HERR IS A CHILD WITH THIS TYPE OF PROBLEM AGED ABOUT 5 YEARS .DIAGNOSIS AND TREATMENT . DR.RAJESH GOPAL .MBBS IMA PMC REG. NO 35726 ...LUDHIANA .PUNJAB .INDIA .

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Grade 4 hypertrophic tonsillitis with fusion of medial aspect with uvula (kissing tonsils). Kid would be having hot potato voice, check for upperjugulodigastric lymph node enlargement & also should not forget to go for an X ray nasopharynx lateral view to r/o adenoids hypertrophy associated wit this presentation. Ideally coblation can be used to get rid of these tonsils along with the capsule and avoiding bleed. Else our own dissection intracapsular dissection identifying the plane.. Although one must be careful to separate the medial part of tonsils from the uvula.. If adhered completely dissect along the plane thereby preserving the anterior part of uvula & then suture the lateral aspects creating neouvula. Endoscopic view of nasopharynx on table would not be a bad idea to check & remove the adenoids if hypertrophied...

Chronic hypertrophic kissing tonsil
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this is grade 4 chronic tonsillitis.. she is just 5 year old...if weight is over 10 kg and hb over 10..then opt for surgery otherwise wait till chuld grows....councel the parebts about prolonged post op pain and possibilty of short term change in voice and nasal regurg in view of adhesiolysis of uvula..resuturing of uvula wont be required

Acute tonsillitis with uvalitis, advised antibiotics & analgesics, increase immunity.

D/D is best
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parenchynatous tonsillitis rx accordingly with systemic antibiotics and analgesic & chlorohexidine with water gargling. ..

Chronic hypertrophic bilateral tonsillitis with acute exacerbation on right side. Uvula is adherent to hypertrophic right tonsil. Advised bilateral tonsillectomy with uvuloplasty.

Acute tonsillitis... Tab Amoxyclave 325 TID

Acute tonsillitis with buried uvula because of enlarged tonsils.

kissing disease due to infectious mononucleosis. .

Kissing tonsil Tonsillectomy

Hypertropic tonsillitis

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