Caseous plugs on the tonsils: causes and treatment

Plugs in the palatine tonsils (or tonsils) are purulent accumulations in the lacunae of the tonsils. In medicine you can find other names for this pathology: purulent plugs, caseous plugs.

Most corks are white, but can have a yellow, brown or gray tint, depending on their composition.

Tonsil plugs may be soft to the touch or harder if they contain a large amount of calcium. Their size varies from a few millimeters to a centimeter. Both men and women are equally susceptible to their appearance, regardless of age.

Some patients mistakenly think that this condition does not need to be treated. But this is fundamentally wrong! The presence of purulent accumulations in the palatine tonsils contributes to the development of complications (not only in the upper respiratory tract, but even in the joints, kidneys and heart!).

Why does an accumulation of pus occur in the tonsils? How to treat tonsil plugs? And is it possible to carry out treatment at home? You will find answers to all your questions in our new article.

Tonsil plugs: causes

To find out the etiology of the occurrence of purulent accumulations in the tonsils, you need to understand what role the palatine tonsils play in the body.

The tonsils are an important organ of the human immune system, which is the first to stand in the way of bacteria and viruses that enter the body through the mouth. As soon as “strangers” reach the surface of the tonsils, they begin to intensify the production of leukocytes, which enter into battle with pathogenic microorganisms. As a result of such “battle actions”, dead leukocytes, bacteria, and epithelial remains accumulate in the lacunae of the tonsils. Over time, minerals accumulate here, and the contents of the lacunae begin to harden, forming caseous plugs.

The main cause of traffic jams is chronic tonsillitis. But they can also form in the palatine tonsils for various reasons:

• accumulation of staphylococci, streptococci, pneumococci and other bacteria;
• in people who have a weak immune system;
• frequent sore throats;
• the presence of herpes virus and fungi in the body;
• dental problems (caries);
• viral infections (flu, ARVI).

Each of the above reasons can provoke inflammation of the tonsils. The risk of accumulation of caseous masses in the lacunae of the tonsils is increased by unhealthy diet, smoking, and alcohol consumption.

Traffic jams do not form just like that, for no reason. They are a consequence of another disease and signal that an inflammatory process is underway in the body.

How dangerous is this?

Often papillomas on the tonsils are benign in nature, but at any age it is not worth the risk, and it is better to initially seek professional advice to eliminate all risks. Medical specialists identify the following among the main factors provoking the appearance of education:

• heredity;
• violation of metabolic processes;
• frequent colds and their complex course.

What color are the formations?

Papillomas blend in with the color of the mucous membrane of the throat, but sometimes they can change their pigmentation, becoming light pink or dark brown. Initially, one formation may appear, which is similar in size to a pea or the head of a pin. Over time, the number of formations can increase significantly and the lesion will look like a cauliflower with multiple papillomas. Sometimes the appearance process can be accompanied by inflammation.

Symptoms

Small accumulations, as a rule, do not cause significant symptoms. With large accumulations, the patient may experience the following symptoms of inflammation:

• bad breath;
• whitish dots are clearly visible on the surface of the tonsils;
• persistent sore throat;
• pain while swallowing;
• body temperature may be increased to 37-37.7 degrees;
• a feeling of discomfort at the site of accumulation of purulent masses;
• swollen tonsils;
• weakness, lethargy, general malaise;
• decreased performance;
• loss of appetite;
• enlarged lymph nodes;
• pain may radiate to the ears.

Traffic jams appear gradually, so in the early stages of the disease the patient experiences only discomfort when swallowing and a sore throat.

This condition is extremely dangerous for pregnant women! In addition to the fact that it has a detrimental effect on the general condition of the expectant mother, it can negatively affect the development of the fetus and, in the worst case, provoke a miscarriage. Therefore, it is extremely important to contact an otolaryngologist in time to receive competent recommendations on how to effectively treat tonsillitis during pregnancy and avoid complications.

How does the tumor feel?

Sometimes the patient does not feel any changes at all due to its small size, since there are no nerve endings in the papilloma, but as the formation grows, symptoms such as awkwardness when swallowing, a feeling of a foreign body in the throat, and cough appear. Similar sensations occur during pharyngitis or laryngitis, and in order to exclude the appearance of formations, it is necessary to urgently make an appointment with a doctor. With a child, the situation is complicated by the fact that he cannot accurately describe his sensations, and it is also difficult for him to carefully examine the oral cavity and pharynx on his own.

Diagnosis, treatment and prevention of recurrence of papillomas is carried out only by a medical specialist under the careful supervision of all stages and the obligatory condition of checking the oncogenic nature.

