Small salivary glands in the paratonsillar space in children

Close metadata

THE AIM OF THE STUDY

Was to study the changes in the small salivary glands in chronic tonsillitis and paratonsillar abscess in children. A histological examination of the palatine tonsils of 22 children aged 5 to 14 years old who had a paratonsillar abscess and 18 children suffering from chronic tonsillitis was carried out. Fragments of small salivary glands, located both superficially, in the mucous membrane between the stratified squamous non-keratinizing epithelium and the lymphoid tissue of the palatine tonsils, and between the muscles of the amygdala were found in 42 of the 80 (52.5%) tonsils studied. Along with the unchanged glandular structure, 26 (61.9%) samples revealed areas of destruction foci in small salivary glands with signs of inflammatory and compensatory regenerative activity. The presence of separate interlobular ducts of the salivary glands with pronounced periductal lymph - macrophage infiltration was noted. The subepithelial lymph-macrophage infiltrates found in the lamina propria are associated with the exit of the excretory ducts of the salivary glands to the surface of the mucous membrane. Many thin-walled veins are surrounded by perivascular lymphocellular infiltrates. The inflammatory and post-inflammatory changes in the small salivary glands revealed by us in children with chronic tonsillitis do not exclude their participation in the pathogenesis of paratonsillitis. At the same time, inflammation in the salivary gland can be both primary, as a result of its infection with live microorganisms from the tissues of the tonsil, and secondary, due to the compression of the excretory ducts by the edematous tissue of the tonsil in acute tonsillitis.

Keywords:

chronic tonsillitis

paratonsillar abscess

small salivary glands

histological changes

Authors:

Kim A.S.

Rostov State Medical University

Boiko N.V.

Rostov State Medical University

ORCID: 0000-0002-1316-5061

Stagnieva I.V.

Rostov State Medical University

ORCID: 0000-0002-2894-2062

Panchenko S.N.

Rostov State Medical University

Received:

21.04.2020

Accepted:

17.09.2020

List of references:

