Tonsillitis

IntroductionThe objective of this systematic review is to determine if the treatment of streptococcal pharyngitis with a daily dose of amoxicillin is similar in effectiveness to other dosing schedules (every 6, 8 or 12hours) of the same antibiotic or penicillin V.

To investigate a possible effect of adenoidectomy, tonsillectomy, or both operations combined in children on hemoglobin concentration and iron metabolism. Children eligible for surgery due to recurrent tonsillitis or upper airway obstruction had a venous blood sample drawn at the time of the operation and 6 months later. One hundred and three preoperative and 91 blood samples at follow-up from patients not given iron supplementation were available for analysis of hemoglobin concentration, serum-ferritin and protoporphyrin-IX in erythrocytes. A 1.4g/dl median increase in hemoglobin concentration during the observation period was associated with a significant reduction of protoporphyrin-IX, while serum-ferritin remained unchanged and low. A preoperative prevalence of anemia of 56.3% was reduced to 7.71%. All combinations of normal and pathological values of serum-ferritin and protoporphyrin-IX were found in anemic and non-anemic patients. A beneficial effect of tonsillectomy and adeno...

To assess the indications for lingual tonsillectomy; to report our experience with lingual tonsillectomy, and to present the evolution of our surgical technique. A review of 5-years experience from a prospectively maintained database of 28 patients was performed together with a focused review of the international literature. Therapeutic procedures included lingual tonsillectomy with access via the Boyle-Davis gag or suspended video laryngoscope and with the resection via diathermy, CO(2) laser, or microdebrider. The indication for lingual tonsillectomy was upper airways obstruction in 22 patients and recurrent infection in six. The operative time for lingual tonsillectomy ranged from 35 to 80 minutes (mean time, 43 minutes). The perioperative in-hospital stay ranged from one to three days for 27 patients. All did very well postoperatively. Lingual tonsillar pathology may cause significant morbidity and is frequently the cause of persisting peripheral obstructive sleep apnea syndrome...

Acute respiratory infections accounts for 20–40% of outpatient and 12–35% of inpatient attendance in a general hospital. Upper respiratory tract infections including nasopharyngitis, pharyngitis, tonsillitis and otitis media constitute 87.5% of the total episodes of respiratory infections. The vast majority of acute upper respiratory tract infections are caused by viruses. Common cold is caused by viruses in most circumstances and does not require antimicrobial agent unless it is complicated by acute otitis media with effusion, tonsillitis, sinusitis, and lower respiratory tract infection. Sinusitis is commonly associated with common cold. Most instances of rhinosinusitis are viral and therefore, resolve spontaneously without antimicrobial therapy. The most common bacterial agents causing sinusitis areS. pneumoniae, H. influenzae, M. catarrhalis,S. aureus andS. pyogenes. Amoxycillin is antibacterial of choice. The alternative drugs are cefaclor or cephalexin. The latter becomes first line if sinusitis is recurrent or chronic. Acute pharyngitis is commonly caused by viruses and does not need antibiotics. About 15% of the episodes may be due to Group A beta hemolytic streptococcus (GABS). Early initiation of antibiotics in pharyngitis due to GABS can prevent complications such as acute rheumatic fever. The drug of choice is penicillin for 10–14 days. The alternative medications include oral cephalosporins (cefaclor, cephalexin), amoxicillin or macrolides.

Acute respiratory conditions are a leading cause of childhood morbidity and mortality. Corticosteroids are effective and established treatments in some acute respiratory infections (e.g. croup) and asthma exacerbations; however, their role is controversial in other conditions owing to inconsistent effectiveness or safety concerns (e.g. bronchiolitis, acute wheeze). To examine clinically relevant short-term safety outcomes related to acute single or recurrent systemic short-term (<2 weeks) corticosteroid use based on systematic reviews of acute respiratory conditions. We searched the Cochrane Database of Systematic Reviews in February 2013 for systematic reviews comparing systemic corticosteroids with placebo for children (aged 0-18 years) with acute asthma, preschool wheezing, bronchiolitis, croup, pharyngitis/tonsillitis or pneumonia. We selected the following outcomes a priori: gastrointestinal (GI) bleeding and abdominal pain; behavioural effects (tremor or hyperactivity, jitt...

