Incidence of tonsillomycosis in chronic tonsillitis on histopathological basis

Faculty Medicine Year: 2012
Type of Publication: Theses Pages: 94
Authors:
BibID 11602769
Keywords : Tonsillitis    
Abstract:
Tonsillomycosis is fungal colonization that obstruct tonsillar crypts present either unilateral or bilateral as concretions of the tonsils associated with halitosis. Incidence of oral cavity invasive mycoses is low in a healthy individual but can involve the tonsils of immunocomptent children. Complications is rare and may include: dehydration and renal failure. Superficial tonsillomycosis is treated locally with simple oral antifungal agents as nystatin and deep invasive tonsillomycosis is treated with systemic agents, such as amphotericin or fluconazole. the definitive treatment for tonsillomycosis is Tonsillectomy.AIM OF THE WORK: The aim of this work is to detect the incidence of tonsillomycosis in chronic tonsillitis in immunocompetent children on histopathological basis after-tonsillectomy.PATIENT AND METHODS: this study carried out on thirty child suffer from chronic tonsillitis (13 male &17 female) after doing surgical bilateral total tonsillectomy. Tonsils collected in 10% buffered formalin then cutted ,dehydrated and stained with (H&E and PAS) stains for histopathological examination.RESULTS: Incidence of Tonsillomycosis in immunocomptent children represents 10%. six tonsils are positive for fungal infection with H&E and PAS stain. All examined cases revealed reactive follicular hyperplasia with multiple; large; variable sized; oblong germinal centers occupying the sub epithelial tissues.Three tonsils (5 %) revealed the picture of Candidiasis with prominent blastopores.Two tonsils (3.3 %) revealed the picture of Aspergillosis with septate hyphae.One tonsil (1.7 %) revealed the picture of Rhinospordiosis with variable-sized cysts.CONCLUSION: Tonsillomycosis is a part of chronic tonsillitis, associated with bad oral hygiene, moderate socioeconomic level and rural distribution areas.Tonsillomycosis is long term process in immunocomptent children ended finally with tonsillar hypertrophy due to crypt concretion or calcification. Tonsillomycosis is significant with hypertrophic than atrophic tonsils, children with mild to moderate Neutropenia. Tonsillectomy is the definitive treatment for tonsillomycosis.. which involves a total gastrectomy or an esophagogastrectomy.In order to settle this debatedown, many studies were carried on to evaluate the palliative resection regarding itsmorbidity, mortality, survival benefit, and its effect on patient quality of life. Many worksfound a reasonable risk, a survival benefit and a positive effect on quality of life. But moreand more patients are needed to confirm these results or disclaim them. We add our work tothe literature hoping for finding a good palliative procedure for gastric cancer patients. This isa study of sixty patients who were proved to have advanced stomach cancer and underwentresection surgery. The study was designed to detect the incidence of post-operative morbidityand mortality rates, what factors affect the outcome of surgery, rate of hospital readmissionwhich indicates the quality of life in this group of patients. The study also recorded the post-operative short term survival rates which gives an indicator to the overall survivalrates.Postoperative morbidity rates recorded in the literature varies greatly from 6% to 65%.In our study postoperative morbidity results was 23%. In review of previous studies;palliative resection mortality rates ranges approximately from 4% to 27%. Our study stated a6.7% mortality rate which is in line with results of these studies.The study included 34 malesand 26 females represent, with mean of age (53 years) for all participants. There was norelation between age and postoperative outcome according to our findings.Fifteen patientshave had medical disease (25%). We found that pre-existing medical condition significantlyaffects the postoperative morbidity and mortality rates. There was no relation between extentof resection and technique of reconstruction to the postoperative outcome according to ourdata.Postoperative hospital stay days was about eight days which is reasonable period andnone of our patients needs hospital readmission which means a good hospital free survivalperiod. The median survival rate was 15 months, but it is a short term survival over follow upperiod of about 22 months. 
   
     
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