The tonsils are an important part of the human immune system. They are the first barrier in the way of microbes entering the body from the external environment. The initial study of pathogens and the production of antibodies occurs in these organs.
The role of glands in the body's defense system
Discussions about the importance of the tonsils have continued between scientists over the past century. Their main functions, according to the research data available today, are barrier and immunological.
- Barrier function. Toxins and bacteria, penetrating through the epithelium into the glands, are rendered harmless by the reticulo-endothelial system. In the process of suppressing pathogens, local antibodies are produced, which contributes to the gradual immunization of the body. Mucous membranes, organ capsule, walls of lymphatic and venous vessels and internal lymph nodes become barriers to infections.
- Immunological role. Bacteria linger in gaps, multiply and grow there. At the same time, the antigens they produce are able to pass through epithelial cells, affect white blood cells (B- and T-lymphocytes) and lead to the production of antibodies, i.e. actually "produce vaccines" naturally.
The nature of the effect of the tonsils on the formation of human immunity has not yet been fully studied.
Features of the structure of the glands
The palatine tonsils are paired formations consisting of lymphoid tissue and located in the tonsillar niches between the root of the tongue and the palatine arches.
A distinctive feature of the structure of the palatine tonsils is that their inner surface, facing the pharynx, is covered with blind canals-lacunae (crypts), which penetrate the thickness of the gland and come out to the free surface in the form of holes of various shapes with a diameter of 1 to 4 mm. There are usually from 10 to 20 such branched and winding lacunae.
The inner side of the organs is covered with squamous epithelial cells, and the outer (facing the pharynx) is covered with dense connective tissue called a capsule or pseudocapsule. The size of the glands depends on the age of the person; in an adult, the length reaches 25-30 mm with a weight of 1.5 g. They can be free (protruding into the pharynx) or hidden in the palatine arches. Their blood supply comes from the carotid artery system, innervation - from various nerves (glossopharyngeal, trigeminal, vagus).
Hypertrophy of the tonsils
This disease is characterized by enlargement of the glands in the absence of any inflammatory processes in them. Most often found in preschool children, as a rule, it is "paired" with adenoiditis.
It has been proven that there is a relationship between hypertrophy and frequent colds in children.
The causes of the disease are not fully understood. According to various researchers, they can be:
- unformed or defective work of the child's immune system;
- chronic tonsillitis;
- regular colds that negatively affect the functioning of lymphoid tissues;
- chronic diseases of the upper respiratory tract and nasopharynx (adenoiditis, sinusitis);
- chemical or thermal effects on the tonsils;
- endocrine diseases and metabolic disorders.
There are three degrees of enlargement of the glands, depending on how much of the space between the anterior edge of the palatine arch and the midline of the pharynx they occupy:
- first degree - 1/3 of the indicated space;
- second degree - 2/3;
- third degree - completely overlap the space, practically in contact with each other.
Hypertrophied organs make it difficult for the baby to breathe, and also interfere with the normal movement of food. With a strong growth of 2 or 3 degrees, especially with the addition of adenoiditis, speech suffers.
Symptoms of the disease:
- the tonsils are edematous, soft, with an uneven surface, pale pink or yellowish;
- plugs in gaps are rare;
- with severe hypertrophy, breathing disorder, snoring, and sleep apnea may occur;
- changes in voice that becomes rough or nasal;
- discomfort in the nasopharynx, a feeling of the presence of a foreign body there.
With a small degree of hypertrophy and the absence of signs of inflammation of the glands and arches of the palate, no specific treatment is performed. It is enough for prevention to carry out regular rinsing of the throat with solutions of baking soda or furacilin. The use of high-quality toothpaste when brushing your teeth due to the presence of anti-inflammatory substances in it also helps to maintain a healthy state of the mouth and throat.
Parents should carefully monitor the correct breathing of the child. The children compensate for the difficulty of nasal breathing with the mouth, which leads to the drying out of the tonsils, their hypothermia and contamination with microbes.
This often becomes the cause of the development of tonsillitis. Therefore, it is necessary to promptly eliminate the reasons that impede full-fledged nasal breathing.
At a higher magnification, it is advisable to see an otolaryngologist. Often in such cases, the doctor, in addition to antiseptic rinses, advises lubricating the surface of the organs with cauterizing or astringent agents, which is carried out for 2-3 week courses. The most commonly used solutions for this are: collargol (3%), lapis (2%), iodine-glycerin (0.5%), tannin-glycerin (5%), hydrogen peroxide. Well protects and nourishes the mucous membrane of carotene, which can be applied to the surface of the glands before bedtime to prevent them from drying out.
