DISEASES OF THE PHARYNX

BY DR ARIF RAZA KHAN ASSISTANT PROFESSOR E.N.T. K.T.H.

DISEASES OF THE PHARYNX.

FOREIGN BODIES. TRAUMA. INFLAMMATORY. NEW GROWTHS. MISCELLANEUS.

DISEASES OF THE PHARYNX.

INFLAMMATORY CONDITIONS. ACUTE. CHRONIC. NONSPECIFIC. SPECIFIC.

ACUTE NONSPECIFIC PHARYNGITIS.

1.
2. 3. 4.

5.
6. 7. 8.

AETIOLOGY. Streptococci. Staphylococci. Pneumococci. Haemophilus influenzae. Trauma of operations. Swallowing(hot, corrosives.) Foreign bodies. Prodromal manifestations of infectious fevers, like, MEASELS,SCARLET FEVER,SMALLPOX,TYPHOID,etc.

ACUTE NON SPECIFIC PHARYNGITIS.

Pathology. VASODILATATION. INCREASED PERMEABILITY. INCREASED GLANDULAR ACTIVITY. 1. REDNESS. 2. OEDEMA. 3. EXUDATION.

ACUTE NONSPECIFIC PHARYNGITIS.

1.
2. 3.

TYPES. CATARRHAL.(SIMPLE.) SUPPURATUVE.(SEPTIC.) GANGRENOUS.(NOMA.)

ACUTE NONSPECIFIC PHARYNGITIS.

1.

CLINICAL FEATURES. CATARRHAL TYPE. Sore throat. Dysphagia. Ear ache (referred.). Cervical lymphadenopathy. Fever. Acute rheumatism. Acute nephritis.

ACUTE NONSPECIFIC PHARYNGITIS.

CLINICAL FEATURES. On examination. 1. Redness of the pharynx. 2. Oedema of the soft palate. 3. Shallow ulcerations.

ACUTE NONSPECIFIC PHARYNGITIS.

SUPPURATIVE TYPE. (greater extent of the following.) Sore throat. Dysphagia. Ear ache (referred). Cervical lymphadenopathy. Fever. Acute rheumatism. Acute nephritis. Oedema of the soft palate. Exudation may form a false memberane.

1. 2. 3.

4.
5. 6. 7. 8. 9.

ACUTE NON SPECIFIC PHARYNGITIS.

GANGRENOUS TYPE.
VERY RARE.

DIFFERENTIAL DIAGNOSIS.
2. 3.

DIPHTHERIA. INFECTIOUS FEVERS. BLOOD DYSCRASIAS.

1.

ACUTE NON SPECIFIC PHARYNGITIS.

TREATMENT.

7.

Antibiotics. 2. Analgesics. 3. Anti inflammatory. 4. Plentyof drinks. 5. Rest. 6. Tracheostomy(rare). Incision and drainage of ludwigs angina.
1.

ACUTE MEMBRANOUS PHARYNGITIS.(VINCENT ANGINA.)

1.

2. 3. 4. 5. 6. 7.

AETIOLOGY. GRAM NEGATIVE FUSIFORM BACILLUS. SPIROCHEATA DENTICOLA. AN-AEROBIC STREPTOCOCCI. BAD TEETH BAD GUMS. OVERCROWDING. UNDERNOURISHMENT.

VINCENT ANGINA.
PATHOLOGY. ACUTE ULCERATIVE LEISONS. On tonsils, pillars, soft palate. Gums. ULCERS ARE, deep, ragged margins. SLOUGH, over the ulcers which BLEEDS.

1.

2.

3.

VINCENT ANGINA.
CLINICAL FEATURES. SEVERE PAIN. FETOR ORIS. FEVER. ENLARGED LYMPH NODES. DEEP RAGGED ULCERS. SLOUGH.

1.
2. 3. 4. 5. 6.

VINCENT ANGINA.

1.
2. 3.

DIFFERENTIAL DIAGNOSIS.
DIPHTHERIA. ACUTE SUPPURATIVE PHARYNGITIS. SYPHILLIS. GROWTHS. AGRANULOCYTOSIS. ACUTE LYMPHOBLASTIC LEUKEMIA. INFECTIOUS MONONUCLEOSIS. AVITAMINOSIS.

4.
5. 6. 7. 8.

VINCENT ANGINA.

1.

TREATMENT.

2.

3.
4. 5. 6. 7.

BROAD SPECTRUM ANTIBIOTICS. MOUTH WASHES. ANALGESICS. ANTI INFLAMMATORY. DRINKS. REST. ANTIBIOTIC LOZENGES.

ACUTE DIPHTHERIC PHARYNGITIS.

1.
2.

AETIOLOGY.

KLEBS-LEFLER BACILLUS. MOSTLY CHILDREN.(2-5 years.)

SPREAD.

