Oropharyngeal lesions. Inflammation of the throat. Treatment of inflammation of the pharynx. Frequent illnesses with sore throat

Inflammation of the larynx is a pathological process that occurs as a result of the spread of a fungal, bacterial or viral infection.

The disease, which is also called laryngitis, can occur in isolation, and also be one of the manifestations of respiratory damage.

What is a larynx?

The most important are the arytenoid cartilages that regulate the position of the vocal cords. The organ performs respiratory, protective and voice-forming functions. It regulates the supply of oxygen by warming the incoming air before it enters the lungs.

The main function of the larynx is to protect against the ingress of foreign objects. The epiglottic cartilage prevents foreign bodies from entering the lungs.

Inflammation of the cartilage of the larynx can be triggered by:

• bacterial infections (staphylococcus, streptococcus, measles);
• various viruses;
• fungi (against the background of the affected immunity);
• allergens (room dust, flower pollen, animal hair, some products).

The disease can be caused by eating too cold food, prolonged exposure to cold, smoking, improper structure of the nasal septum, foreign body, work in hazardous industries.

Types of inflammation of the larynx

Diseases of the pharynx and larynx can take an acute and chronic form. Let's consider them in more detail.

Acute laryngitis

Acute diseases of the larynx accompanies such diseases as influenza, scarlet fever, diphtheria, Staphylococcus aureus. The disease often develops in people who have reduced immunity as a result of previous illnesses or as a result of long-term use of antibiotics.

The acute form is often found in preschool children. This is due to the peculiarities of the structure of the respiratory organs and larynx in a child (not wide enough gap), not formed immunity, a higher tendency than in adults to allergic reactions. The development of the disease in children is often preceded by influenza or SARS.

In children 2-6 years old, a rather rare disease occurs - inflammation of the epiglottis. The disease is characterized by rapid development: the child has shortness of breath. obstructing free breathing, severe sore throat, chills, salivation, slurred speech.

Inflammation of the back wall of the larynx (pharyngitis) is usually caused by viral diseases. Patients experience pain, a feeling of itching and "scratching" in the throat. Treatment with antibiotics in this case is not justified.

Chronic laryngitis

In most cases, to the chronic form of the disease. Other provoking factors include prolonged exposure to unfavorable conditions (work in dusty or gassed rooms), alcohol and smoking abuse, increased stress on the vocal cords associated with professional activities.

A fungal infection of the throat can cause candidiasis, which is also called "thrush". The disease is characterized by the appearance of curdled plaque on the tongue, dryness and irritation in the mouth, redness and swelling of the mucous membranes.
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How to determine the presence of inflammation in the larynx by the main symptoms?

Symptoms of the disease manifest themselves depending on the cause that provoked the pathology. Adults and children develop cough, pain and burning sensation in the throat.

Other symptoms include:

• hoarseness and change in the timbre of the voice;
• dry mouth;
• increased salivation;
• severe pain when swallowing food;
• red larynx;
• accumulation of mucous secretions in the throat;
• increase in body temperature;
• general weakness and malaise.

Chronic laryngitis is characterized by severe wheezing and the complete disappearance of the voice, a strong cough when trying to get rid of accumulated mucus, enlarged lymph nodes, and swelling of the mucous membranes.

In the absence of proper treatment, the mucus can change its color from clear to yellowish. Over time, the appearance of purulent discharge is noted, the patient's throat muscles hurt.

In some forms of laryngitis, such as those caused by the herpes virus, patients notice the appearance of blisters on the back of the throat. With the progression of the disease, they are able to spread to the epiglottis and the surface of the tongue. When opened, the vesicles leave behind painful sores covered with plaque.

In children, laryngitis manifests itself with the appearance of a barking cough, wheezing, difficulty breathing, worsening sleep, irritability and increased nervous excitement. The child's condition usually worsens at night when he is in the supine position.

When should you see a doctor? What is needed?

With a mild form of inflammation, it can be dealt with at home. But, if the symptoms of the disease do not go away within two weeks after their appearance, you must definitely seek medical help. The treatment of larynx disease is carried out. In children, this disease is treated by a pediatrician.

Medical assistance is required immediately if the patient has severe difficulty breathing, bloody discharge is observed in the separated mucus, and body temperature is significantly increased.

What diagnostics will be needed?

Before treating the larynx, it is necessary to establish the cause that caused the pain and inflammation. This will require modern diagnostic methods. First of all, pay attention to the patient's complaints and general examination data. At the next stage of diagnosis, a general blood test and laryngoscopy are prescribed.

Laryngoscopy allows you to determine the condition of the larynx and vocal cords, to identify foci of inflammation and swelling. At the stage of diagnosis, it is important to exclude other diseases with similar symptoms, such as tracheitis, diphtheria, allergic lesions, as they require different treatment.

It is possible to prescribe video laryngoscopy, during which it is possible to determine the vibration of the vocal cords.

In order to check the body for the presence of a malignant tumor, tissue is taken for a biopsy.

Treatment: how to relieve inflammation?

The treatment process of inflammation of the larynx is complex and includes drug therapy, physiotherapy and special exercises for the larynx. The goal of treatment is to eliminate the symptoms of the disease and prevent the formation of laryngospasm.

Treatment of the syndrome of inflammation of the larynx with laryngitis includes:

• carrying out inhalations;
• drug therapy to relieve pain and relieve inflammation in the throat (sprays, solutions, tablets);
• antibiotics for bacterial origin of the disease;

• topical medications to eliminate pain and perspiration;
• antipyretics;
• vitamins and drugs to improve immunity.

The selection of all pharmaceuticals should be carried out exclusively by the attending otolaryngologist, taking into account the type of laryngitis and the patient's condition. Incorrect treatment can cause complications or allergic reactions (anaphylactic shock, angioedema, and others).

Inhalation treatment

Inhalation is one of the most effective methods of treating inflammation of the larynx. For its implementation are used:

• decoctions and infusions of medicinal plants (chamomile, calamus, sage, eucalyptus leaves);
• aroma oils;
• and softening of sputum;
• mineral waters (Borjomi, Essentuki);
• antiseptics (Furacilin,).

Carrying out inhalations allows you to remove swelling and eliminate soreness in the throat, moisturize the mucous membranes and remove sputum residues from the body. For treatment, both steam and nebulizer inhalations are prescribed, which have an expectorant, anti-inflammatory and antibacterial effect.

Proper procedure is of great importance. The duration of inhalation should not exceed 10-15 minutes. It is recommended to carry out 1-2 procedures in the morning and evening, not earlier than half an hour after a meal. During the procedure and immediately after it is not recommended to talk.

Steam inhalation is contraindicated if the patient is prone to nosebleeds, at high body temperature, the presence of purulent secretions, and attacks of bronchial asthma.