With 2 and 3 degrees of hypertrophy, conservative treatment may not give the desired result. Difficulty breathing and speaking, difficulty swallowing food, frequent colds with swelling of the mucous membranes require more effective measures. In such cases, surgery is required.
Plugs in the tonsils
Plugs are most often formed in lacunae, however, in some cases, they may appear under the epithelium or directly in the lymphoid tissues. Corks are rotting dead cells of the immune system, glandular tissue, and food debris. The reasons for their appearance are acute and chronic tonsillitis, infections of the nasopharynx, food stuck in deformed lacunae.
Manifestations of the disease:
- plugs are usually clearly visible on examination and look like yellowish-gray spots with a diameter of 1 to 5 mm;
- a feeling of plaque and discomfort in the throat;
- unpleasant (putrid) odor from the mouth.
For the bacterial cause of tonsillitis, antibiotics should be used. Local therapy consists of irrigation or rinsing with antiseptics (chlorhexidine, miramistin) and antibacterial drugs (bioparox). In an outpatient clinic, plugs are removed by washing with a syringe, at home - with a cotton swab or a finger wrapped in a bandage. After removing plaque, gargle with an antiseptic.
In the case of a regular appearance of plugs, a laser lacunotomy has been increasingly proposed recently, which is a laser excision of individual affected crypts, after which they stop clogging due to an increase in the diameter of the hole. At the same time, unlike tonsillectomy, the organ itself continues to function fully.
Tonsillectomy: pros and cons
Operations on the glands have been known to mankind for more than 3 thousand years. As a rule, they are simple, have a low risk of postoperative complications and are performed under general or local anesthesia using special instruments.
Indications for surgery:
- ineffectiveness of conservative treatment;
- tonsillitis with frequent relapses (at least 5-7 exacerbations per year);
- chronic tonsillitis in a decompensated form or with toxic phenomena that increase the risk of developing renal or cardiovascular complications;
- swallowing or breathing problems, sleep apnea syndrome;
- signs of brain hypoxia due to lack of oxygen (pallor, hyperactivity, poor sleep);
- complications with the formation of pus.
There are a number of permanent or temporary contraindications for surgical intervention. Permanent include:
- blood diseases (hemorrhagic diathesis, leukemia);
- mental illness;
- pulmonary tuberculosis;
- diabetes;
- ailments of the liver, kidneys, lungs, heart in the acute stage;
- anomalies of the pharynx.
Contraindications such as infectious diseases, caries, menstruation, dermatitis, flu are temporary. The operation is carried out after their elimination.
There are two main types of such operations:
- tonsillotomy (a more gentle procedure) - cutting off a part of an enlarged organ using a special loop or tonsillotomy. Often it is carried out in combination with the removal of overgrown adenoids (adenectomy).
- tonsillectomy - complete excision of organ tissue along with a capsule. Modern medicine offers a wide range of instruments for intervention: scissors, wire loop, ultrasonic scalpel, high frequency electric current, radio waves, carbon and infrared lasers.
Removing the tonsils is a serious measure, since this paired organ is an integral part of the body's local immune system.
In the postoperative period, the cleaned niches are covered with a white bloom, which disappears by the end of the first week, on the 10-12th day, the tonsillar niches are completely cleansed, and three weeks after the manipulation they are covered with epithelium. Complications are rare, as a rule, bleeding, less often infectious and inflammatory processes.
Tonsillectomy can weaken the immune system in the nasopharynx, resulting in recurrent upper respiratory infections. Therefore, the decision to promptly remove the glands is made only after all possible conservative methods of therapy have been applied.
Traditional medicine recipes
Using the recommendations of traditional medicine, you can prevent the occurrence of inflammatory processes in the throat. Most popular proven tips:
- after each meal, gargle with plain water or sea salt solution to remove stuck food pieces;
- lubricate the glands with aloe leaf juice (can be mixed with honey in a ratio of 1: 3) or oils (sea buckthorn, apricot, peach) half an hour after eating;
- gargle 2-3 times a day with warm mineral water without gas, decoction of oak bark, walnut leaves or chamomile;
- give older children a pea-sized piece of propolis to chew.