Help yourself?

The biggest mistake most patients make is overconfidence that caseous plugs can be removed at home using improvised means. They use a whole arsenal of objects that are absolutely not intended for this: spoons, forks, toothpicks... At best, such amateur activities simply will not bring results, at worst, they will cause injury to the surface of the tonsils and provoke severe bleeding, swelling and inflammation! This will most likely be followed by a sore throat! Plus, if you press incorrectly with a hard object on the accumulation of pus, you can push it even further into the thickness of the tonsil.

Some people try to gargle, believing that gargling will bring relief. Yes, the feeling of discomfort in the throat temporarily passes, but the accumulations of pustules do not disappear, because the rinsing solution comes into contact only with the surface of the tonsils, and getting inside it is extremely problematic, or rather, impossible. Therefore, this method is also not effective.

The best method to get rid of traffic jams is to consult an otolaryngologist!

Why do they appear?

There are several reasons for the appearance of cysts in the throat. For example, they can be genetically determined, and can often manifest themselves after a generation, notes Vladimir Zaitsev. Another point is problems with nasal breathing. “If it is absent, then the pharynx does not receive enough oxygen, a state of hypoxia develops, and the risk of developing cysts and polyps increases. Also, the reason may lie in the anatomical structure of the skull, when it develops atypically, which leads to a tendency to hypoxia of the nasopharynx. For example, when the soft palate sticks to the back wall of the pharynx and does not allow the nasopharynx to ventilate fully, this is also a precedent for the formation of tumors,” says the doctor.

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Possible complications

As already mentioned, the presence of clusters of caseous masses is not as harmless as it might seem at first glance. The danger of this condition is that pathogenic microflora from the lacunae of the tonsils can spread to other organs beyond the tonsils and provoke various kinds of complications:

1. Peritonsillar abscess of tissue around the tonsils. A severe inflammatory process starts in the tissues around the tonsils. A patient with this condition experiences a sore throat. He can't help but feel like there's a foreign object stuck in his throat. There are difficulties with swallowing and wide opening of the mouth (trismus of the masticatory muscles). Periodically, the patient has a fever, and other unpleasant symptoms of intoxication of the body appear. In this case, only opening the peritonsillar abscess, sometimes with the simultaneous removal of the tonsils (abscessonsillectomy), will help improve the patient's condition.
2. Cervical phlegmon is an infection of the tissue of the neck. The patient experiences severe pain at the site of inflammation, and the body temperature rises to 40°C. The danger is that a purulent infection can enter the blood and cause sepsis and purulent damage to other organs. The abscess can also descend into the mediastinum - the case where our heart is located. This inflammation is called mediastinitis. This is a disease with an extremely high mortality rate!
3. Sepsis (blood poisoning), caused by infection in the blood. This condition is extremely dangerous for humans and requires urgent hospitalization.
4. Kidney diseases.
5. Joint diseases.
6. Heart diseases.

What is tonsillitis?

Tonsillitis is an inflammatory process in the tonsils. The disease can be acute or chronic. The acute form is better known as tonsillitis. In chronic cases, periods of exacerbation (inflammation of the tonsils) are replaced by a period of remission (calm). Most often, the disease occurs in children 5-15 years old, although adults are also susceptible to the disease. The tonsils in children are larger than in adults. The palatine tonsils reach their maximum size by the age of 7, and then begin to shrink. Constant viral attacks on the tonsils lead to tonsillitis. Chronic tonsillitis most often acts as a complication after an infectious disease (sore throat, caries, etc.). The chronic form of the disease, according to statistics, occurs in 5% of adults and 11% of children. That is, chronic tonsillitis is a common disease. Tonsillitis plugs on the tonsils often appear with chronic tonsillitis.

Treatment of tonsil plugs

When contacting an ENT doctor, the patient is offered conservative treatment, which includes washing the tonsils, physiotherapeutic procedures and drug therapy.

There are two methods of rinsing: removing pus with a syringe and hardware rinsing. The method using a syringe is used much less frequently if the patient has a strong gag reflex. The most effective method is to wash the tonsils using a vacuum method using the Tonsillor apparatus. In our ENT clinic, we use a special vacuum attachment for this, which has no analogues today! With the help of this attachment, it is possible to effectively and painlessly wash the entire contents of the lacunae of the tonsils, and improve the patient’s condition after the first session.

