An abscess of the ENT organs is an accumulation of pus in the tissues of the larynx, pharynx, ear and nose. Such acute diseases are handled by an otolaryngologist or ENT specialist. As the disease progresses, treatment can be either medical or surgical. Do not be afraid that the doctor will prescribe you an opening of the abscess - surgery can prevent further accumulation of pus in the tissue and spread it deeper into the deeper layers. The method of emergency opening of abscesses also works for otolaryngologists of our medical center. The high qualification of our doctors allows us to quickly determine the nature and duration of the abscess of the ENT organs and prescribe the appropriate treatment. In no case should a festering process be allowed to take its course, because the consequences can be unpredictable.
A common abscess of the ENT organs, affecting every second inhabitant of the planet, is a boil. Inflammation of the hair follicle can occur both in the nose and on the auricle. The penetration of infection through a tiny wound can cause inflammation and accumulation of pus in large quantities in a short time. Therefore, the most used method of treating this abscess of the ENT organs is opening the abscess, draining the contents and removing dead tissue.
Abscess of ENT organs - paratonsillar abscess near the tonsil - a consequence of complications of angina or exacerbation of chronic tonsillitis. This abscess is dangerous because the continuous accumulation of pus can lead not to a breakthrough to the surface, but to deepening inside the tissues, as well as to the development of fatal complications. Therefore, opening the abscess and outflow of contents will quickly solve the problem of the disease.
Abscess of ENT organs is retropharyngeal or retropharyngeal. The process of suppuration of the lymph nodes and tissue of the pharyngeal space. The disease can be a complication of measles, influenza, scarlet fever, or it can independently develop from an injury to the mucous membrane of the pharynx with solid food or a foreign body. In most cases, the otolaryngologist prescribes first opening the abscess, and then antibiotic therapy.
Abscess of ENT organs in the form of acute purulent sinusitis is a common and long-term disease. Due to the lack of knowledge about the nature of the pathogens of sinusitis, it is necessary to state the fact that the “addiction” of microorganisms to antibiotics leads to a rapid transition from an acute form to a chronic or protracted one. Therefore, one scheme for the treatment of abscess does not exist. Our otolaryngologists prefer to approach each case individually. This means an increased chance of recovery of the patient.
Any inflammatory process in the ENT organs requires a qualified specialist approach. Therefore, our center is always open for your visits!
Suppurative diseases (abscesses and phlegmons) are terrible complications of many inflammatory processes occurring in the body. Especially dangerous are such complications in the face and head, since it is possible for pus to spread from the focus to the brain and the development of life-threatening complications.
Abscesses and phlegmons in diseases of the ENT organs are in second place in frequency after odontogenic suppurative complications.
Abscess- This is a purulent inflammatory process of a limited nature. When a virulent infection penetrates deep into the tissues, purulent inflammation occurs with necrosis, the formation of a cavity filled with pus and it is limited from the surrounding tissues by a capsule. The formation of a capsule is a protective reaction of the body to prevent the spread of suppuration.
Phlegmon- this is a more formidable complication, which is characterized by a diffuse spread of purulent inflammation, unrestricted from surrounding tissues.
Abscesses and phlegmons can form in almost all inflammatory diseases of the upper respiratory tract, as well as as a result of trauma. There is no clear classification of suppurative processes of ENT organs. You can list the most common forms in practice:
The development of abscesses and phlegmon occurs most often in the subcutaneous or interstitial tissue, which is rich in blood and lymphatic vessels.
Furuncle
A festering boil also refers to abscesses. This inflammation starts in the hair follicle and spreads to the sebaceous gland and surrounding tissues. In ENT pathologies, boils are found in the nasal cavity and in the external auditory canal, where there is skin with hair follicles. The penetration of infection into them is facilitated by microtrauma, as well as a general decrease in protective forces, severe somatic diseases - diabetes mellitus, hypovitaminosis. Hypothermia can also be a provocative moment.
