A Rare Case of an Intratonsillar Abscess

The case describes the anatomy and pathophysiology of the palatine tonsils and the development of intratonsillar abscess. The abscess can be caused by a suppurative focus that arises in acute tonsillitis when outward drainage is prevented, leading to pus accumulation in the tonsillar tissue. Dehydration or a history of peritonsillar abscess can also lead to intratonsillar abscess. The condition can be mistaken for tonsillolith or malignancy, such as lymphoma. A computed tomography (CT) scan is recommended for diagnosis, showing a low-density and ring enhancement. Aspiration using a large bore needle is the preferred mode of treatment, but if repeated aspirations fail, tonsillectomy may be necessary. Intratonsillar abscess is rare and so far only 29 cases have been reported.1 The differential diagnoses include lymphoma, which usually presents as unilateral enlargement of the tonsil, tonsillolith due to its appearance and peritonsillar abscess again due to the unilateral enlargement of the tonsil. This case is different as compared to other reported cases we did not do a CT scan as recommended by most of the studies (cost being a concern). Also, in this case, we resorted to surgery as the main modality unlike other cases wherein the surgeons opted to do an aspiration of the pus mainly keeping the intraoperative complications in mind.

Is There a Difference between the Preoperative and Postoperative Serum Levels of Interleukin-6 and Tumor Necrosis Factor-α in Children Submitted to Adenotonsillectomy?

Abstract Introduction Palatine and pharyngeal tonsils are the first line of defense against pathogens. Clinically, two alterations may require surgical removal of the tonsils: hypertrophy and recurrent tonsillitis. The two conditions probably result from a dysfunction of the immune system. Objective To evaluate possible differences in the plasma levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-10 (IL-10) in patients submitted to adenotonsillectomy. Methods Prospective, longitudinal study with 25 children undergoing adenotonsillectomy separated into 3 different groups: recurrent tonsillitis (RT), composed of 7 patients; recurrent hypertrophy tonsillitis (RTTH), with 8 patients; and the tonsillar hypertrophy (TH) group, with 10 patients. Ten healthy control children (SD) were also included in the study. Peripheral blood was collected, and plasma was separated to measure the levels of TNF-α, IL-6, and IL-10. The Mann-Whitney test was used for statistical analysis. Results The plasma level of IL-6 was higher in the RT (p= 0.0394) and TH (p= 0.0009) groups, compared with the control group. The TH group also had higher levels of IL-6 than the RT group (p= 0.039). The IL-6/IL-10 ratio was higher in the RT (p= 0.029) and TH (p= 0.0005) groups compared with the control group. Between the RT and RTTH groups, the IL-6/IL-10 ratio was higher in the RT group, with a statistically significant difference (p= 0.0091). Conclusion Patients with a history of chronic tonsillitis had higher levels of IL-6, compared with the control group.

Mechanism of Shengjiang Powder in treating chronic tonsillitis in children based on network pharmacology and molecular docking / 中国中药杂志

Based on the network pharmacology and molecular docking method to explore the molecular mechanism of Shengjiang Powder in treating chronic tonsillitis in children. This research first based on the Traditional Chinese Medicine System Pharmacology(TCMSP) and the Bioinformatics Analysis Tools for Molecular Mechanism of Traditional Chinese Medicine(BATMAN-TCM), the effective active ingredients of the drugs contained in Shengjiang Powder were screened out by the pharmacokinetic(ADME) parameters, the targets were predicted, and then chronic tonsillitis disease in children targets were obtained by GeneCards database. Afterwards, the target protein names were standardized by the Uniprot database. The drug targets were matched with the disease targets to obtain the potential therapeutic targets of Shengjiang Powder. Cytoscape 3.8.0 software was used to screen out and construct the network diagram of "drug-components-core targets-disease". DAVID database and R language were used to conduct the enrichment analysis of core action targets. Finally, AutoDock software was used to conduct molecular docking between drug components with a high network medium value and core action targets. According to the findings, after standardized treatment, a total of 79 active ingredients of Shengjiang Powder were obtained; it was predicted to get 1 261 potential targets, 268 potential targets for treatment of chronic tonsillitis in children, and 29 core targets; and 81 entries of GO enrichment were determined(P<0.05), including 63 biological processes, 7 cell components, 11 molecular function items, 24 KEGG pathway enrichment items(P<0.05), mainly including cell cycle, inflammatory factors, viral infection, immune regulation and other signaling pathways. The results of molecular docking showed that main active components in Shengjiang Powder had a stable binding activity with the core targets. This study revealed the mechanism of Shengjiang Powder in the treatment of chronic tonsillitis in children, mainly by resisting virus, inhibiting inflammation, regulating immunity and other means to play a synergistic effect, so as to provide a theoretical basis for rational clinical application.

