What kind of pharyngitis do you have?
Chronic pharyngitis can be divide into three types according to its pathological changes and pharyngeal examination. Chronic simple pharyngitis: Pathological changes include chronic congestion of the pharyngeal mucosa, dilation of small blood vessels, hyperplasia of submucosal connective tissue and lymphoid tissue, hypertrophy of mucous glands, and hypersecretion. Examination of the pharynx shows diffuse congestion of the pharyngeal mucosa, dark red color, dilation of small blood vessels, scattered lymph follicles, and a small amount of viscous secretions.
Chronic hypertrophic pharyngitis (also known as chronic hyperplastic or granular pharyngitis): pathological changes are congestion and hypertrophy of the mucosa, extensive hyperplasia of connective tissue and lymphoid tissue under the mucosa, and granular protrusions on the posterior pharyngeal wall. If the lateral pharyngeal cord lymphoid tissue proliferates, it will thicken in a cord-like manner. Eye examination findings: diffuse congestion and hypertrophy of the pharyngeal mucosa, dark red. The thick-walled lymphoid follicles of the pharynx are congested and edematous, with granular protrusions, typically like a “toad’s back”, or fused into a mass, and the lateral pharyngeal cords on both sides are also congested and hypertrophic.
Atrophic pharyngitis
Atrophic pharyngitis (or dry pharyngitis): Pathological changes are mainly mucosal epithelial cell degeneration and thinning of the mucosal epithelium. The glands atrophy, secretion decreases, becomes thicker, and the mucosa dries. Then the submucosal tissue gradually mechanizes and contracts, compressing the mucous glands and blood vessels, hindering gland secretion and nutrient supply, causing the submucosal tissue to atrophy and thin. In severe cases, the pharyngeal aponeurosis and muscles may be involve. Purulent and smelly crusts may be attach to the posterior pharyngeal wall. Pharyngeal examination findings: The pharyngeal cavity may be wider than normal, the pharyngeal mucosa is dry and thin, pale in color, and shiny like “oil paper” (or wax paper), the mucosa is attach with sticky secretions or purulent crusts, and sometimes the outline of the cervical vertebral body can be see on the posterior pharyngeal wall. Pharyngeal sensation and reflexes are reduce.
Chronic pharyngitis generally refers to simple or hypertrophic pharyngitis.
After reading the above detailed introduction to the three types of chronic pharyngitis, it may seem difficult to understand, but as long as you understand the following basic concepts, you will understand it.
Generally speaking, acute inflammation and congestion of the pharyngeal mucosa are mainly arterial congestion, so the acute inflammation mucosa is mostly bright red. Chronic inflammation of the pharyngeal mucosa is mainly venous congestion, so the mucosa is dark red in chronic inflammation.
The pathological changes of chronic simple pharyngitis are mainly chronic congestion of the mucosa, so the pharyngeal mucosa is diffusely congested and dark red. In addition to chronic congestion of the pharyngeal mucosa, the pathological changes of chronic hypertrophic pharyngitis are characterize by mucosal hypertrophy and lymphoid tissue hyperplasia. Therefore, the pharyngeal mucosa is thicken and has granular lymphoid follicle hyperplasia and thickening of the lateral pharyngeal cords on the dark red background of diffuse congestion. Therefore, chronic pharyngitis patients with diffuse chronic congestion of the oropharyngeal mucosa, which is dark red, can be diagnose as chronic simple pharyngitis. Those with “toad back” changes on the dark red back of the oropharyngeal mucosa can be diagnose as chronic hypertrophic pharyngitis. However, in clinical practice, these two types of chronic pharyngitis are usually simply diagnose as chronic pharyngitis.
Atrophic pharyngitis should be diagnose separately.
Atrophic pharyngitis is different from chronic simple pharyngitis or chronic hypertrophic pharyngitis in terms of etiology, pathological changes, patient complaints, pharyngeal examination findings and treatment. The pathological changes of atrophic pharyngitis are mainly atrophy of the mucosa and glands. The main complaint is a dry feeling in the pharynx. Examination of the pharynx shows that the mucosa is dry, thin, pale and shiny like “oil paper”, and there are gray-brown dry scabs attach. The treatment of atrophic pharyngitis also has different characteristics. Therefore, atrophic pharyngitis should be treat as an independent diagnosis. Some patients come to the doctor for discomfort in the pharynx, and the doctor diagnoses it as atrophic pharyngitis. After checking the nasal cavity, atrophic rhinitis is found. Severe atrophic pharyngitis may be accompanied by atrophic laryngitis.