Antibiotics in treatment

This group of drugs is prescribed only in cases where laryngitis is caused by a bacterial infection. A good result is obtained by treatment with drugs Amoxicillin, Cefuroxime, Metronidazole. The duration of treatment is 7-10 days, in the absence of positive dynamics, the drug should be replaced.

Long-term treatment with antibiotics should necessarily include the use of antifungal drugs to avoid throat candidiasis.

Treatment of allergic laryngitis involves the exclusion of the allergen from the patient's life. In most cases, limiting the patient's contact with the allergen leads to a rapid recovery of the patient.

Antiseptics in treatment

Various aerosols and sprays are used to treat the throat. Effective drugs include Ingalipt, Tantum Verde, Geksoral, Lugol. When using these drugs, contraindications should be considered. So, for example, Lugol is not recommended for children under five years of age and patients with an allergy to iodine.

For gargling with infectious laryngitis, antiseptic solutions Miramistin, Furacilin are used. Ready-made alcohol tinctures of medicinal herbs, which can be purchased at a pharmacy, are also effective.

Physiotherapy

Among the effective physiotherapeutic agents, it is worth highlighting:

• magnetotherapy;
• electrophoresis with hydrocortisone;
• UHF therapy;
• laser exposure.

The listed physiotherapy procedures are additional methods of treatment and should not replace the main therapy.

Patients with chronic inflammation of the larynx are shown sanatorium treatment in places with a humid and warm climate. These include the resorts of Crimea, Sochi, Anapa.

How to treat at home?

Inflammation of the larynx is successfully treated at home, subject to the following general rules:

• minimize conversations, and even better remain silent, this will contribute to the rapid recovery and healing of mucous membranes;
• maintain a favorable indoor climate (regular ventilation, keeping the air humidity level at least 50-60%, maintaining the room temperature at 20-24 C);
• drinking 2-3 liters of liquid per day (herbal teas, fruit drinks, warm milk with mineral waters);

• the exclusion of hot, spicy, cold and salty foods, alcoholic beverages, coffee, chocolate, the inclusion in the menu of liquid cereals, soups with vegetable broths, dairy products, non-acidic fruits;
• taking hot foot baths.

The throat area must be kept warm. To do this, it is wrapped with a scarf or scarf made of natural fabric. Warming compresses or mustard plasters are applied to the calf and chest area.

It is worth noting

One of the most effective home remedies is rinsing. For medicinal decoctions, decoctions of chamomile, calendula, sage, plantain, oak bark are used.

To relieve inflammation and swelling at home, use a soda solution. To prepare it, stir a tablespoon of soda in a glass of warm water. It is necessary to gargle for 5-7 days several times a day.

Voice restoration

• a milk-egg mixture made from a glass of milk and one egg yolk, which is drunk or gargled with it;
• infusion of viburnum berries with the addition of honey for taking before meals;
• a mixture of finely chopped aloe leaf and honey, taken in equal proportions, must be kept in the mouth until it is completely dissolved;
• mix a tablespoon of honey with 30 ml of cognac and add one yolk to the mixture, with this tool you can return the lost voice in an extremely short time.

Prevention of the disease includes hardening procedures, following the rules of a healthy diet, giving up bad habits, walking in the fresh air, especially near water bodies. Infectious and viral diseases should be detected and treated in time, preventing their complications.

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The functions performed by the pharynx are quite diverse: it is involved in the process of digestion (swallowing food), respiration and voice formation. Therefore, any inflammatory processes that affect the throat affect the functioning of the whole organism as a whole. Not to mention the significant discomfort that the patient experiences with inflammation of the pharynx. What types of pharyngitis are distinguished and how to properly treat the disease in order to prevent the development of complications?

Pharyngitis: classification

Pharyngitis is one of the most common diseases of the pharynx, manifested in inflammation of the mucous membranes of the pharynx and its lymphatic tissues. Patients often confuse the manifestations of angina with pharyngitis and begin to treat a completely different ailment. However, you should be aware that with angina, the inflammatory process extends to the tonsils, and pharyngitis affects the mucous membrane.

Despite the fact that pathology has only two forms of development, there are quite a lot of varieties of this disease. In most cases, the disease develops along with other diseases, so the causes of its occurrence must be identified among them: injuries, colds, caries, sinusitis, rhinitis, etc.

Classification of pharyngitis

There are two forms of pharyngitis: acute and chronic. The acute type develops as an independent pathology, however, sometimes it can be accompanied by an infectious disease (chickenpox, measles, etc.) or SARS. This type of pharyngitis occurs after eating spicy or hot food, hypothermia, and also as a result of the fact that a person has inhaled dust or fumes. The classification of acute pharyngitis is determined by the type of pathogen.

There are the following types of illness:

The course of chronic pharyngitis is less pronounced, there are no signs such as a feeling of weakness, fatigue, and fever. Mucus formed in the larynx interferes with normal coughing, as a result of which a person is constantly tormented by coughing.

If chronic pharyngitis is not treated for a long time, the disease flows into one of three forms: catarrhal, atrophic or hypertrophic.

catarrhal form is the most common type of pharyngitis. Its appearance is due to the penetration into the throat of pathogenic bacteria and viruses.

The main cause of the development of pharyngitis, both acute and chronic forms are infections. According to statistics, in 70% of cases the main pathogens are viruses. A pathogenic virus, as a rule, is associated not only with the respiratory organs. In fact, the source of infection may be in the stomach, intestines and other organs. For example, in adults, the infection is often localized in the genitourinary system. Therefore, among the causative agents of pharyngitis, there are gonorrheal, chlamydial and candidal types of harmful microorganisms. The initially emerging viral factor further provokes the development of a bacterial lesion.

Hypertrophic form due to the secondary growth of the mucous membrane on the old areas, as a result of which the doctor reveals granules or ridges on the back of the pharynx.

At atrophic form sections of the mucosa atrophy, and the whole process is accompanied by a feeling of perspiration and dryness in the throat. With timely treatment, the symptoms of the disease increase.

Causes of the disease

Pharyngitis usually develops as a result of the following factors:

• development of inflammatory and catarrhal processes;
• excessive consumption of ice cream;
• hypothermia;
• viral or fungal infection;
• hormonal disruptions;
• decreased immunity;
• endocrine disorders.

Chronic pharyngitis, as a rule, affects people employed in hazardous industries, as well as heavy smokers.

In addition, the development of the disease can provoke such factors:

• caries;
• regular consumption of spicy, salty and spicy foods;
• chronic diseases of the stomach, provoking belching, heartburn;
• absence of tonsils or their inflammation;
• inflammatory processes of a purulent nature in the sinuses of the nose;
• prolonged use of vasoconstrictor drugs.

