A patient came into the emergency room complaining that he could not swallow. This is his back story:
He was 21 years old and had 2 missing front teeth. Of course, he wanted to look good and wanted to get dentures. The problem was he lacked funds. Upon the advice of a friend, he went to a “technician” who allegedly sold cheap dentures. Everything was all right until one day, he fell asleep and ACCIDENTALLY SWALLOWED his dentures.
At the emergency room, laboratory work up and imaging studies were done. He was then rushed to the operating room for emergency esophagoscopy (an operation where a tube is passed via your mouth to visualize the esophagus or the swallowing tube). During the operation however, there was difficulty in removing the dentures because the sharp and jagged edges were buried so deep into the mucosa (inner lining) of the esophagus. A skin incision was subsequently made anterior to the sternocleidomastoid muscle in the neck to make a lateral pharyngotomy approach (making an incision on the muscles to the side of the esophagus) to removing the dentures stuck into his neck.
MORAL LESSON:
Always remove your dentures before sleeping.
Never sacrifice the quality of your dentures for the price. It may end up costing you more.
The (palatine) tonsils are a pair of pinkish soft tissue lumps on both sides of the back of the throat or pharynx. The surface of the tonsils are not smooth, but have crypts, or pit-like intentations, that stores cells used to fight infections. The tonsils are part of the lympatic system which fights infections. But since they are the first line of defense against bacteria and viruses, especially once they enter the body through the mouth, they may swell in response to infection.
WHAT IS TONSILLITIS? WHAT CAUSES TONSILLITIS?
Most tonsillitis cases are usually caused by a virus. Bacteria can also cause tonsillitis. The most common bacterial cause of tonsillitis is group A beta-hemolyticstreptococcus (GABHS), which also causes strep throat.
Rarely, tonsillitis can also be caused by fungi or parasites. This happens in patients who have compromised immune systems.
WHAT ARE CONDITIONS AFFECTING THE TONSILS Tonsillitis: infection of the tonsils Enlarged/ hypertrophic tonsils: enlargement of the tonsils may be caused by frequent tonsillitis Tonsillolith/tonsil stones: because tonsils have crypts or pits, dead cells or mucus may be stuck here. When the debris calcifies or turn hard, they may form tonsilloliths. Most tonsilloliths may have no symptoms especially when they are small. Peritonsillar abscess: this happens when tonsillitis spreads to the nearby structures of the palate or pharynx.
WHY ARE CHILDREN MORE AFFECTED
In children who haven’t reached puberty, the tonsils’ immune system is much more active than in adults. Also, children have immune systems that are still developing, which leaves them vulnerable to infection as they interact with other people. Furthermore, since they are always interacting with other children at school or in playgrounds, the infection is easily transmitted.
HOW IS TONSILLITIS TRANSMITTED?
Tonsillitis is spread by close contact with an infected person. Droplets of pathogens pass through the air when an infected person breathes, coughs, or sneezes and may be passed on to another person. Infection can also occur if pathogens get on objects that come in contact with your mouth, nose, eyes, or other mucous membranes. Symptoms usually appear about 2 to 5 days after exposure.
Tonsillitis caused by a virus infection usually is contagious for about 7-10 days. Bacterial tonsillitis can remain contagious for about two weeks. Persons with bacterial tonsillitis that are treated with antibiotics are considered non-contagious after approximately 24-48 hours after taking the proper antibiotics.
Because the tonsils are located at the back of the mouth, swollen tonsils may cause blockage and difficulty in breathing, which can lead to disturbed sleep patterns. Untreated tonsillitis may spread to the area behind and around the tonsils resulting in an abscess.
If tonsillitis is caused by a strep throat infection that is not treated or does not go away, it could lead to rheumatic fever (inflammation of the heart, joints, and other tissues), or to post-streptococcal glomerulonephritis (inflammation of the kidneys).
WHAT CAN BE DONE AT HOME?
Drink a lot of water and fluids.
Rest well.
Eat easy-to-swallow food.
Maintain good oral hygiene. Gargle with warm salt water several times a day.
Throat lozenges may be used.
Use a humidifier/vaporizer to moisten the air in your home.
A patient came into the emergency room complaining that he could not swallow. This is his back story:
