E.N.T Quiz: Tonsils Overview

Introduction to Tonsils

• Tonsils are lymphoid tissue masses essential for the immune system, located at the respiratory and digestive tract's entry points.
• They serve as the first defense against pathogens inhaled or ingested.
• Comprise four types arranged in a circular formation known as Waldeyer’s ring around the pharynx.
• Structure includes lymphoid follicles supported by connective tissue, with germinal centers densely packed with lymphocytes.

Types of Tonsils

• Palatine tonsils: Positioned between the palatoglossal arch (anterior) and the palatopharyngeal arch (posterior).
• Lingual tonsils: Small elevations located at the posterior part of the tongue, varying in size and shape.
• Tubal tonsils: Found just behind the Eustachian tube opening in the nasopharynx.
• Pharyngeal tonsils (adenoids): Located in the superior nasopharynx, attached to the sphenoid bone's periosteum by connective tissue.

Tonsillitis

• Definition: Inflammation of the tonsils, two tissue pads at the throat's back.
• Causes: Commonly caused by viruses, with Streptococcus pyogenes (group A streptococcus) being the most prevalent bacterial cause.
• Vulnerability: Tonsils are the immune system's frontline against pathogens, making them susceptible to infections, particularly in children. Their immune function decreases after puberty.

Clinical Picture of Tonsillitis

• Symptoms in Children (ages 5-15):
  • Red, swollen tonsils
  • White/yellow patches on tonsils
  • Sore throat and difficulties in swallowing
  • Fever and tender lymph nodes in the neck
  • Scratchy or muffled voice, bad breath, stomachache, headache
• Symptoms in Young Children:
  • Difficulty describing symptoms may lead to drooling and refusal to eat.

Complications of Tonsillitis

• Potential issues from chronic tonsillitis:
  • Obstructive sleep apnea
  • Tonsillar cellulitis (deep tissue infection)
  • Peritonsillar abscess (pus collection behind a tonsil).
• Risks with untreated streptococcal infections:
  • Rheumatic fever: serious inflammation affecting heart, joints, nervous system, and skin.
  • Complications from scarlet fever: characterized by a notable rash.
  • Post streptococcal glomerulonephritis: kidney inflammation.