Prevention

To prevent pathological enlargement of the tonsils, you must adhere to the following recommendations:

• Increase immunity: eat properly and well, exercise, exercise, give up bad habits, and maintain proper sleep patterns.
• Avoid provoking factors: do not overcool, humidify the air in the room, remove allergens from the environment.
• Treat infectious diseases promptly at the very beginning and prevent them from becoming chronic.
• Carry out preventive gargling and rinsing of tonsil lacunae. These procedures are carried out in our clinic, and our doctors will be happy to advise you about them.

If you are concerned about enlarged tonsils without fever, make an appointment with otolaryngologists at the Ear, Nose and Throat Clinic - you will receive comprehensive consultations and quality treatment.

Stages of the disease

The staging of tumors with intracellular DNA inclusions of human papillomavirus type 16 (16HPV) and without it differs.

For virus-negative neoplasms, everything is simple:

• Stage 1 - local formation up to 2 cm, without metastases in the lymph nodes;
• 2 tbsp. - tumor less than 4 cm and lymphatic collector without signs of cancer;
• 3 tbsp. - neoplasm more than 4 cm with “clean” lymph nodes or less and there is a node up to 3 cm;
• 4 tbsp. suggests either a primary tumor of any size with distant metastases, or a very widespread lesion of the oropharynx with a large conglomerate of lymph nodes on the same side, or a not very large cancerous node with lymph nodes on the opposite side of the neck.

When staging papillomavirus cancer in stages 1 and 2, metastatic lymph nodes are possible, and stage 4 - only with distant metastases from any tumor and lymph nodes.

Diagnosis of laryngopharyngeal cancer

How to diagnose throat cancer in the early stages? If there are symptoms of throat cancer, diagnosis should be comprehensive. Doctors at the Yusupov Hospital diagnose cancer of the throat and larynx using the following methods:

• Direct and indirect laryngoscopy,
• Hypopharyngoscopy;
• Computed tomography;
• Histological examination;
• Trial laryngofissure;
• Cytological examination of prints from the larynx and lymph nodes;
• Determination of tumor marker levels.

How to recognize throat cancer? Otolaryngologists first perform indirect laryngoscopy. When examining the true vocal cords, attention is paid to their mobility during phonation and the asymmetry of the lesion inherent in the tumor process, and the size of the tumor lesion and its location are specified. To examine the posterior parts of the larynx, they are examined with a laryngeal mirror from bottom to top, when the doctor sits in front of a standing patient.

How to diagnose throat cancer in an elderly person if the picture is not clear enough or if the tumor is masked by secondary inflammatory phenomena with decay, infiltration and edema? In this case, otolaryngologists resort to local anesthesia, elevating the epiglottis, palpating with a probe, using a magnifying mirror, and also tilting the patient’s head accordingly. If a lesion of the subglottic region or lower parts of the pharynx is suspected, direct laryngoscopy and hypopharyngoscopy are used.

How to check your throat for cancer using computed tomography. This research method expands diagnostic capabilities for tumors that are localized in the area of ​​the ventricular and true vocal cords and laryngeal ventricles, as well as when the tumor has spread to the subglottic region. At the Yusupov Hospital, patients are examined using the latest generation computer tomographs with high resolution capabilities.

How to check the throat and larynx for cancer using laboratory methods? Histological examination determines the nature of the tumor, its structure, the degree of differentiation of cellular elements and the degree of malignancy of the tumor - all these details influence the course of the disease and are taken into account when choosing a treatment method

To avoid stimulation of increased growth and spread of the tumor process due to damage to the lymphatic and blood vessels during biopsy, oncologists perform several sessions of radiation therapy before surgery.

How to diagnose laryngeal cancer using other methods? In cases where the biopsy data are not convincing enough or it is impossible, a trial laryngofisure is used. Since during the procedure, contamination of surrounding tissues with atypical cells may occur, in such cases, a histological examination is urgently performed at the operating table, having previously obtained the patient’s consent for radical intervention. Cytological examination of prints from the larynx and lymph nodes is carried out in cases where the patient categorically refuses surgery and a biopsy is not indicated.

How to detect throat cancer at an early stage? For early diagnosis of throat and larynx cancer, doctors at the Yusupov Hospital examine the level of tumor markers SCC and CYFRA 21-1. Highly qualified doctors, equipping operating rooms with modern diagnostic equipment and instruments allows oncologists at the Yusupov Hospital to improve five-year survival rates for throat cancer.

How to treat laryngeal cancer? Doctors at the Yusupov Hospital have extensive experience in treating laryngeal cancer. The treatment method is selected depending on the stage of the disease, type and spread of the tumor. The following methods are used:

• Surgical interventions (chordectomy, laryngectomy);
• Organ-preserving laser surgery for laryngeal tumors;
• Operations to remove tumors using a shaver;
• Radiation treatment (external gamma therapy);
• Neoadjuvant, adjuvant and curative chemotherapy;
• Palliative treatment.