All of the above reasons for the development of pharyngitis are characteristic, mainly for the adult population. Children from 0 to 5 years of age have very weak immune defenses, so viruses and bacterial infections are the main culprits in the development of the disease. In addition, a child may develop pharyngitis against the background of advanced form of tonsillitis, rhinitis, laryngitis and other chronic diseases of the nasopharynx.

Pharyngitis: symptoms and treatment

Acute pharyngitis manifested by the following symptoms:

For chronic pharyngitis body temperature, as a rule, does not rise. Patients report the following symptoms:

• dry throat;
• perspiration;
• burning, scratching, or tickling sensation in the throat;
• cough;
• pain when swallowing;
• the need for constant expectoration of viscous mucus.

Symptoms atrophic pharyngitis manifested by severe dryness of the throat. The mucous membrane of the pharynx is thinned, in some cases it is covered with dried mucus. Sometimes, injected vessels can be seen on the mucosa. With hypertrophic pharyngitis, foci of hyperplastic lymphoid tissue are observed on the back of the pharynx. An increase in tubopharyngeal ridges is also possible. In the event of an exacerbation of the disease, edema of the mucous membrane, hyperemia joins the above symptoms.

In children, in addition to a constant dry cough with chronic pharyngitis, there is such a sign as wheezing. Therefore, when diagnosing, a specialist must accurately differentiate a similar condition with bronchial asthma. The method of treatment is determined by the cause of the development of the disease, so self-medication is not worth it.

Signs of pharyngitis in children

In babies, the course of pharyngitis is very difficult, especially for children under one year old. Sometimes in babies with acute pharyngitis body temperature rises to critical levels(40 degrees). Due to severe pain in the affected throat, the child refuses to eat food. Swelling of the mucous membrane can cause an asthma attack. Often, an inflammatory process in the pharynx in a child can lead to the development acute otitis media.

In no case do not try to treat the baby yourself, as this can lead to serious consequences. At the first symptoms of acute pharyngitis, the child must be urgently hospitalized.

Possible Complications

Although pharyngitis is not considered a dangerous disease, nevertheless, in the absence of timely and adequate treatment, rather serious complications may develop, among which the following can be noted:

• Chronical bronchitis;
• laryngitis;
• acute articular rheumatism;
• perintosillar abscess, the development of which is due to streptococcal pharyngitis;
• tracheitis.

With chronic pharyngitis, the timbre of the voice changes. In addition, a person's quality of life decreases, as he is deprived of the opportunity for long-term communication due to the appearance of symptoms such as a scratchy and dry throat.

Treatment

In the treatment of pharyngitis, first of all, medications are prescribed, the action of which is aimed at relieving the symptoms of an exacerbation of the disease. Today, the pharmacological industry has an extensive list of drugs that can cope with the disease on an outpatient basis.

Treatment with medicines should be started only after an examination by an ENT doctor, who will make an accurate diagnosis and prescribe appropriate therapy.

Principles of treatment of the disease

The method of treatment of the disease is determined by the type and stage of pharyngitis.

With a mild form of the disease complex therapy is not required. It is only necessary to carry out local treatment and take preventive measures.

Preventive measures in this case are to eliminate external provoking factors. Of no small importance is the rejection of bad habits, rational nutrition, as well as limiting exposure to the cold.

In later stages of pharyngitis an integrated approach is needed, which consists in conducting antibacterial or antiviral therapy. In addition, the following steps are taken:

• strengthening the immune system and tissue repair;
• symptomatic therapy (painkillers, anti-inflammatory and other medications);
• exclusion of possible relapses of exacerbation;
• disease prevention.

Therapeutic measures include physiotherapy, local therapy (solutions, compresses, lozenges, therapeutic sprays, etc.), drug therapy (tablets, injections), restorative measures.

Drug therapy for inflammation of the pharynx

With advanced forms of the disease, drug therapy is used, the action of which is aimed at eliminating the pathogen and resolving purulent formations. The complex method with the simultaneous use of drugs of the following types showed the greatest efficiency:

• vitamin complexes;
• sulfonamides;
• antibiotics that act on a certain type of pathogen.

The following medications are used to suppress streptococci:

In combination with these antibiotics, tablet preparations with antihistamine properties are prescribed: Diazolin, Suprastin. As well as antifungal agents: Nystatin, Livolin, Ketoconazole. To restore immunity - Cycloferon, Levamisole, Immunal.

The acute course of pharyngitis requires the use of medications that help reduce inflammatory activity and relieve pain. For this purpose, drugs such as Naproxen, Ibuprofen or Paracetamol are prescribed.

Local therapy

Particular attention in the treatment of pharyngitis is given to local therapy, which uses drugs in the form of lozenges, lozenges, aerosols, inhalations and solutions for gargling. The composition of therapeutic agents includes sulfonamides, antibiotics (Framycetin, Fuzafungin), vitamins (ascorbic acid), anesthetic components (menthol, tetracaine, lidocaine), essential oils, antiseptics (alcohols, iodine-containing compounds, benzydamine, Timol, Chlorhexidine, Ambazole).

Recently, agents based on plant extracts, bacterial lysates (Imudon), synthesized components that protect the mucous membrane (Interferon, Lysozyme) have been widely used. Also, in the local therapy of pharyngitis, sprays (aerosols) are widely used. Such drugs have analgesic, antiseptic and anti-inflammatory properties of local action. The composition of the aerosol must be kept in the mouth until swallowed with saliva for at least three minutes.

• Ingalipt. Product based on thymol, sulfanilamide, mint and eucalyptus oils.
• Theraflu Lar based on benzoxonium chloride and lidocaine.
• Tantum Verde. The basis of the drug is benzydamine hydrochloride. The product is available in the form of aerosols and lozenges. Especially effective for viral pathogens.
• Cameton. The composition of the drug includes eucalyptus oil, levomenthol, camphor and chlorobutanol.
• Hexoral spray. The active substance is hexetidine.
• Stopangin. Contains essential oils of plant origin, Hexetidine, Levomenthol.

Very easy to use topical preparations in the form of lozenges, lozenges and lozenges. Their composition and effectiveness are similar to sprays.

Inhalations and gargles for the throat

A good therapeutic effect was shown by inhalations and solutions for gargling, which include antibiotics together with antiseptic and anti-inflammatory substances.

Among the most popular compositions are the following:

• Evkalimin. Solution based on eucalyptus extract. Used for inhalation.
• Bioparox. Fusafungine-based solution. Used for inhalation.
• Rotakan and Vokadin - solutions for rinsing.

Timely treatment of pharyngitis and compliance with all the doctor's recommendations will allow you to quickly cope with the disease and avoid possible complications.