Sore throat is most commonly caused by viruses, but when caused by bacteria, the most important is group A streptococcus (GAS). The aim of these guidelines is to determine optimal treatment for streptococcal sore throat and reasonable indications for tonsillectomy, as well as recommend how to differentiate streptococcal infection for which antibiotics are justified, from numerous other sore throats where antibiotics wont have a significant effect on disease course, but might contribute to bacterial resistance to antibiotics. The development of the guidelines was initiated by the Interdisciplinary Section for Antibiotic Resistance Control (ISKRA) of the Croatian Ministry of Health and Social Welfare in accordance with the principles of AGREE (Appraisal of Guidelines for Research and Evaluation) methodology which means that the guidelines are the result of consensus between all interested professional societies and institutions. For streptococcal sore throat diagnostics, the Working G...

To compare postoperative pain between monopolar cautery tonsillectomy and harmonic scalpel tonsillectomy (HST).Randomized controlled trial using paired organs.Community hospital with academic affiliation.One hundred and fourteen consecutive patients six years of age or older undergoing tonsillectomy for indications of hypertrophy or recurrent infection.For each subject, monopolar cautery tonsillectomy was performed by four senior surgeons on one side and HST was performed on the other side. Allocation of technique to side was randomized and revealed to the surgeon at the start of the operation. Validated visual analog pain scales were used to quantify pain at rest and with swallowing for each side and were completed daily for 14 days. All subjects were prescribed weight-equivalent doses of analgesics. Secondary outcome measures included postoperative complications (hemorrhage and readmission).Pairwise comparisons of pain scores revealed no significant difference between monopolar cautery tonsillectomy and HST (P < 0.05).Subjects undergoing monopolar cautery tonsillectomy do not experience increased postoperative pain in comparison to HST.

Os cáseos amigdalianos afetam uma significativa porcentagem da população. As cirurgias, conservadoras ou não, têm sido as únicas alternativas viáveis de tratamento. Entretanto, ainda hoje não há um método econômico e não-invasivo de tratamento que apresente resultados satisfatórios. OBJETIVOS: Os objetivos deste estudo são avaliar a eficiência de um enxaguatório, cujos ingredientes ativos associam substâncias oxigenantes e antimicrobianas, na diminuição da formação dos cáseos amigdalianos e da saburra lingual, cuja etiologia é semelhante à dos cáseos, e avaliar a redução da concentração dos compostos sulfurados voláteis (CSVs). FORMA DE ESTUDO: Estudo clínico e experimental, randomizado, duplo-cego, placebo-controlado. MATERIAL E MÉTODO: Foi utilizada uma amostra de 50 voluntários, com queixa de tonsilite crônica caseosa há mais de um ano. A pesquisa foi realizada em 2005, nas cidades de São Paulo e Campinas. RESULTADOS: Para o grupo que utilizou a solução placebo, não houve correlação entre as variáveis nem significância estatística nos resultados. Para o grupo que utilizou o enxaguatório, os resultados foram significativos em todos os quesitos analisados. CONCLUSÕES: O novo enxaguatório demonstrou ser uma alternativa conservadora viável para o tratamento da tonsilite crônica caseosa, sendo eficiente também na redução da formação de saburra lingual e concentração dos CSVs.

Inappropriate use of antibiotics for upper respiratory tract infections (URTIs), many of which are viral, adds to the burden of antibiotic resistance. Antibiotic resistance is increasing in Streptococcus pneumoniae, responsible for most cases of acute otitis media (AOM) and acute bacterial sinusitis (ABS). The Infectious Diseases Society of Southern Africa held a multidisciplinary meeting to draw up a national guideline for the management of URTIs. Background information reviewed included randomised controlled trials, existing URTI guidelines and local antibiotic susceptibility patterns. The initial document was drafted at the meeting. Subsequent drafts were circulated to members of the working group for modification. The guideline is a consensus document based upon the opinions of the working group. Penicillin remains the drug of choice for tonsillopharyngitis. Single-dose parenteral administration of benzathine penicillin is effective, but many favour oral administration twice dai...

Background: Ethically it is our jurisdiction to decide upon the medical procedure we undertake after weighing the risk benefit ratio. Tonsillectomy is conventionally operated under general anesthesia but it has its own merits and demerits. The aim of the study was to analyse the better procedure. Methods: Hundred patients were operated in the medical college over period of two years in HIMS Barabanki and Govt medical college Kannauj. Seventy patients were operated under general anesthesia and another thirty under local anesthesia. Results: The total operation time, VAS, blood loss, complications, cost effectiveness, bed occupancy, patient turnover rate and patient satisfaction was better in surgical exercise done under local anesthesia when compared to general anesthesia. Conclusions: Tonsillectomy done under local anesthesia definitely has an edge over the general anesthesia.