1.
2. 3.

4.
5.

DIRECT CONTACT. DROPLET INFECTION. THERMOMETERS. TONGUE DEPRESSORS. DIPHTHERIA CARRIERS.

ACUTE DIPHTHERIC PHARYNGITIS.

1. 2.

PATHOLOGY.

LOCAL LESION. NECROSIS OF THE TISSUES. MEMBRANE FORMATION. LOCALIZED. SPREAD. GREY/WHITE/YELLOW/BROWN. CHARECTERISTIC SMELL. BLEEDS ON REMOVAL.

ACUTE DIPHTHERIC PHARYNGITIS.

1.

PATHOLOGY. DISTANT LEISON. EXOTOXINS causing, Toxic myocarditis. Renal tubular necrosis. Peripheral neuritis. Cranial nerve palsies.

ACUTE DIPHTHERIC PHARYNGITIS.

1.
2. 3. 4. 5. 6.

CLINICAL FEATURES. FEVER LESS THAN 100F. SORE THROAT. VOMITING. LETHARGY. TOXIC. PULSE, tachycardia.

ACUTE DIPHTHERIC PHARYNGITIS.

1.

2. 3. 4. 5. 6. 7.

DIFFERENTIAL DIAGNOSIS. ACUTE FOLLICULAR TONSILLITIS. SUPPURATIVE PHARYNGITIS. VINCENTS ANGINA. SYPHILLIS. AGRANULOCYTOSIS. LEUKEMIA. INFECTIOUS MONONUCLEOSIS.

ACUTE DIPHTHERIC PHARYNGITIS.

1.

2.

3.

4.

TREATMENT. ANTIDIPHTHERIC SERUM,(ATD) S/C, I/M, I/V. SYSTEMIC ANTIBIOTICS. (penicillins.) TRACHEOSTOMY. TREATMRNT OF DISTANT LESIONS/PALSIES.

CHRONIC NON SPECIFIC PHARYNGITIS.

1.
2.

1. 2. 3. 4. 5.

AETIOLOGY. REPEATED ATTACKS OF ACUTE PHARYNGITIS. ONE ATTACK OF ACUTE PHARYNGITIS(PERSISTANT) ORGANISMS. STREPTOCOCCI. STAPHYLOCOCCI. PNEUMOCOCCI. HAEMOPHILLUS INFLUENZA. VIRUSES.

CHRONIC NON SPECIFIC PHARYNGITIS.

1.
2. 3.

4.

5.

PATHOLOGY. CHRONIC INFLAMMATION. LYMPHOID HYPERTROPHY. PROMINENT LATERAL BANDS. RETENTION CYSTS. FIBROSIS.

CHRONIC NON SPECIFIC PHARYNGITIS.

1.
2. 3. 4. 5. 6.

CLINICAL FEATURES. IRRITATION IN THROAT. DRY COUGH. CONSTANT CLEARING OF THE THROAT. TIRING OF THE VOICE. FEVER . EAR ACHE.

CHRONIC NON SPECIFIC PHARYNGITIS.

1.

2.

3. 4.

CLINICAL TYPES. CATARRHAL. Exudate, congested. HYPERTROPHIC. Granules,lateral pharyngeal bands. FOLLICULAR. Cysts. ATROPHIC.dry, glossy.

CHRONIC NON SPECIFIC PHARYNGITIS.

1. 2. 3. 4. 5. 6. 7.

TREATMENT. REMOVAL OF PREDISPOSING CAUSE. RESTRICTION ON FAULTY USE OF VOICE. AVOIDENCE OF SPICY AND ICY FOODS. ANTIBIOTICS. ANALGESICS. SILVER NITRATE, GALVANIC CAUTRY.(PAST). AMPUTATION OF UVULA, THROAT PAINTS.(PAST).

PREDISPOSING CAUSES OF CHRONIC NON SPECIFIC PHARYNGITIS. LOCAL.

1.

2. 3. 4. 5.

NOSE AND PARA NASAL SINUSES. DNS, allergic rhinitis, sinusitis,polypi. BUCCAL CAVITY. Sepsis in teeth, and gums. AFTER TONSILLECTOMY. Badly removed tonsils, scarring. LONG STYLOID PROCESS. With inflammation of the tonsil. NASOPHARYNX. Adenoiditis.

PREDISPOSING CAUSES OF CHRONIC NON SPECIFIC PHARYNGITIS.

1. 2. 3. 4. 5.

GENERAL.

6.
7. 8. 9. 10.

11.

DIET. USE OF VOICE. TOBACCO. ALCOHOL. ATMOSPHERIC CONDITIONS. RHEUMATIC AND GOUTY DIATHESIS. LOW RESISTANCE. AVITAMINOSIS. EXCESSIVE CLEARING OF THE THROAT. CHEST DISEASES. STOMACH DISEASES.