Chronic Pharyngitis – Laser Surgery
Chronic inflammation of the pharynx. Prevalent in adults, sometimes very long duration, symptoms stubborn and difficult to cure.
Caused by recurrent acute pharyngitis, postnasal drip from sinusitis, nasal congestion due to the long period of using mouth-breathing, and dental caries. Smoking, alcohol drinking and systemic diseases, like respiratory infections, gastrointestinal diseases (GERD), Endocrine disorders, diabetes, anemia etc. It can present as hypertrophic granular pharyngitis and chronic atrophic pharyngitis.
The mucous membrane of the pharynx and fauces is somewhat thickened and of a vivid red or dusky color. The venules are dilated and tortuous and the mucous surface is studded with small, round, red bodies, the enlarged mucous follicles. The hypertrophied mucous membrane, when relaxed and flabby, appears as if laid in ridges. In some cases there is atrophy of the mucous follicles, and the surface is dry, red, and glistening.
The patient experiences a sense of dryness and pain in the throat, and, to get relief, there is frequent effort to remove it by hawking, or, where the surface is dry, there is almost constant swallowing. The mucous membrane is swollen, red, and bathed in mucus; later we find it dusky in color, and studded with the enlarged mucous follicles or granulations. Again, the surface is red, glistening, and dry, or red and covered with tenacious mucus.
Conservative and symptomatic treatment first.
In beginning the treatment, the patient must clearly understand that all sources of irritation are to be avoided. Smoking, the use of alcoholic drinks, highly seasoned food, the prolonged use of the voice, especially in the open air, are to be discontinued. Try to eliminate pathogenic factors which cause this in the first place .The local treatment will consist of warm saline gargles, antiseptic throat spray. Treatment of allergy, sinusitis and GERD will help to some extent. Antibiotics won’t help much. Steroid gargle may help.
Co2 Laser – Using low power setting the granulations are cauterized under local anesthetic (Xylocaine spray). It may need to repeat few times.