Catad_tema Laryngitis and pharyngitis - articles

Inflammatory diseases of the oropharynx. Modern concepts of etiopathogenesis and adequate treatment

MD, prof. A.Yu. Ovchinnikov, Ph.D. V.A. Gabedava
First Moscow State Medical University named after I.M. Sechenov, Department of Ear, Nose and Throat Diseases, Moscow

Inflammatory diseases of the pharynx are widespread among the population and are recorded in all age groups, which leads to a significant number of days of disability. Painful changes in the pharynx can be manifestations of both an independent pathological process and a symptom of any disease of the body.

The pharynx is one of the initial sections of the respiratory tract and performs vital functions. It provides air passage to the lungs and back, while the air stream, passing through the pharynx and in contact with its mucous membrane, continues to be moistened, warmed up and cleared of suspended particles. The absence of pathological changes in the pharynx guarantees the separation of air and food bolus movement and provides a protective function due to reflex muscle contraction, coughing and vomiting when mucosal receptors are irritated by foreign bodies, chemical or thermal factors. The pharynx serves as a resonator for the voice. In the region of the soft palate and the root of the tongue, there are receptors involved in the formation of taste sensitivity.

There is no doubt about the huge role of the lymphadenoid ring of the pharynx, which is part of the unified immune system of the body and is its outpost. Lymphoid pharyngeal tissue plays an important role in the formation of both regional and general protective reactions of the body. At present, a large amount of research material has been accumulated on the receptor function of the tonsils and their neuro-reflex connections with internal organs, in particular, with the heart (tonsillocardial reflex) and with the central nervous system (reticular formation of the midbrain and hypothalamus, controlled by autonomic functions). The mucous membrane of the pharynx, and especially its posterior and lateral walls, has a rich sensory innervation. Therefore, pathological processes in the pharyngeal structures are accompanied by symptoms that are rather painful for the patient - pain, sensations of dryness, a foreign body, discomfort, and perspiration. Of great clinical importance is such an anatomical feature of the pharynx as the presence in the immediate vicinity of spaces filled with loose connective tissue. With various injuries and inflammatory diseases of the pharynx, their infection is possible, and in the future the development of such formidable complications as purulent mediastinitis, sepsis and life-threatening massive bleeding due to erosion of the large vessels of the neck.

The problem of chronic tonsillitis is of great importance and relevance, due to its wide distribution (from 2.84 to 35%). There is a tendency to increase the number of patients with chronic tonsillitis, with the highest incidence in the age group of 16-20 years.

Despite the significant variety of treatment methods, medical tactics for chronic tonsillitis have not been finally determined. To date, there are still no exact criteria on the basis of which it would be possible to determine when the tonsils from an organ that carries useful functions in the body turn into a focus of infection or contribute to the occurrence of diseases of other organs and systems. Accordingly, the decision on conservative or surgical treatment remains quite subjective. At the same time, modern ideas about the role of the palatine tonsils in the body dictate the need for the most sparing attitude towards them.

Already in the 20s of the twentieth century, separate opinions were expressed that “surgical removal of the tonsil, especially total removal, as practiced by many doctors, is completely unacceptable. A sick tonsil should be treated, not removed. The data of recent studies, proving the unconditional protective role of the palatine tonsils in the body, indicate the need to significantly limit the radical surgical treatment of patients with chronic tonsillitis. Currently, there is information both about the participation of palatine tonsils in the formation of regional immunity of the oral cavity, and about their influence on systemic immunity. It is known that the tonsils take part in the formation of antiviral immunity and serve as a barrier to the spread of respiratory viruses from their primary localization site (nasal cavity and nasopharynx) throughout the body. Interferon, obtained from tonsil lymphocytes, has a wide spectrum of antiviral activity, suppressing the cytopathic effect and reproduction of representatives of different groups of viruses - adenovirus type 1, vesicular stomatitis viruses, parainfluenza 2, Coxsackie B1, OB-40. The role of interferon produced in the tonsils in the formation of antiviral immunity is evidenced by the increased incidence of certain viral infections in individuals with tonsils removed. There are indications that tonsillectomy is associated with an increased risk of polio in children. The risk of poliomyelitis in children subjected to tonsillectomy is 3 times greater than in non-operated children, and the risk of developing the bulbar form of poliomyelitis is 11 times higher. B. Folczinsky believes that tonsillectomy, in all likelihood, contributes to the development of poliomyelitis in children who were healthy carriers of the virus before the operation.

In addition to the need for a sparing approach to the palatine tonsils, the risk associated with its implementation speaks in favor of limiting the use of tonsillectomy: bleeding, pulmonary complications, deep cervical infections, intracranial complications, mediastinal abscess, air embolism, subluxation of the 1st cervical vertebra, anaphylactic reactions to anesthesia, etc. According to P. Krishna and D. Lee, bleeding after tonsillectomy was observed in 3.3% of patients with normal coagulation parameters; in patients with changes in the coagulogram, bleeding was observed in 8.7% of cases. S. A. Theilgaard noted the occurrence of bleeding in the postoperative period after tonsillectomy in 8.5% of patients, and in 2.8% of patients the resulting bleeding required their return to the operating room. S. Maini observed secondary bleeding after tonsillectomy in 9.5% of patients. According to other authors, the frequency of bleeding associated with tonsillectomy varies from 1 to 5.2%. Tonsillectomy is especially dangerous when the internal carotid artery is abnormally located. This arrangement often goes undiagnosed and can be fatal. Among the complications of tonsillectomy, pulmonary embolism, jugular vein thrombosis, acute liver failure, meningococcal septicemia, subcutaneous emphysema of the neck, and necrotizing fasciitis are also described. According to D. J. Blum, the mortality associated with tonsillectomy is 0.006%. I. Kaygusuz showed that in 25% of cases tonsillectomy is accompanied by bacteremia, which explains the risk of various suppurative and septic complications and, as an example, described the development of an abscess in the paratonsillar tissue after tonsillectomy. M. Rivas Lacarte observed various complications after inpatient tonsillectomy in 1.89% of cases, and after outpatient tonsillectomy in 2.17% of cases. D. A. Randall and M. E. Hoffer noted bleeding, aspiration complications, pulmonary edema, reactions to anesthesia among possible complications after tonsillectomy.

The need to limit the use of tonsillectomy is also due to the fact that, on the one hand, being far from a safe method, it does not always lead to the desired result. Scottish Audit of Tonsillectomy 1992/1993. revealed a positive result in 97% of cases, however, according to a survey of patients, satisfaction with the results of the operation after 6 months was confirmed by 75%, and after a year - only 45% of patients. According to a tonsillectomy audit conducted in England and Wales in 1997, 8% of patients did not improve after tonsillectomy.