There is a sharp pain, redness, swelling, the formation of an infiltrate. After 3-4 days, softening and the formation of a purulent core appear in the infiltrate. The furuncle can open on its own, along with the release of purulent contents, relief comes. With an unfavorable course and progression of the boil, complications such as sepsis, facial phlegmon, orbital and cerebral complications may develop.
Treatment in the infiltrative stage: antibiotics - aminopenicillins, cephalosporins, macrolides, fluoroquinolones. Locally apply semi-alcohol compresses, UHF. When abscessing a boil against the background of massive antibiotic therapy, a surgical opening of the abscess is performed, the wound is washed with antiseptics and drainage is established.
Peritonsillar abscess
A paratonsillar abscess occurs as a result of purulent inflammation in the paratonsillar tissue (it is located between the capsule of the palatine tonsil and the fascia of the pharynx). The infection penetrates here most often directly from the palatine tonsil along the crypts - deep grooves penetrating the entire thickness of the tonsil. The causative agents are mainly, less often - anaerobic flora.
A paratonsillar abscess usually occurs at the end of the course or. Inflammation before the formation of an abscess is called paratonsillitis. Its usual localization (in 90% of cases) is the upper pole of the palatine tonsil.
During paratonsillitis, three stages are distinguished: edematous, infiltrative and directly abscessing.
Abscess formation usually begins 3-4 days after the onset of the disease.
On examination, a rounded bulge is determined in the upper part of the palatine tonsil and palatine arches. When abscessed, pus shines through. The soft palate moves towards the midline. Puffiness and soreness of the muscles of the neck and subcutaneous tissue are noted.
Rarely, posterior or inferior localization of the abscess is noted. Bulging in such cases is less pronounced, which can make diagnosis difficult.
In the general blood test, signs of bacterial inflammation are revealed - an increase in the number of leukocytes with a shift in the leukocyte formula to young forms, an increase in ESR.
A paratonsillar abscess may open spontaneously into the pharyngeal cavity on the 4th-6th day of development, while the condition improves. Less often, a breakthrough of pus occurs in the peripharyngeal tissue with the development of more severe complications - parapharyngitis and mediastinitis.
Treatment of paratonsillitis in edematous and infiltrative stages begins with broad-spectrum antibiotics. Painkillers, antihistamines are also prescribed, and detoxification therapy is also carried out.
AT stages of abscess formation an emergency opening of a tonsillitis abscess is necessary, possibly with subsequent removal of the tonsil (abscess tonsillectomy). The operation is performed under local or application anesthesia. The incision is made at the site of the greatest protrusion. The edges of the wound are expanded with a blunt instrument for more complete emptying of the abscess.
parapharyngeal abscess
This is a purulent inflammation of the peripharyngeal tissue. It occurs as a result of a complicated course of angina, chronic tonsillitis, progression of paratonsillitis, purulent (,), odontogenic inflammation.
With phlegmon, purulent inflammation is not limited to the capsule, pus spreads through the fiber, passing through the neurovascular bundles from one fascial pocket to another, the surrounding tissues-vessels, muscles, tendons are involved in the process, purulent fusion of tissues occurs.
The causative agents of phlegmon are usually streptococci and staphylococci, Pseudomonas aeruginosa. In more severe cases, phlegmon causes anaerobic flora.
Phlegmon are characterized by:
With deep-seated sluggish phlegmon of the neck, the symptoms may not be so pronounced, which makes diagnosis difficult.
Phlegmon in ENT pathology can be divided into the following groups:
Face phlegmon
With ENT pathology, phlegmon of the face occurs as a complication of the course of nasal boils, when an infection enters after operations on the nasal cavity, as well as with the progression of rhino-orbital complications.
Facial phlegmons are more often located in the area of the nose, in the area of the lower jaw.
Phlegmon of the orbit
This type of phlegmon is mainly a complication of purulent sinusitis (most often inflammation of the cells of the ethmoid labyrinth, less often other paranasal sinuses).
- With the transition to retrobulbar tissue.
