Pharyngite chronique : Introduction et prise en charge

Chronic pharyngitis develops from persistent viral or bacterial infections, allergic rhinitis, chronic cough, and recurring tonsillitis. Environmental factors like smoke, chemicals, and pollutants worsen inflammation. Habitual alcohol and tobacco use, inadequate dental hygiene, mouth breathing, and laryngopharyngeal reflux also contribute to persistent pharyngeal inflammation.

Hypertrophic pharyngitis features a thickened, congested pharyngeal mucous membrane. Atrophic pharyngitis, a later stage, shows a thin, whitish, glistening membrane that may appear wrinkled. Chronic granular pharyngitis is characterized by numerous swollen lymph follicles on the pharyngeal wall, creating a distinct granular appearance.

Chronic pharyngitis presents with persistent sore throat, fever, headache, difficulty swallowing, hoarseness, and swollen lymph nodes in the neck. Patients may also experience intermittent postnasal drip. Symptoms persist due to ongoing inflammation of the pharyngeal mucosa and underlying contributing factors.

Nasal congestion is relieved with short-term sprays containing phenylephrine or ephedrine sulfate. Allergy sufferers receive antihistamine-decongestant medications like pseudoephedrine. Persistent bacterial infections are treated with antibiotics, while acetaminophen or ibuprofen manage pain. These medications target specific symptoms while addressing underlying causes like infections and allergies.

Staying hydrated, using humidifiers, and gargling with warm salt water reduce throat irritation. Patients should avoid irritants, moderate alcohol and caffeine, rest their voice, quit smoking, and manage reflux. Maintaining good hygiene and a healthy diet prevent infections. These self-care measures enhance overall throat health and complement medical treatment.

Tonsillectomy, surgical removal of tonsils, is considered for recurrent throat infections related to tonsillitis management. Healthcare providers typically recommend it when patients experience seven episodes in one year or at least five episodes annually for two consecutive years. The decision depends on severity and frequency, made collaboratively by healthcare professionals and patients.

Patients should avoid alcohol, tobacco, secondhand smoke, and occupational pollutants. Wearing a disposable N95 mask filters 95% of small particles, including molds and dust, during exposure to environmental hazards. Minimizing contact with allergens like pollen and pet dander, combined with proper hydration and throat lozenges, effectively prevents irritant-related inflammation.