Among childhood illnesses, diseases of the throat also have their place. ENT diseases are of crucial importance for the proper development of the child, as well as posing a direct threat to the child's life and health in terms of the future and the complications of untreated ENT diseases. Among these, we can mention problems with the palatine tonsil and the pharyngeal tonsils, which often require surgical intervention.
Acute palatine tonsillitis
Acute palatine tonsillitis can be caused by bacterial, viral and mixed agents, with bacterial infection being the most common cause of the development of this condition. Streptococcus, the most common bacterium causing tonsillitis, can have serious complications due to the fact that it is particularly dangerous due to its toxin secretion. Hence, the complications of tonsillitis can even include rheumatic fever, nephritis or myocarditis.
In order to confirm a streptococcal aetiology, a culture is necessary.
Symptoms
Fever, sore throat or enlarged lymph nodes, both submandibular and cervical, indicate the development of tonsillitis. The appearance of the palatine tonsils, which are covered with a characteristic purulent plaque or suppositories, is also an important symptom.
Therapy
The mainstay of treatment is antibiotic therapy administered over a period of 10 days. Shorter use of antibiotics, creates a greater risk that not all pathogens will be eradicated, significantly increasing the likelihood of dangerous sequelae.
One of the complications after tonsillitis is a peri-tonsillar abscess, which is characterised by concentrated pain, clearly on one side. In the case of an abscess, we may also have to deal with a spike in fever or trismus. In the case of treatment of an abscess, in addition to antibiotic therapy, drainage may be carried out, removing the purulent contents from inside. The occurrence of an abscess is an indication for the removal of the palatine tonsils, i.e. a tonsillectomy.
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Enlargement of the palatine tonsils
From a diagnostic point of view, the size of the palatine tonsils in children is not very important. Children, due to tissue development, tend to have tonsils much larger than adults and, as with the palatine tonsil, regression occurs, but not completely. The problem arises when the child has problems with basic physiological functions such as breathing or swallowing. The first herald is usually snoring, but this is quite often underestimated by parents, who tend to believe that it is a family affliction. Medical advice is sought when a child manifests problems with sleep apnoea and uneven breathing or increased breathing effort, which is associated with upper airway obstruction.
Diagnostics
Pulse oximetry performed during sleep, allows us to check if the saturation falls above 85%. If such drops are recorded, this indicates hypoxia.
Other tests needed are nasal patency tests, such as rhinomanometry or acoustic rhinometry. An endoscopic examination of the upper respiratory tract is also performed to check the proper functioning of the respiratory system.
A very useful diagnostic test with 100% sensitivity is polysomnography (PSG). This test is performed in the sleep laboratory and allows respiratory disorders to be determined according to the sleep phase.
Tonsillectomy
Removal of the palatine tonsils is performed when there are indications such as respiratory obstruction, recurrent tonsillitis (3 to 4 times per year), detected carriage of haemolytic streptococcus type A, per tonsillar abscess or uneven, asymmetrical tonsillar proliferation. [1]