Soldatsky YuL, Denisova OA, Bulynko SA. The specific features of the past medical history and etiology of pharyngeal abscess in children. Vestnik otorinolaringologii. 2017;82(5):12-14. (In Russ.). https://doi.org/10.17116/otorino201782512-14
Azamatova EK, Charaeva ZF, Malceva GS. Characteristics of microbial properties of persistence in children with chronic tonsillitis. Rossiiskaya otorinolaringologiya. 2011;52(3):3-6. (In Russ.).
Boiko NV, Bachurina AS, Oksenyuk OS, Kolmakova TS. Postoperative inflamation treatment after tonsillestomy in children. Pediatriya. Zhurnal im. G.N. Speranskogo. 2016;95(1):93-96. (In Russ.).
Pal’chun VT, Gurov AV, Guseva OA. The specific pathogenetic features of the development of chronic tonsillar pathology. Vestnik otorinolaringologii. 2018;83(2):30-33. (In Russ.). https://doi.org/10.17116/otorino201883230-33
Nosulia EV. Paratonsillitis. Vestnik otorinolaringologii. 2013;3:65-70. (In Russ.).
Kriukov AI, Aksenova AV, Zakharova AF, Chumakov PL, Zhuk LG. Peculiarities of epidemiology of chronic tonsillitis under current conditions of providing specialized aid to the patients presenting with ENT diseases. Vestnik otorinolaringologii. 2013;3:4-7. (In Russ.).
Kriukov AI, Ivoĭlov AIu, Turovskiĭ AB, Khamzalieva RB, Tovmasian AS. Conservative therapy and surgical treatment of chronic tonsillitis in the children. Vestnik otorinolaringologii. 2013;4:15-20. (In Russ.).
Klug TE. Incidence and microbiology of peritonsillar abscess: the influence of season, age, and gender. European Journal of Clinical Microbiology & Infectious Diseases. 2014;D33(7):1163-1167. https://doi.org/10.1007/s10096-014-2052-8
Izvin AI, Kuznetsova NE. On the issue of the prevalence of peritonsillary abscesses in children in the Tyumen region and the tactics of surgical treatment. Detskaya otorinolaringologiya. 2014;1:49-51. (In Russ.).
Fordham MT, Rock AN, Bandarkar A, Preciado D, Levy M, Cohen J, Safdar N, Reilly BK. Transcervical ultrasonography in the diagnosis of pediatric peritonsillar abscess. Laryngoscope. 2015;125(12):2799-2804. https://doi.org/10.1002/lary.25354
Svistushkin VM, Mustafaev DM. Parapharingitis, tonsillogenic sepsis: peculiarities of pathogenesis, clinical picture, and modern approaches to the treatment. Vestnik otorinolaringologii. 2013;3:20-34. (In Russ.).
Boiko NV, Letifov GM, Kim AS, Stagniena IV. Evaluation of efficacy of treatment of acute tonsillopharyngitis associated with acute respiratory viral infections in children. Pediatriya. Zhurnal im. G.N. Speranskogo. 2018;97(1):168-178. (In Russ.).
Boiko NV, Kim AS, Stagnieva IV, Lodochkina OE, Filonenko NA. The significance of antistreptolysin O characteristics for the determination of indications for tonsillectomy in the children. Vestnik Otorinolaringologii. 2018;83(4):73-77. (In Russ.). https://doi.org/10.17116/otorino201883473
Klug TE, Rusan M, Fuursted K, Ovesen T. Peritonsillar Abscess: Complication of Acute Tonsillitis or Weber’s Glands Infection? Otolaryngol Head Neck Surg. 2016;155(2):199-207. https://doi.org/10.1177/0194599816639551
Blair AB, Booth R, Bfugh R. A unifuing theory of tonsillitis, intratonsillar abscess and peritonsillar abscess. American Journal of Otolaryngology-Head and Neck Medicine and Surgery. 2015;36(4):517-520. https://doi.org/10.1016/j.amjoto.2015.03.002
Passy V. Pathogenesis of peritonsillar abscess. Laryngoscope. 1994;104:185-190. https://doi.org/10.1288/00005537-199402000-00011
El-Saied S, Puterman M, Kaplan DM, Cohen-Lahav M, Joshua BZ. Involvement of minor salivary glands in the pathogenesis of peritonsillar abscess. Otolaryngol Head Neck Surg. 2012;147(3):472-474. https://doi.org/10.1177/0194599812445552
Kaltiainen E, Wikstén J, Aaltonen L-M, Ilmarinen T, Hagström J, Blomgren K. The presence of minor salivary glands in the peritonsillar space. Eur Arch Otorhinolaryngol. 2017;274(11):3997-4001. https://doi.org/10.1007/s00405-017-4738-x
Fujisaka M, Ohtani O, Watanabe Y. Distribution of lymphatics in human palatine tonsils: a study by enzyme-histochemistry and scanning electron microscopy of lymphatic corrosion casts. Arch Histol Cytol. 1996;59(3):273-280. https://doi.org/10.1679/aohc.59.273
Klug TE, Henriksen JJ, Fuursted K, Ovesen T. Significant pathogens in peritonsillar abscesses. Eur J Clin Microbiol Infect Dis. 2011;30:619-627. https://doi.org/10.1007/s10096-010-1130-9
Del Mar CB, Glasziou PP, Spinks AB. Antibiotics for sore throat. Cochrane Database Syst Rev. 2006;4:CD000023. https://doi.org/10.1002/14651858.cd000023
El-Saied S, Kaplan DM, Zlotnik A, Abu Tailakh M, Kordeluk S, Joshua B-Z. A comparison between amylase levels from peritonsillar, dental and neck abscesses. Clin Otolaryngol. 2014;39(6):359-361. https://doi.org/10.1111/coa.12298
Kordeluk S, Novack L, Puterman M, Kraus M, Joshua B-Z. Relation between peritonsillar infection and acute tonsillitis: myth or reality? Otolaryngol Head Neck Surg. 2011;145(6):940-945. https://doi.org/10.1177/0194599811415802
Farmer SE, Khatwa MA, Zeitoun HM. Peritonsillar abscess after tonsillectomy: a review of the literature. Ann R Coll Surg Engl. 2011;93(5):353-355. https://doi.org/10.1308/003588411x579793
Kraitrakul S, Sirithunyaporn S, Yimtae K. Distribution of minor salivary glands in the peritonsillar space. J Med Assoc Thail. 2001;84(3):371-378.
Pal’chun VT. Classification and therapeutic strategy for chronic tonsillitis. Vestnik otorinolaringologii. 2013;3:8-11. (In Russ.).
Mal’ceva GS. Chronic tonsillitis: current issues (clinical lecture). Consilium medicum. 2011;13(11):32-38. (In Russ.).
Arzamazov SG, Ivanets IV. Paratonsillar abscess in the patients presenting with non-anginous form of chronic tonsillitis. Vestnik otorinolaringologii. 2013;3:25-28. (In Russ.).
Garov EV, Gurov AV, Guseva AL, Ivanec IV, Kirasirova EA, Kunelskaya VYa, Kucherov AG, Lapchenko AS, Turovsky AB. Manual on focal infection in otorhinolaryngology. M.: GEOTAR-Media; 2015. (In Russ.).

Close metadata