Already in the 20s of the twentieth century, separate opinions were expressed that “surgical removal of the tonsil, especially total removal, as practiced by many doctors, is completely unacceptable.

A. V. Chernysh believes that tonsillectomy does not contribute to the restoration of the immune status either immediately after surgery or in a longer period of time, and connects this with the peculiarity of the distribution of HLA antigens.

Speaking about the effectiveness of tonsillectomy, it is necessary to dwell on the significance of the unremoved remnants of the tonsils. R. Boies Lawrence found remnants of lymphoid tissue in 31% of patients. In the presence of remnants of lymphoid tissue in the tonsil niches, tonsillectomy is ineffective.

Tonsillectomy is especially dangerous when the internal carotid artery is abnormally located. This arrangement often goes undiagnosed and can be fatal.

The decision to perform a tonsillectomy remains not only quite subjective, but also (in some cases) unreasonable. M. Ikram, after conducting a histological examination of the removed tonsils in 200 patients, noted that the tonsils of 7.5% of patients had a normal morphological picture. Only 10% of patients had clear morphological signs of chronic tonsillitis, in other cases there were signs of hyperplasia of the lymphoid tissue. Despite convincing evidence of the need for limited use of tonsillectomy, it continues to be widely used in clinical practice. More than 390,000 surgeries are performed annually in the USA. Obviously, such a widespread use of tonsillectomy, despite the obvious need to limit it, is due to the lack of sufficiently effective methods for sanitation of the palatine tonsils. This is confirmed by the many proposed methods of conservative treatment.

As you know, an important factor in the pathogenesis of chronic tonsillitis is a violation of the emptying of tonsil lacunae from pathological contents. The difficulty in the outflow of the contents of the crypts is often explained not only by their anatomical features (length, branching, tortuosity), but also by the changes that occurred as a result of the existing pathological process (intralacunar adhesions, narrowing of the lacuna as a result of protrusion of its wall by a hypertrophied lymphoid follicle). The narrowing, and sometimes complete obliteration of the mouth, leads to a flask-shaped expansion of the lacuna, and its epithelial cover becomes thinner or completely disappears. The epithelium subjected to dystrophy does not provide sufficient barrier function. A prolonged inflammatory process leads to a violation of tissue and vascular permeability, which plays a significant role in the pathogenesis of both chronic tonsillitis and metatonsillar diseases. Protein breakdown products, bacterial toxins and antigens, immune complexes penetrate into the blood through the damaged lymphoepithelial barrier, causing intoxication and sensitization of the body.

Sparing surgical interventions on the palatine tonsils are designed to help resolve this problem, which ideally should not only improve drainage of the lacuna, but also reduce the absorption of toxins and antigens from the lumen of the lacuna. Regardless of the surgical technique used, all organ-preserving operations on the palatine tonsils can be divided into three groups:

Methods of isolated conservative treatment of chronic tonsillitis do not always provide stable compensation for the disease. A clear disadvantage of conservative treatment methods is the need for long repeated courses. Despite the apparent safety, local conservative treatment is not without possible complications: pharyngitis, allergic reactions, microtrauma of the palatine tonsils, etc. Known methods of conservative treatment of chronic tonsillitis do not eliminate such a link in the pathogenesis of the disease as a violation of the emptying of tonsil lacunae from pathological contents, which contributes to the maintenance of inflammatory process, sensitization and intoxication of the body. In this regard, since the beginning of the twentieth century. the concept of sparing surgical treatment began to be developed. Sparing operations on the palatine tonsils (regardless of the physical characteristics of the instrument used for exposure) either come down to the destruction of areas of the lymphoid tissue affected by the inflammatory process, or are aimed at improving the drainage function of the tonsil lacunae to prevent the accumulation of detritus in them.

The foregoing suggests that the need for adequate treatment of pharyngeal pathology in order to improve the quality of life, reduce the number of days of disability and prevent possible complications is beyond doubt. Inflammatory processes in the pharynx can be caused by various microorganisms. A predisposing moment for the development of the disease is almost always a decrease in immunity, including local immunity, caused by the action of adverse physical and chemical factors on the pharyngeal mucosa. However, the use of systemic drugs, primarily antibiotics, in a number of inflammatory diseases of the pharynx is inappropriate, and sometimes simply harmful. This is due to the fact that, in addition to bacterial agents, such etiological factors as viruses, fungi and other groups of microorganisms play an important role in pharyngeal pathology. It is a well-known fact that the unjustified widespread use of systemic antibiotics leads to the growth of strains of pathogens resistant to the bulk of the used antibacterial drugs. It is also necessary to take into account the risk of possible development of side effects and immunodeficiency during therapy with systemic antibiotics.

In this regard, local treatment of pathological changes in the pharynx is relevant. Currently, the doctor's arsenal has a significant number of drugs that act on the mucous membrane of the pharynx by irrigation, rinsing, lubrication, inhalation, and also during resorption. Most often, these are over-the-counter products, due to the safety of their ingredients. The composition of these dosage forms includes active antiseptic substances (most often phenol derivatives) in combination with a soothing or softening base, trace elements, and flavoring additives. But, despite this diversity, the emergence of new types of drugs always causes a certain interest from doctors and patients.

Antibacterial and anti-inflammatory drugs deserve special attention, among which, first of all, fusafungin-Bioparox can be attributed. The drug is a topical antibiotic with anti-inflammatory properties. Under in vitro conditions, the drug has an antimicrobial effect on the following microorganisms, which suggests a similar effect in vivo: group A streptococcus (group A Streptococci), pneumococcus (Pneumococci), staphylococcus (Staphylococci), some strains of Neisseria (Neisseria), some anaerobes, fungi genus Candida (Candida albicans) and Mycoplasma pneumoniae (Mycoplasma pneumoniae). Thus, the spectrum of antimicrobial activity of Bioparox is adapted to microorganisms, most often the causative agents of infections of the upper respiratory tract and, in particular, the oropharynx. In addition, for all the long time of its use in medicine, the emergence of new bacterial strains resistant to it has not been noted. In addition to antibacterial properties, fusafungin has its own anti-inflammatory effect, which has been demonstrated in experimental studies. It enhances macrophage phagocytosis and inhibits the formation of inflammatory mediators.

The drug is indicated for the treatment of infectious and inflammatory diseases of the respiratory tract, including the oropharynx. Attention should be paid to a new form of the drug, the appearance of which is due to the following circumstances. In the early 90s. last century, a world convention was signed to ban freon. At that time, most companies - manufacturers of aerosol preparations used freon as a propellant gas, including the manufacturer of Bioparox. After freon was banned in Bioparox, norflurane began to be used as a propellant gas, which has proven its safety and is used today as a propellant gas in most inhaled drugs for the treatment of patients with bronchial asthma, COPD, etc.