The Combined Effect Of Varabhrihatyadi Kashaya And Sarapunkha Lepa In Chronic Tonsillitis In Children

Children with the clinical features of Chronic Tonsillitis coming under the age group 3-12 years were included in the study. The patients were randomly allocated in to the study group and control group using simple random sampling technique. In the study group the dose of Varabrihatyadi Kashaya was fixed as follows, in the age group 3-6 years: 10ml bd before food, in the age group 6-9 years: 20ml bd before food, in the age group 9-12 years: 30ml bd before food. Sarapunkha lepa was applied around the neck where enlarged lymph nodes were found. Frequency of paste was fixed as two times daily and at each time, it is kept until it becomes dry. At the same time those in the control group were subjected to external application of Sarapunkha lepa only. Both the groups were followed for a period of 1 month after the scheduled course of intervention. Routine blood investigations were also carried out before and after the study. The data were analyzed using the most appropriate statistical tests. Significant changes were obtained in the clinical parameters in the study group used for assessment such as recurrent attacks of sore throat, pain in the throat, pain on swallowing, difficulty in swallowing, halitosis, mouth breathing, hoarseness of voice, chocking spells at night, size of the tonsil, congestion of pillars, oedema of the uvula, deviation of the uvula and lymph node enlargement. There was a significant change in the routine blood investigations also. Moreover the trial drug sustained its potential action even during the follow up period. The effect of control drug was insignificant. The final evaluation proved that combination of Varabhrihathyadi Kashaya and Sarapunkha lepa was effective in reducing the signs and symptoms of Chronic Tonsillitis in children of 3-12 yrs age group.

Clinical effects of Bairui Granules combined with tonsil-pecking method on cases with chronic tonsillitis / 中草药

Objective To observe the curative effect of tonsil-pecking method combined with Bairui Granules for the treatment of chronic tonsillitis. Methods A total of 116 patients with chronic tonsillitis treated in Qinhuangdao City Chinese Medicine Hospital from January 2017 to June 2018 were randomly divided into the treatment group and the control group according to the random number table method. Sixty-six cases in the treatment group were treated with tonsil-pecking method combined with Bairui Granules, tonsil-pecking method once 3 d, Bairui Granules one bag (5 g) three times daily. Fifty cases in the control group were only received tonsil-pecking method. One course was 7 d, both groups were treated for two courses. Result The total effective rate of the treatment group was 93.9%, which of the control group was 92.0%, there was no significant difference in the efficacy between the two groups (P > 0.05). But the significant effective rates of the treatment group was 80.3%, which of the control group was 68.0%, there was a significant difference between the two groups (P < 0.05). And the improvement in symptom and physical signs of the treatment group was significantly better than the cntrol group (P < 0.05). Conclusion Tonsil-pecking method can disperse swelling and stasis. Bairui Granules have antipyretic and antiphlogistic effect, combination administration had higher cure rate in the treatment of chronic tonsillitis, symptoms and signs were improved significantly.

Epidermoid Cyst of The Tonsil: A Rare Finding

Epidermoid cysts are benign developmental cyst with a low incidence in the head and neck region of approximately 2%.  The various locations where the cyst can arise are sublingual, submental, submandibular, buccal mucosa and very rarely the tonsils. Here we present an epidermoid cyst of left tonsil which was incidentally detected in a patient diagnosed of chronic tonsilitis.