Expert opinion

Author: Alexey Andreevich Moiseev

Head of the Oncology Department, oncologist, chemotherapist, Candidate of Medical Sciences

Throat cancer accounts for 3% of all cancers. At the same time, the tumor is the most common among neoplasms of the upper respiratory tract. It is diagnosed in 50–70% of cases. As throat cancer progresses, permanent disability occurs. As a result, the tumor remains a problem for clinical medicine.

Recently, in Russia there has been an increase in the number of newly diagnosed throat cancers. This is due to the influence of external and internal factors. Around the world, the statistics are no less comforting. Every year 15,000 new cases of pathology are diagnosed. The ratio of sick men to women is 1000:8.

The Yusupov Hospital provides a full course of diagnostics necessary to identify pathology even at the formation stages. The earlier the examination is performed, the more favorable the prognosis. The quality of treatment meets international standards. An individual therapy and rehabilitation program is developed for each patient, aimed at improving the quality of life and preventing relapse.

The main treatment method for laryngeal cancer is surgery. Radical surgical intervention for a malignant tumor is removal of the larynx. The consequences may vary. After surgery, some patients lose their voice and tumor growth resumes.

A laryngofissure is applied when the exophytic tumor is localized on the free edge of the anterior two-thirds of the true vocal cord, without the tumor spreading to the anterior commissure and the arytenoid region.

If a significant area of ​​the larynx is affected by the cancer process, and mobility in the affected area is very limited or even completely absent, the process is macroscopically one-sided, surgeons perform throat surgery for oncology - resection of half of the larynx. Hemilaryngectomy is indicated not only for internal cancer that does not grow through the cartilage of the larynx, but also when the tumor process has spread to the anterior commissure and the area of ​​the arytenoid cartilage.

If the tumor is localized in the anterior two-thirds of one true vocal cord with transition to the anterior commissure or even to the anterior part of the other true vocal cord, a half resection of the larynx according to Otan is performed. During this operation, the anterior parts of the larynx are removed, leaving its posterior wall. After the intervention, swallowing and voice function are preserved. Partial surgical interventions for laryngeal cancer include frontal resection of the larynx. It is used for damage to the anterior commissure.

Currently, the most common organ-preserving operations for localized laryngeal cancer remain chordectomy and diagonal resection of the larynx. After surgery, patients' voice function is impaired; they note hoarseness, fatigue during conversation, and a significant deterioration in sound when overloaded. An undesirable consequence of sagittal resection of the larynx is a disorder in swallowing after surgery.

How to cure throat cancer at an early stage? Laryngeal surgery (tumor removal) is performed using a shaver. During the operation, healthy tissue is not injured. The operation is performed endoscopically. A tracheostomy for laryngeal cancer is performed after total removal of the organ. The Yusupov Hospital provides nutrition after removal of the larynx for throat cancer.

Throat cancer is treated with anticancer drugs. Oncologists practice two treatment options: monotherapy and polychemotherapy. In monotherapy, one drug is used, to which cancer cells are especially sensitive. The drug is prescribed in large doses. For polychemotherapy, several cytostatic drugs are used sequentially or simultaneously.

Chemotherapists at the Yusupov Hospital use combinations of cytostatics recommended by the International Association of Oncologists to achieve the greatest effectiveness of treatment. They use drugs that are highly effective and have minimal side effects. Patients at the Oncology Clinic have the opportunity to receive the latest anticancer drugs thanks to a research program in which the Yusupov Hospital participates. The effectiveness of radiation therapy for throat cancer is assessed by professors and doctors of the highest category.

A combined approach to the treatment of laryngeal cancer can improve treatment results. Radiation therapy for throat cancer is used both as primary treatment and as part of combination therapy. Is there a cure for throat cancer? Most patients with early stages of laryngeal cancer are cured with radiotherapy. How suitable radiation therapy for laryngeal cancer is for a particular patient depends on the volume and location of the tumor, and is determined by the depth of its growth in the throat tissue.

In the early stages of the disease, treatment in most cases is carried out with radiation sessions 5 times a week for 3-7 weeks. The radiotherapist calculates the total radiation dose to laryngeal cancer for the entire course, and then divides it into fractions. This separation allows you to reduce the undesirable consequences of treatment. Can throat cancer be cured? If complex treatment is started on time, the prognosis for recovery improves many times over.