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Understanding Tonsillitis & Airway Issues: Indications, Risks, and Recovery

Learn about predisposing factors, chronic tonsillitis indications, and contra-indications for tonsillectomy. Post-surgery diet tips, complications management, and symptoms of airway obstruction are covered. Understand swallowing problems, differential diagnosis, and lifestyle changes for better health. Discover insights on GERD and LPR symptoms and predisposing factors. Stay informed on airway issues for improved well-being.

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Understanding Tonsillitis & Airway Issues: Indications, Risks, and Recovery

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  1. SORETHROAT, SWALLOWING &AIRWAY PROBLEMS

  2. APHTHOUS ULCER Herpes Simplex

  3. PREDISPOSING FACTORS FOR CHRONIC TONSILLITIS Sinusitis Oral sepsis Immunity (HIV) Mouth breathing Incorrect treatment of acute tonsillitis Remember!.........Tuberculosis, Syphilis and HIVin chronic tonsillitis

  4. TONSILLECTOMY / ADENOIDECTOMY Indications Contra-indications (local & systemic) INFORMEDCONSENT

  5. INDICATIONS FOR TONSILLECTOMY • 5 attacks / year • Severe attacks • Airway obstruction • Unilateral enlargement • Rheumatic fever / Glomerulonephritis • Quinsy • Halitosis

  6. CONTRA-INDICATIONS FOR TONSILLECTOMY Cleft palate Bleeding disorder Skills of the surgeon and anaesthetist – and ability to management thecomplications!

  7. POST TONSILLECTOMY DIET: • Spices • Tomatoes • Bananas • Avoid Pineapples • Avocado • Pawpaw • No Salicylates • Maintain hydration • “Jelly & ice cream”

  8. Cartilage framework (trauma) Mucous membrane Vocal folds Muscles (spasm/paralysis) Nerve supply

  9. HYPOTHYROIDISM DIABETES MEDICATION

  10. SYMPTOMS & SIGNS OFAIRWAY OBSTRUCTION RHINOLALIA OPERTA HOT PATATO VOICE SNORING HOARSENESS STRIDOR (3 types) RHINOLALIA CLAUSA ANY NOISY BREATHING = AIRWAY OBSTRUCTION

  11. STRIDOR Inspiratory Biphasic Expiratory

  12. Swallowing • Mechanism is complex • Involves the actions of 26 muscles and 5 cranial nerves • CN V -- both sensory and motor fibers; important in chewing • CN VII -- both sensory and motor fibers; important for sensation of oropharynx & taste to anterior 2/3 of tongue • CN IX -- both sensory and motor fibers; important for taste to posterior tongue, sensory and motor functions of the pharynx • CN X -- both sensory and motor fibers; important for taste to oropharynx, and sensation and motor function to larynx and laryngopharynx; important for airway protection • CN XII -- motor fibers that primarily innervate the tongue • A normal adult swallows unconsciously 600 times in a 24-hour period

  13. Inflammatory lesions Thrush (Candida) Tonsillitis (PTA vs. lingual tonsillitis) Abscesses (retro-, para-) Systemic causes Scleroderma Plummer-Vinson syndrome Neuromuscular disorder Esophageal spasm Pseudobulbar palsy CVA Multiple Sclerosis Myasthenia Gravis Dermatomyositis Muscular Dystrophy Differential Diagnosis • Intrinsic lesions • Zenker’s diverticulum • Benign tumors (leiomyoma) • Carcinoma (SCCA, Adeno) • Strictures • Achalasia • Esophageal webs • Extrinsic lesions • Thyroid mass • Dysphagia lusoria • Aortic aneurysm

  14. Swallowing problems + OTAL = NB!!!

  15. STRIDOR Inspiratory Biphasic Expiratory

  16. ? New “disease” (1618 Fabricius) Awareness Diagnostic aids available ? Overdiagnosed Lifestyle changes

  17. GERD: Lower oesophageal sphyncter Normal = 50X per 24 hours Pepsin does not burn oesophagus Saliva dilute acid Symptoms: Heartburn esp. when lying down Shoulder and chest pain Referred otalgia Reflex bradycardia

  18. PREDISPOSING FACTORS: Hiatus hernia Pregnancy Lifting heavy objects, constipation, prostatism Overweight Tight clothing Sleeping after meals Eat in front of TV Computer work No exercise DIET: “restaurant menu” Medication

  19. LPR: Cricopharyngeal muscle Pepsin burns Seldom heartburn Symptoms: ENT related

  20. LPR SYMPTOMS: Hoarseness Coughing Globus sensation Throat clearing Dysphagia Asthma Ear, sinusses, Laryngospasm Croup Larynx, subglottic stenosis Hallitosis PREDISPOSING FACTORS same as GERD

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