Classification
Pathologically, chronic pharyngitis can be divided into the following five categories:
1. Chronic simple pharyngitis
This type is more common, and is characterized by chronic congestion of the pharyngeal mucosa. The lesions are mainly concentrated in the pharyngeal mucosal layer, with more lymphoid tissue infiltration around its blood vessels, and leukocyte and plasma cell infiltration can also be seen. Mucosal and submucosal connective tissue hyperplasia, can be accompanied by mucous gland hypertrophy, gland hypersecretion function, mucus secretion increased and thicker.
2. Chronic hypertrophic pharyngitis
Also known as chronic granulomatous pharyngitis and pharyngolaryngitis, chronic simple pharyngitis can form chronic hypertrophic pharyngitis if it is not cured, and this type is also very common in the clinic. The mucosal layer of the pharynx is congested and thickened, and there is extensive connective tissue and lymphoid hyperplasia in the mucous membrane and submucosa. The lymphoid hyperplasia around the mucous glands is raised, and there are multiple granular lymphoid follicles in the posterior wall of the pharynx, which may be chronically congested, or multiple lymphoid follicles may be fused into one. Inflammatory exudate from the mucous glands may be enclosed in them, forming cystic white spots at the top of the lymphoid granular bullae, and yellowish-white exudate may be seen when the granules are ruptured. This type of chronic pharyngitis often involves the lymphatic tissue of the lateral pharyngeal cords, making them hyperplastic and hypertrophic, with a striated appearance.
3. Atrophic and dry pharyngitis
It is less common in clinical practice. At the beginning of the disease, mucous gland secretion is reduced, the secretion is thick and dry. Following the chronic inflammation of the submucosa, the gradual mechanization and contraction, compression of the glands and blood vessels, so that the gland secretion is reduced and nutritional disorders, resulting in the mucosa and the submucosa gradually atrophy and thinning. The posterior wall of the pharynx may have dry crusts or pus crusts adhering to it, usually accompanied by a foul odor.
4. Chronic allergic pharyngitis
Also known as chronic allergic pharyngitis. It is an IgE-mediated type I allergic reaction that occurs in the pharyngeal mucosa. The allergen stimulates the pharyngeal mucosa, causing the plasma cells that synthesize IgM to transform into plasma cells that synthesize IgE, and the IgE adheres to the surface of mast cells and basophils, which puts the pharyngeal mucosa in a sensitized state. When the same allergen comes into contact with the organism again, the allergen combines with the IgE on the surface of the media cells, leading to degranulation of the media cells and the release of a variety of inflammatory mediators, including histamine and synthetic prostaglandins, which can cause capillary dilatation, increase in vascular permeability, and increased secretion of the glands, resulting in an allergic reaction. Food allergens mainly cause allergic reactions through the complement C3 and C4 pathways. Chronic allergic pharyngitis is often accompanied by systemic allergic diseases or allergic rhinitis, and can also
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