fiber is easily infected from the tonsil. Clinic: complaints of increasing pain when swallowing, more often with one
hand, body temperature rises. The pain intensifies when swallowing, coughing, and turning the head. Opening the mouth is difficult and painful. The voice becomes nasal. With pharyngoscopy, sharp hyperemia of the mucous membrane and infiltration of the corresponding half of the soft palate and palatine arches are determined. The palatine tonsil is tense and shifted to the middle and down (to the healthy side). Cervical and submandibular lymph nodes are enlarged.
Treatment: prompt. The incision is made in the middle of the line connecting the base of the tongue and the last molar. Anesthesia is produced by lidocaine in the form of an aerosol. Make an incision up to 1 cm long. Then stupidly (preferably with a nasal forceps) they pierce and push the soft tissues to a depth of 1-2 cm. The next day, you need to examine the patient, part the edges of the incision and release the accumulated pus.
If an abscess is opened, but pus does not stand out, this is an infiltrative form of paratonsillitis.
Antibiotic therapy may be used at the discretion of the attending physician.
In other forms of paratonsillitis, antibiotic therapy is required.
Augmentin, an inhibitor of r-lactamase, and rocefin, cephalosporin, are used. It is applied once a day. Rinses are carried out often. They provide mechanical cleansing. You can rinse by any means. Aspirin, vitamins, a sparing diet, heavy drinking, observation are also prescribed.
2. Back paratonsillar abscess
It is located between the amygdala and the posterior palatine arch. It is rare. The clinical picture is poorly expressed. Spontaneous dissection of the abscess is dangerous, which can lead to aspiration of pus, reactive swelling of the larynx. An autopsy, drainage on the background of a powerful antibacterial treatment is recommended.
3. Lower paratonsillar abscess. It is located between the palatine and lingual tonsils.
4. External paratonsillar abscess. Located out of the tonsils.
Often found in childhood. It is located between the vertebral fascia and fascia, covering the muscles of the pharynx in the cellular space, where blood and lymph flow from the tonsils. This space is divided by a crescent ligament, communicates with the anterior mediastinum. An abscess is usually one-sided. An abscess needs to be drained.
Peripharyngeal (parapharyngeal) phlegmon
Occur when the infection spreads to the lateral cellular spaces. May extend to the mediastinum. Urgent surgical treatment is needed.
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Paratonsillar abscesses. Types, Technique and features of surgical treatment
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