Infections of the Oropharynx

The Use of Flexible Rhinolaryngoscopy for Allergy-Immunology Practice

Flexible rhinolaryngoscopy is an underused procedure that can provide allergists-immunologists and other physicians with several benefits over existing imaging techniques. In this article, we highlight the many benefits of flexible rhinolaryngoscopy and expand on its safety, cost-effectiveness, and convenience. This article also covers current procedure techniques and assesses the most common indications and relevant clinical findings for which flexible rhinolaryngoscopy can be used to evaluate the nasopharyngeal tract. Videos for the clinician showing some of the most common findings are included.

[Microbiocenosis-regulating therapy of inflammatory pathology of the oropharynx]

Inflammatory pathology of the oropharynx, which does not lose its relevance, is a problem that is of interest to doctors of various specialties. As one of the main causes of inflammatory diseases of the pharynx, the influence of microorganisms, primarily viruses, on the mucous membrane of the upper respiratory tract is indicated. The authors of the article emphasize the importance of preserving the indigenous microbiota, which provides a barrier function and prevents the adhesion and colonization of pathogenic microorganisms. In this regard, the most effective and safe is local microbiocenosis-regulatory therapy using lysozyme, a natural peptide that has antiseptic, anti-inflammatory and immunoregulatory effects. As such a drug, the authors recommend the combined drug Lorolizin, which can be used in the treatment of acute pharyngitis, acute tonsillitis, and adenoiditis.

Ubi pus, ibi evacua: a review of 601 peritonsillar abscess adult cases

Background

Peritonsillar abscess (PTA) is the most common deep neck infection, occurring as a consequence of bacterial acute tonsillitis or as a result of infection of the Weber glands, with frequent and life-threatening complications.

Aim

To investigate several factors associated with complications and worse prognosis, such as defining the method of surgical drainage and treatment of a PTA which remains an area of controversy in the literature

Methods

The purpose of this retrospective study is to examine the epidemiological, clinical, and laboratory findings of 601 adult patients and to discuss them along with their treatment plan.

Results

Pharyngalgia was the most common reported symptom, followed by trismus, odynophagia, fever, hot potato voice, malaise, and cervical lymphadenopathy. Sixty-eight patients developed complications. Streptococcus species were the most common pathogens. A statistically significant difference was found in days of hospitalization, WBC and CRP levels, age, and the pre-existing systemic diseases between patients with and without complications. A comparison of patients treated with intravenous and oral antibiotics revealed no statistically significant difference.

Conclusion

Οver 10% of PTA cases may develop complications, the most common of which is extension into deep neck spaces. Comorbid conditions increase the risk of complications. Despite the wide range of treatment strategies, incision and drainage remain the cornerstone of surgical treatment. In patients with no comorbidities, intravenous antibiotics appear to have no advantage over oral antibiotics.

Ear, Nose, Throat: Beyond Pharyngitis: Retropharyngeal Abscess, Peritonsillar Abscess, Epiglottitis, Bacterial Tracheitis, and Postoperative Tonsillectomy

Ear, nose, and throat (ENT) emergencies presenting with a chief complaint of pharyngitis can be due to infection, trauma, or postprocedure complications. The entities described in this article include retropharyngeal abscess, peritonsillar abscess, epiglottitis, bacterial tracheitis, and post-tonsillectomy bleeding. This article provides the emergency physician with the tools needed to decipher between the mundane and the critical, variations in presentation, and their emergent management. All of them require early recognition for any airway compromise or obstruction in order to avoid serious complications.