The results of a number of studies have shown that the active substance of the drug - fusafungin - is soluble in the propellant (norflurane) and large amounts of isopropyl myristate as a solvent are not required for its dissolution. In order to reduce the number of requests from patients regarding sensitivity to essential oil, the content of isopropyl myristate in the fusafungin solution (from 4.4 to 0.1 ml), ethanol and aromatic additives was significantly reduced in the composition of the new form of Bioparox, and the amount of propellant gas was almost halved - from 15 ml of norflurane in the previously presented form to 9.41 ml in the new form. Thus, in the new Bioparox, the amount of excipients is minimized, which suggests high tolerance and a decrease in the number of complaints about negative sensations and side effects.

The qualitative composition of the drug remained unchanged: fusafungin - a medicinal substance, isopropyl myristate - a solvent and a valve lubricant, anhydrous ethanol - a solvent, saccharin - a sweetener, a flavoring additive to give a pleasant smell.

The estimated volume of the solution in the can is 10 ml, which is equal to 400 inhalations of 25 µl, each containing 125 µg of fusafungin. The therapeutic dose of the drug is 4 inhalations, the inhaler contains 100 doses (400 inhalations = 100 doses). The changes also affected the dosing regimen:

The unjustifiably widespread use of systemic antibiotics leads to the growth of strains of pathogens resistant to the bulk of the used antibacterial drugs. It is also necessary to take into account the risk of possible development of side effects and immunodeficiency during therapy with systemic antibiotics.

The design of the nozzles has also changed. The throat and nose attachments that came before are better adapted. In addition, an additional, third nozzle for the nose has been created, which will allow treating runny nose and nasal congestion in young children. It is shorter in length and smaller in diameter than the adult nozzle. The end of the nozzle is specially rounded for convenience and safety of use.

In the new Bioparox, the amount of excipients is minimized, which suggests high tolerance and a decrease in the number of complaints about negative sensations and side effects.

The arsenal of existing drugs is currently quite large and it is advisable to take the advice of a qualified doctor to select a specific treatment regimen. Particular care should be taken when prescribing antibacterial drugs of systemic action. The immoderate and unreasonable use of such a method of treatment not only does not contribute to recovery, but also provokes a number of negative side effects. The place of use of systemic antibiotics in inflammatory diseases of the pharynx should be clearly defined. Chronic tonsillitis without exacerbation and pharyngitis of any severity are not indications for the use of systemic antibiotic therapy. Even with catarrhal angina, in our opinion, one should refrain from using systemic antibacterial agents. Such treatment is justified only with a burdened course of inflammatory diseases of the pharynx. Such conditions should include lacunar, follicular and phlegmonous tonsillitis, as well as tonsillogenic phlegmon and abscesses.

Chronic pharyngitis is a disease of a completely different nature. This pathological condition rarely occurs in isolation from painful manifestations from other organs and body systems. The causes that cause and maintain chronic pharyngitis can be diseases of the gastrointestinal tract (gastro-pharyngeal syndrome), diseases of the endocrine system (diabetes mellitus), pathology of the cardiovascular system, osteochondrosis of the cervical spine, renal pathology, chronic tonsillitis, sinusitis, pathology nervous system and many other diseases. Chronic pharyngitis can also occur with certain unfavorable professional factors: work in hot shops, in chemical industries, with increased dust and gas contamination of working or domestic premises. Often chronic pharyngitis occurs in smokers. Pathologically, chronic pharyngitis is not so much an inflammatory disease as it is a change in the mucous membrane of a degenerative, dystrophic nature. The success of ongoing therapeutic measures largely depends on the correct definition of the classification form of pharyngitis. At the same time, it is necessary to take into account the fact that when chronic pharyngitis is combined with the pathology of other organs and systems of the body, treatment should be comprehensive, including the normalization of the state of the mucous membrane of the posterior pharyngeal wall and aimed at eliminating the disease that caused the formation of chronic pharyngitis. Thus, in some cases, not only an otorhinolaryngologist, but also a doctor of another specialty (gastroenterologist, endocrinologist, etc.) should take part in the treatment of chronic pharyngitis. Local treatment depends on the clinical form of chronic pharyngitis. With hypertrophic pharyngitis, treatment is aimed at eliminating excessively enlarged areas of the mucous membrane of the posterior pharyngeal wall. This can be done with laser coagulation, cryosurgery, or cauterization with silver nitrate. Subatrophic and atrophic pharyngitis is treated with group A vitamins, biostimulants, and anticholinesterase drugs that can be injected into the back of the pharynx by injection or by electrophoresis. The therapeutic effect of these drugs (for example, prozerin) is based on the ability to improve the nervous tissue trophism, stimulate the secretion of mucous glands and increase the tone of the muscles of the pharynx, resulting in improved blood circulation in this area.

Inflammation of the pharynx or pharyngitis, a disease that in itself does not pose a great danger and disappears after a few rinses. However, its consequences can be dire. Left untreated or not fully treated, it can cause inflammation of the kidneys, rheumatism and lead to heart disease.

A feeling of sore throat, itching that makes you want to clear your throat, and all this against the background of an absolutely normal body temperature. This feeling is familiar to many people. After a couple of days, they turn into a severe sore throat with a slight increase in temperature. Patients with such symptoms rarely go to the doctor and prefer to be treated themselves.

Inflammation of the mucous membrane and lymphoid tissue of the pharynx, which appears as a result of the influence of aggressive external and internal factors on them, is called pharyngitis. The disease can occur in acute and chronic form. Depending on the location of the focus of the disease, there is nasopharyngitis, when the nasal mucosa of the nasopharynx is affected, and mesopharyngitis, if the membrane of the oral part of the pharynx is inflamed. The second type of disease is the most common.

Almost the entire population of the globe has been ill with this disease. There are few who would not imagine the unpleasant sensations caused by it. No one can be insured against pharyngitis, since it can develop equally from eating cold food and from drinking a glass of too hot tea. The disease can even be caused by cigarette smoke, which is inhaled while being in the same room with a smoker.

There are many diseases of the larynx that are confused with pharyngitis:

• scleroma;
• laryngospasm;
• pharyngomycosis;
• edema, stenosis of the larynx;
• angina or tonsillitis;
• laryngitis.

Many of them are dangerous to humans, can be fatal if not treated in a timely manner.

Causes of the disease

The throat is the most vulnerable part of the human body. Therefore, the inflammatory process can occur due to many reasons. In the autumn-spring period and in winter, cold air that enters the larynx directly, and not through the nose, can become the cause of the disease. With a viral infection, the pharynx will be irritated by bacteria that have entered the body and secretions from the paranasal sinuses flowing down it.