- Without transition to retrobulbar fiber.
Neck phlegmon
1) Localized:
- Chin;
- Submandibular;
- Anterior neck region;
- Lateral region of the neck.
2) Common:
- With the transition to the periesophageal fiber.
- Complicated by mediastinitis.
- With the transition to the cellular spaces of the back.
Treatment of phlegmon of the face and neck is carried out in a specialized department of purulent surgery. An emergency operation is required, the purpose of which is:
- Opening of the purulent cavity,
- Maximum and sparing removal of necrotic tissue,
- Washing the wound with solutions of antiseptics and antibiotics,
- Establishment of drainage for the outflow of inflammatory exudate.
- In the postoperative period, massive antibiotic therapy and detoxification measures are prescribed.
Orbital complications
The orbit borders directly on the paranasal sinuses: the lower wall is with the maxillary sinus, the inner wall is with the ethmoid and sphenoid, the upper is with the frontal. The veins of the nasal cavity are connected to the ophthalmic. Therefore, purulent processes in the paranasal sinuses can lead to suppurative complications in the orbit. Of the rhino-orbital complications in sinusitis, one can distinguish: subperiosteal abscess, retrobulbar abscess, orbital phlegmon.
The clinical picture of all orbital complications is similar. It is noted:
- Swelling of the eyelids and surrounding tissues
- protrusion of the eyeball,
- conjunctival hyperemia,
- Pain when looking away
- purulent discharge,
- Rapidly progressive loss of vision up to blindness.
- With paresis of nerves and muscles, the eye becomes motionless, the eyelid does not close, double vision is noted.
- Common symptoms are also expressed: headache, weakness, vomiting, fever.
The diagnosis is confirmed by a CT scan of the orbit. The treatment of purulent complications of the orbit consists in an emergency operation on the affected sinus of the nose - a radical wide access to the affected sinus, its sanitation with the removal of necrotic tissues. In addition, the orbit is decompressed and drained through external incisions or by the endonasal endoscopic method.
Sometimes, when an infection spreads from the nasal cavity or paranasal sinuses through the lacrimal canal, suppuration of the lacrimal sac and its surrounding tissue occurs. In this case, one speaks of phlegmon of the lacrimal sac. Most often it is a complication of ethmoiditis or sinusitis.
In the area of the inner corner of the lower eyelid, redness, swelling, pain, and lacrimation occur. Edema quickly spreads to both eyelids, cheek, nose. The temperature rises. After a few days, softening appears in the center of the seal, purulent contents become visible.
An abscess may open outward, sometimes as a consequence of this, a fistula may form. A breakthrough of pus through the nasolacrimal canal into the nasal cavity can be complicated by an internal fistula. The most severe complication is the phlegmon of the orbit.
Treatment - antibiotic therapy, surgical opening of the focus, drainage.
Prevention
Unfortunately, quite often patients end up in hospitals with already formed advanced forms of suppurative complications. This indicates a late visit to the doctor for the treatment of the underlying disease. It is necessary to remember:
The disease is diagnosed on the basis of data from an external examination, a digital examination of the pharynx and examination under conditions of special lighting - pharyngoscopy. The doctor necessarily prescribes laboratory tests (clinical blood test, bacteriological examination of a throat swab), which make it possible to determine the type of pathogen that caused the pharyngeal abscess.
The only effective way to treat a throat abscess is an autopsy. NIRMEDIC specialists warn - you can not wait for spontaneous opening. Manipulation should be carried out as soon as possible and only within the walls of a medical facility.
Operations take place, as a rule, in a hospital. When opening a paratonsillar abscess in children, intravenous anesthesia is used, in an adult, the method of anesthesia is determined individually. The procedure for opening a pharyngeal abscess is quite complicated. It is important to prevent pus from entering the respiratory tract. To prevent aspiration (sucking) of pus into the underlying paths, it is sucked off immediately after opening the abscess. Sometimes the pus is removed beforehand - with a puncture.
