Anyway, whenever you see or hear the suffix “–itis” attached to the back of a word, think of “inflammation.” Thus, tonsillitis = “inflammation of the tonsils.” Inflammation is a rather broad term, referring to a response of the body part or organ to some insult such as trauma, foreign objects, chemicals, adverse effects of medications, or microorganisms such as bacteria, viruses and fungi. An infection is a type of inflammation caused by microorganisms (which lay people often call “germs”) invading that specific organ or bodily part.
Sore Throat 101
talked about pertinent anatomy; you can look back at that discussion for a
refresher and review those awesome drawings (imagine me patting myself on the
back right now).
So when someone has a sore throat caused by inflammation, it
could be described as:
Pharyngitis: a broader
topic referring to the structures of the oropharynx as defined and shown in Sore
Throat 101, but often referred to oropharynx structures other than the palatine
tonsils, or in patients who’ve had their tonsils previously removed.
Tonsillitis: involving the palatine tonsils, but also can
involve the lingual tonsils and adenoids, all of which are similar in makeup
and part of a family called Waldeyer’s Ring—more on this later.
Laryngitis: often mild soreness but more so voice changes such
as hoarseness or loss of voice, and it’s more critical subtype, epiglottitis,
a potentially life threatening condition especially in children.
Of course there are other causes of sore throats, such as
tumors or cancers, which is an entirely different topic altogether. Most causes of sore throats deal with
infections of Waldeyer’s Ring.
“What the…?” you
might ask.
 |
| "The Ring" |
Tonsils, adenoids, lingual tonsils are collective called
Waldeyer’s Ring. I’ll refer to these
tissues simply as “The Ring,” not to confuse them with the horror movie about a hideously,
super-scary girl with long dark hair creeping out of the T.V. screen on all fours,
killing everyone in her path. Sorry
about the aside. Anyway, The Ring is a sentry,
so to speak, a protective part of the portal of entry into the body from the
nose and mouth. Think of The Ring as
border guards or the TSA (Transportation Security Administration) at the
airport. The Ring is part of the lymphoproliferative system, a fancy term
for the immune system of the body’s defense against foreign invaders. It allows direct exposure of immunologically
active cells to foreign antigen (such
as bacteria, viruses, fungi etc.) and when these lymphoid tissues get exposed to the antigen, they produce antibodies against those antigens, microscopic
proteins that attach to the antigen.
They also signal other defense-cells to divide and grow, aiding to rid
the body of those bad foreign invaders.
The palatine tonsils are what we often refer to as “the
tonsils”: they are the largest of the lymphoid tissue in The Ring and are
visible to most people. They also tend
to have more “crypts”—deep canyons or spaces within the tissue lined by specialized
cells. This increases the surface area
to maximize exposure to antigens. These
very crypts however can be the source of problem when they trap debris and
bacteria. Thus, those palatine tonsils often
are major source of infection in The Ring.
The Ring is more active during childhood, typically up until
10 years of age. That’s the reason kids
often have large tonsils since their immune system is being primed by all those
germs in their environment. Afterwards,
they do not have a major function since other aspects of the immune system
takes over and often shrink, oftentimes withering away to mere fraction of
their former selves. The adenoids and
lingual tonsils can also be involved, but the symptoms are typically not as bad
as when those palatine tonsils are involved.
But all these guys can become the source of problems, still trapping
nasty invaders and creating problems for their host, which is the person
holding these tissues, and potentially you and me.
Yes I know, you're itching to see the sequels, so hold onto your pants and when time permits there'll be more on specific causes of sore throats and how they
relate to The Ring.
©Randall S. Fong, M.D.
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