Weakened by any diseases, the body is easily infected with various types of microbes (staphylococci, streptococci, pneumococci), viruses, fungi. This group also includes people who abuse alcohol and smoke.

If there is a focus of infection in the oral cavity, then this can also provoke inflammation of the posterior wall of the nasopharynx. For this, not fully treated dental caries or stomatitis is enough.

For people working in the service sector and, by virtue of their profession, having contact with chemicals every day, this is what can cause the disease. Air pollution has a great influence on the occurrence of pharyngitis. This is the reason that urban residents complain of throat diseases more often than people living in rural areas.

Types of disease

First of all, it is necessary to determine what type of pharyngitis worries: chronic, allergic or acute. Each of them has its own sources and provoking factors, which means that the subsequent treatment should be different.

The acute form is excited by staphylococci and streptococci, and therefore often accompanies adenovirus and influenza. In addition, adverse factors can activate the disease:

The allergic form is often found in workers of large enterprises and among citizens. It can be triggered by polluted air and industrial emissions. Appearing dryness, perspiration are caused by swelling of the posterior pharyngeal wall.

The chronic form can develop as a result of acute or untreated pharyngitis, appear in the elderly or senile age, act as a consequence of serious diseases of the gastrointestinal tract, cardiovascular and urinary systems.

Chronic form

There are several types of chronic pharyngitis:

• atrophic;
• hypertrophic;
• catarrhal;
• combined form.

Atrophic pharynitis is combined with degradation of the mucous membrane lining the nasal cavity. As a result of this atrophy, microbes freely enter the human body and primarily in the throat. The cause of this form may be the defeat of the throat fungus due to prolonged use of antibiotics.

The hypertrophic form is accompanied by nausea and vomiting due to mucus accumulating in a large volume. It also causes a desire to constantly expectorate and cough. In addition to mucus, pus periodically accumulates in the throat, due to which the smell from the mouth worsens.

Catarrhal pharyngitis causes a sensation of a "lump" in the throat. The disease is accompanied by mild pain when swallowing with moderate tingling and intermittent cough resulting from perspiration.

The mixed form is characterized by the fact that one of the forms of chronic pharyngitis or several can be added to the sore throat and cough. Before treating a chronic disease, it is necessary to identify and eliminate all the factors that cause it. Otherwise, the therapeutic measures taken will not only not give a positive result, but will also cause irreparable damage to the health of the patient.

Symptoms of the disease

Irritation of the pharyngeal mucosa at the beginning of the disease has no characteristic symptoms and is similar to all other diseases of the throat. Only a doctor can make an accurate diagnosis, on the basis of which treatment will be prescribed, after a personal examination of the patient and passing tests.

Signs characteristic of acute and chronic pharyngitis at the initial stage of the disease:

• pain;
• sore throat;
• general condition is normal;
• the temperature does not rise.

If the disease is caused by viruses, then it is necessary for 2-3 days:

• runny nose appears;
• there is a dry, sharp cough;
• voice hoarse, becomes hoarse;
• coughing up light sputum;
• the temperature rises to 38°C and above.

A bacterial infection will cause several other symptoms:

• enlarged lymph nodes;
• the voice is hoarse or disappears;
• sharp "barking" cough to the point of nausea;
• body temperature ranges from 37°C to 38°C.

The chronic form causes approximately the same conditions in patients. The difference lies in the color of the outgoing sputum and its quantity.

This form is characterized by:

This form is also characterized by soreness when eating salty, spicy foods, a feeling of a lump in the throat.

Treatment of the disease

Self-medication is undesirable. How long it takes for treatment depends only on the form of the disease. This also affects the duration of the course of the disease.

The acute form lasts from 4 days to 2 weeks. For treatment:

• throat spraying with medicines;
• solutions with alkaline content are sprayed;
• alcohol intake and smoking are excluded;
• spicy and salty foods are limited;
• drugs are prescribed to fight bacteria;
• temperature-lowering agents.

In the chronic form of the disease, the focus of inflammation in the body, which caused the exacerbation of the disease, is primarily blocked. For this:

• crusts and mucus are removed, for this they do inhalations, sprays;
• treat the pharynx with solutions that reduce its swelling;
• carry out treatment with ultrasonic phoresis;
• antiseptic and anti-inflammatory drugs are prescribed.

Only after that a course of treatment is carried out, which can last about a year.

mouth Back in 1655, a wealthy Dutch shopkeeper from Delft decided that he had enough time and money to do what he loved - to create microscopes and study the microcosm with their help. Antonio Leeuwenhoek - that was the name of the Delft merchant - is considered the founder of microscopy. It was to him that the discovery of the infusoria of the shoe belongs, it was he who first described blood cells and a variety of forms of bacteria.

But then, back in the 17th century, he was incredibly surprised when he first discovered microscopic "animals" in pepper broth. And he was completely shocked by the discovery that hundreds of such animals live in his mouth.

Since the time of Antonio Leeuwenhoek, science has made a tremendous leap forward, including microbiology. Now it is difficult to surprise someone with the message that thousands of microorganisms live in his mouth. But does every patient think about the harm these microorganisms bring to health?

Meanwhile, we know that infectious and inflammatory diseases of the oral cavity and pharynx (pharyngitis, glossitis, stomatitis and gingivitis) are among the most common reasons for patients to visit district physicians, family doctors and otorhinolaryngologists, which indicates the widespread prevalence of this problem.

The main cause of the development of inflammatory processes of the upper respiratory tract (pharyngitis, rhinitis, tonsillitis, etc.) is a viral infection (rhinovirus, adenovirus, coronavirus, parainfluenza, influenza, etc.).

When the oropharynx is affected, adenoviral and rhinovirus infections are more common than others. The body reacts to the introduction of an infectious agent and violation of the integrity of the mucous membranes by the development of an inflammatory process, in which a number of protective mechanisms are activated: changes in the permeability of the vascular wall, increased blood flow, increased activity of macrophages and polymorphonuclear cellular elements, release of inflammatory mediators, free oxygen radicals. Macrophages play a major role in the defense mechanism, causing an increase in the level of T-lymphocytes through the release of cytokines. Various diseases accompanied by a decrease in local and general body resistance (primary and acquired immunodeficiency states, cystic fibrosis, endocrine diseases, etc.). Local hypothermia of the oropharynx with cold food, drinks or cold air, as well as exposure to various irritating agents (tobacco or other smoke with systematic exposure, dustiness of the air, the presence of irritating chemicals in the air) can lead to a decrease in local immunity. With inflammation of the paranasal sinuses, infected secretions can enter the pharynx and stimulate infectious inflammatory processes in it.