PREDICTIVE FACTORS OF LIFE QUALITY OF ADULT PATIENTS WITH CHRONIC TONSIL-LITIS AFTER TONSILLECTOMY / 现代医院

Objective To explore the predictive factors of life quality of adult patients with chronic tonsillitis after tonsillectomy .Methods 68 adult patients with chronic tonsillitis treated with tonsillectomy admitted to our hos-pital from January, 2013 to June, 2014 were divided into the observation group (SF-36 score50 points, n=30) according to SF -36 scale scores 1 week after operation. Life quality ( SF-36) score of the 2 groups before and after treatment were statistically analyzed .The predictive fac-tors of life quality of adult patients with chronic tonsillitis after tonsillectomy were analyzed by single factor analysis and logistic factors analysis .Results Life quality scores of preoperative eight dimensions in the 2 groups including physiological functions, physiological roles, physical pain had no statistically significant difference (p>0.05).Life quality scores of the two groups at weeks 1, 2 and 4 after surgery were higher than those before surgery .Life quality scores of the observation group after treatment were lower than those of the control group in the same period ( p<0.05).The results of single factor analysis showed that relative factors of life quality of adult chronic tonsillitis after tonsillectomy were gender, age, Hamilton depression rating scale (HAMD) scores and Hamilton anxiety rating scale ( HAMA) scores, etc..The results of logistic multifactor analysis showed that age , HAMD scores and HAMA scores were independent predictors of life quality of adult chronic tonsillitis after tonsillectomy .Conclusion Independent predictive factors of life quality of adult chronic tonsillitis after tonsillectomy includw age , HAMD scores and HAMA scores.Therefore, diets and sports can improve disease resistance ability of aged patients .And psychological condi-tion regulation can also effectively improve patient's life quality .

A Case of Supernumerary Tooth in Tonsil / 대한이비인후과학회지

The supernumerary teeth mean excessive teeth that appear in addition to the regular number of teeth and occur in a wide variety of sites. Mesiodens, which is a malformed, peg like tooth that occurs between the maxillary central incisor is most common. The next common site is the fourth molar and lateral incisors. Tonsil as a site of supernumerary teeth is rare, however, we experienced one such case of an ectopic supernumerary tooth embedded in tonsil.

Study and analysis on the quantitive detection of EBV-DNA in adenoidal hypertrophic and tonsillitis tissues of children / 临床耳鼻咽喉头颈外科杂志

Objeetive:To investigate the epidemiology of EBV in adenoidal hypertrophy and chronic tonsillitis and discuss the effection of EBV on the nosogenesis of adenoidal hypertrophy and tonsillitis of children.Method:Fifty-two children with chronic tonsillitis and/or adenoidal hypertrophy had the operations of the tonsillectomy and/or the adenoidectomy.These tissues reseeted and plasma of all cases were detected to find EBV-DNA by RQPCR.Result:The infection rate of EBV in the tissues of adenoidal hypertrophy and tonsillitis of childen was 51.9%.The boys'infection rate of EBV was 50.0%,and the girls'infection rate of EBV was 55.6%,which had not significantly different.The EBV infection rate in the tissues of tonsillitis was 40.4%,The EBV infection rate in the tissues of adenoidal hypertrophy was 48.9%,which had not significant difference.The school age group(7to 14 years old)presented higher infection rate of EBV in the tissues of adenoid and tonsil(65.5%)than the preschool children group(2 to 6 years old)(34.8%).Comparing the copies numbers of BV-DNA in the different degrees of adenoidal hypertrophy,we found that the copies numbers of EBV-DNA in the severe hypertrophy group were higher than the midrange and slight hypertrophy groups(P＜0.05).Meanwhile we detected EBV-DNA in these childrens'blood plasma by RQ-PCR.No blood plasma was detected EBV-DNA copies higher than normal(＜1×10~3 copies/ml).Conclusion:The tissues of adenoidal hypertrophy and tonsillitis had same sensitivity to EBV.There was not significant difference between the infection rates of the boys and girls with adenoidal hypertrophy and/or tonsillitis.With these children growing up and the course of diseases prolonging,the infection rate of EBV increased correspondingly.There was a certain correlation between the hypertrophy of adenoid and EBV.There were NO EBV-DNA fragments in blood plasma of the children with adenoidal hypertrophy and/or tonsillitis.So there were essential different between benign hyperplasy and nasopharyngeal carcinoma.