A doctor discusses the treatment of chronic tonsillitis, emphasizing the ineffectiveness of washing out purulent plugs from the palatine tonsils. He explains that purulent plugs are a symptom of the disease, not the cause, and that washing them out does not address the underlying inflammatory process. Instead, the doctor recommends treating the inflammation in the tonsils, allowing them to shrink and become less congested, making it easier for the body to naturally expel the purulent plugs.
The doctor also explains the anatomy of the tonsils, including the role of the crypts and the stellar masses in the immune system. He notes that chronic tonsillitis occurs when the normal, controlled infectious process in the tonsils becomes uncontrolled and leads to inflammation.
The doctor describes a treatment approach that involves reducing inflammation and allowing the tonsils to heal, rather than trying to wash out the purulent plugs. He also discusses the use of ultrasound to help loosen and remove any remaining purulent plugs at the end of treatment.
The doctor emphasizes that washing out purulent plugs is not a cure for chronic tonsillitis and that it can even cause more harm by traumatizing the tonsils and making the inflammation worse. He advocates for a more holistic approach to treating the disease, focusing on reducing inflammation and promoting the body's natural healing processes.
Here are the key facts from the text:
1. Patients with chronic tonsillitis often have purulent plugs in their tonsils.
2. Purulent plugs are not the cause of chronic tonsillitis, but rather a symptom.
3. Chronic tonsillitis is an inflammatory process that develops in the palatine tonsils.
4. The inflammatory process causes the formation of purulent plugs.
5. Washing the palatine tonsils does not affect the mechanism of inflammation or the formation of purulent plugs.
6. Washing the palatine tonsils can traumatize the tonsils and increase the inflammatory process.
7. The palatine tonsils are an important immune organ that provides antibodies against microbes.
8. The tonsils have a structure that includes lymphoid follicles, crypts, and a stellar mass.
9. The stellar mass is a mixture of epithelium, macrophages, lymphocytes, and bacteria.
10. The stellar mass is normally updated through the process of swallowing, which helps to remove pathogens and update the immune system.
11. In chronic tonsillitis, the inflammatory process causes the tonsils to become inflamed and the crypts to become narrowed.
12. The narrowed crypts can lead to the formation of dense plugs, which can become stagnant and lead to suppuration.
13. The presence of infection and disruption of the stellar mass can create conditions for the formation of purulent plugs.
14. Removing the inflammatory process in the tonsils can help to reduce the size of the tonsils and improve drainage.
15. The use of ultrasound can help to pierce the tonsil and remove any remaining purulent plugs.
16. The procedure of using ultrasound to influence the tonsil is typically carried out at the end of treatment, after the tonsils have shrunk and softened.