With a decrease in immunity, the so-called "transient flora" can acquire the status of "pathogenic". The "transient flora" includes streptococci, staphylococci, pneumococci, gram-negative diplococci and other microflora, usually sown in the norm and in a healthy person.

Pharyngitis

Pharyngitis is divided into acute and chronic. Acute pharyngitis is an infectious inflammation of the mucous membrane of the oropharynx and palatine tonsils. With favorable development, acute pharyngitis may resolve spontaneously, without medical intervention. But most often, acute pharyngitis is accompanied by the development of inflammatory, and sometimes purulent processes in adjacent tissues. The main complaints of patients with acute lesions of the mucous membrane of the oropharynx are unpleasant sensations - burning, tingling, dryness, pain when swallowing; headache localized in the occipital region. Children often have shortness of breath and nasality. In adults, this disease occurs without a sharp deterioration in the general condition, and in children it can occur with a sharp increase in temperature up to 39 ° C. Especially in cases where inflammation spreads to the larynx and trachea. Acute pharyngitis is characterized by an increase and soreness of the cervical and occipital lymph nodes. Examination of the patient reveals hyperemia of the posterior pharyngeal wall and palatine arches, separate inflamed lymphoid granules, but there are no signs of inflammation of the palatine tonsils characteristic of tonsillitis.

Chronic pharyngitis, in contrast to acute, as a rule, is bacterial in nature, less often fungal. This is a polyetiological disease characterized by the presence of inflammatory and degenerative changes in the pharyngeal mucosa. Chronic pharyngitis is characterized by complaints of dryness, perspiration, soreness and sensation of a foreign body in the throat, often a dry cough and the formation of viscous sputum, fever. A significant deterioration in the general condition is rare in patients with chronic pharyngitis. When making a diagnosis, the pharyngoscope picture is taken into account. The development of chronic pharyngitis is associated with the harmful effects of such irritating factors as alcohol, nicotine, spicy food, carbonated drinks, various adverse industrial and climatic influences. The formation of the disease is facilitated by pathological conditions of the nasal cavity, leading to a violation of nasal breathing - curvature of the nasal septum, vasomotor and hypertrophic rhinitis, nasal polyposis, adenoids. The cause of chronic pharyngitis can be recurrent infections of the respiratory tract, leading to persistent damage to the mucociliary barrier and significant inhibition of the mechanisms of local and general immunity. Atrophic pharyngitis is a consequence of progressive atrophy of the pharyngeal mucosa in the elderly.

gingivitis and periodontitis

Imbalance in the oral defense system can cause inflammation of the gum mucosa - gingivitis. When inflammation spreads from the gingival margin to the tissues surrounding the teeth, gingivitis turns into periodontitis, which can later lead to inflammation of the bone tissue, loosening and loss of the tooth. In patients older than 15 years, in 50% of cases, the cause of tooth loss is periodontal disease. In gingivitis, the gum becomes inflamed, swelling occurs, its contour changes. Due to edema, the gingival sulcus between the tooth deepens, and the so-called gingival pocket is formed. As a result, there is reddening of the gingival margin, swelling and bleeding of the gums, it becomes sensitive and painful, there are difficulties in chewing and swallowing. Gingivitis can be either acute or chronic. Chronic gingivitis is more common in adults.

Stomatitis

Infectious and inflammatory diseases of the oral cavity include stomatitis - inflammation of the oral mucosa. According to the clinical manifestation, stomatitis is divided into catarrhal, ulcerative and aphthous. The most common cause of stomatitis is non-compliance with oral hygiene, dental disease, dental plaque, oral dysbacteriosis, as well as gastrointestinal diseases (gastritis, duodenitis, colitis, etc.). Aphthous stomatitis is characterized by a connection with allergic reactions, viral infections, rheumatism. Depending on the severity and form of the disease, patients complain of pain in the oral cavity and pharynx, severe pain during chewing, swallowing articulation. Sometimes there is an increase in body temperature up to 37.5 ° C, an increase in regional lymph nodes, malaise, headache. On examination, defects in the mucous membrane of the oral cavity and tongue are determined.

Treatment: general principles

Therapeutic tactics for infectious and inflammatory diseases of the mucous membrane of the oral cavity and pharynx includes the appointment of drugs with anti-inflammatory, analgesic, immunocorrective effects, local antiseptics, decongestants and hyposensitizing drugs. In the complex of therapeutic measures, an important role belongs to drugs that have a combined effect.

What exactly is the treatment?

So, a specialist treating a patient with an inflammatory disease of the oral cavity and pharynx has the main mission: choosing the most effective drug. It is on this choice that the speed and effectiveness of the therapy depends.

Scientific reference

Causes of inflammation of the oral cavity

1. Traumatic inflammation. Trauma can be mechanical, chemical or physical, acute or long term.
2. Infectious inflammatory processes (viral, bacterial, fungal infections).
3. Allergic reactions, accompanied by swelling and inflammation of the oral mucosa.
4. Inflammation of the mucosa in systemic diseases: hypo- and beriberi, endocrine diseases, diseases of the blood system, diseases of the gastrointestinal tract, etc.

HEXETIDINE

Broad-spectrum antiseptic against gram-positive and gram-negative microorganisms. Bactericide for anaerobic bacteria. Bacteriostatic for most strains of bacteria at a concentration of 100 mg / ml. Fungicide against fungi of the genus Blastomycetes, Trichophyton, Histoplasma, Microsporum. It inhibits the growth and reproduction of more than 40 strains of fungi of the genus Candida. Weak analgesic.

The undeniable advantage of hexetidine, in addition to a wide spectrum of action, is a high degree of adhesion on the mucous membrane of the oropharynx. At the same time, in the absence of absorption, hexetidine has a lasting effect (active concentrations of hexetidine on mucous membranes persist for 10-14 hours after a single application).

CHOLINE SALICYLATE

A powerful analgesic and antipyretic, a derivative of salicylic acid. It blocks the enzymes COX-1 and COX-2, inhibits the synthesis of prostaglandins, due to which it has a powerful anti-inflammatory effect. It inhibits the activation of macrophages and neutrophils, showing anti-edematous action. It has an antipyretic and analgesic effect. It is indispensable in the treatment of diseases of the oropharynx, accompanied by an increase in local temperature, severe inflammation, swelling and soreness. It is well absorbed from mucous membranes, has a fast effect.

CHLOROBUTANOL

A fast-acting local anesthetic, a reliable tool in the arsenal of dentists and otorhinolaryngologists. It has additional properties: antibacterial and antifungal effects. Helps to enhance the analgesic effect in combination with hexetidine and choline salicylate.

An “ideal” composition means should provide:

1. Antibacterial and antiviral effect.
2. Anti-inflammatory effect.
3. analgesic effect.