Chronic Granular Pharyngitis
A chronic inflammation of the mucous surfaces of the pharynx and adjacent tissues. It is characterized by hypertrophy of the mucosa, seromucinous glands and sub epithelial lymphoid follicles.
Types
1. Chronic catarrhal pharyngitis
2. Chronic hypertrophic (granular) pharyngitis
Etiology
1. Prolonged/Repeated pharyngitis
2. Mouth breathing –nasal blockage, adenoid, nasal allergy
3. Chronic irritants (E.g. tobacco chewing, cigarettes etc)
4. Faulty voice production.
5. Environmental pollution.
6. GERD-Acid reflux from stomach
7. Chronic sinusitis causing postnasal drip
Symptoms
1. Pain in throat-soreness
2. Foreign body sensation in throat
3. Tiredness of voice
4. Halitosis-Bad breath
5. Throaty Cough
6. feeling of lump in the throat
7. Fever, malaise, body aches
Signs
1. Congestion of posterior pharyngeal wall, which may have red nodules. (Chronic hypertrophic/granular pharyngitis)
2. Hypertrophy of lateral pharyngeal bands.
3. Increased mucous secretions may cover the mucosa.
Treatment
1. Identification of cause and its correction. Avoid alcohol, tobacco, control of GERD, treat sinusitis, allergy
2. Warm saline gargles with turmeric
3. Mandl’s throat paint is useful in preventing secondary infections.
4. Betadine®gargle
5. Short course of broad spectrum antibiotic, antihistamines and deflazacort might give temporary relief.
6. Laser treatment Granular Pharynx
7. Laser vaporization undrer Local anesthesia
Laser Treatment
The surgical procedure, called Laser Granular Ablation (LGA), uses a CO2 laser to surgically remove, reduce or vaporize the granular follicles in the posterior pharyngeal wall and the hypertrohied lateral pharyngeal bands..
This laser procedure generally takes15 to 20 minutes and can be performed in an office setting. Those who have gag reflex it may have to be done under GA.
Dr.K.O.Paulose.FRCS, DLO.
Consultant ENT /Plastic/Laser Surgeon