DIAGNOSTIC VALUE OF KEY SYMPTOMS IN CHRONIC RHINOSINUSITIS DURING PREGNANCY: PAIN, NASAL OBSTRUCTION, AND NASAL DISCHARGE

Аннотация

Chronic tonsillitis is a persistent inflammation of the palatine tonsils, frequently resulting from recurrent acute infections or ineffective treatment of primary tonsillitis. Clinically, the disease manifests in two primary forms: the simple form and the toxic-allergic form. This article reviews the distinguishing characteristics of each form, including symptomatic differences, systemic involvement, and laboratory findings. Particular attention is paid to the criteria used in differential diagnosis, which are essential for determining the appropriate therapeutic approach. Early recognition of the clinical form of chronic tonsillitis is crucial to prevent complications such as rheumatic fever, glomerulonephritis, and chronic fatiguesyndrome. Key words:chronic tonsillitis, clinical forms, toxic-allergic form, simple form, differential diagnosis, tonsil inflammation,ENT diseases, streptococcal infection. Chronic tonsillitis is one of the most prevalent chronic inflammatory diseases of the upper respiratory tract. It is characterized by prolonged or recurrent inflammation of the palatine tonsils and commonly affects children and young adults. The disease often develops as a result of incomplete treatment of acute tonsillitis or repeated infections, leading to pathological changes in the lymphoid tissues of the tonsils. Chronic tonsillitis not only poses a local inflammatory problem but also represents a potential source of systemic complications due to thespread ofbacterial toxins andimmune-mediated damage. Clinically, chronic tonsillitis is divided into two main forms: the simple(or compensatory) form and the toxic-allergic form (which is further categorized into Type I and Type II). These forms differ in their clinical manifestations, systemic involvement, and prognostic implications. Accurate differentiation between them is critical in clinical practice, as it directly influences treatment strategy — ranging from conservative management to surgical intervention (e.g., tonsillectomy). Despite the commonality of the disease, many patients remain undiagnosed or inadequately treated due to thenon-specific nature of early symptoms and the lack ofawareness regarding differential diagnosticcriteria[1] This paper aims to explore the clinical forms of chronic tonsillitis, focusing on their distinguishing features and diagnostic indicators, while emphasizing the importance of timely andaccurate classification for effective patient care. The classification of chronic tonsillitis into simple and toxic-allergic forms is primarily based on clinical symptoms, patient history, and objective findings during otorhinolaryngological examination. Simple Form: This form is usually characterized by localized symptoms without significant systemicinvolvement. Patients may complain of: - Sorethroat, - Halitosis(bad breath), page916 INTERNATIONAL JOURNAL OF ARTIFICIAL INTELLIGENCE ISSN:2692-5206,ImpactFactor:12,23 AmericanAcademicpublishers,volume05,issue06,2025 Journal: https://www.academicpublishers.org/journals/index.php/ijai - Discomfort during swallowing, - Intermittentsubfebrile temperature.[2] Objective examination may reveal hypertrophic tonsils with crypts filled with caseous plugs, mild hyperemia, and scar tissue. However, general health is typically unaffected. This form is often managed conservatively through regular antisepticirrigation, immunomodulatory therapy, andmonitoring. Toxic-Allergic Form Type I(TAF-I): In addition to local symptoms, patients develop signs of systemic reaction, such as: Fatigue, Low-gradefever, Arthralgia (joint pain), Palpitationsorprecordial discomfort. Laboratory findings may include elevated antistreptolysin-O (ASO) titers and moderate leukocytosis. This form indicates that the tonsils have become a focus of chronic infection affecting systemic organs through immunopathological mechanisms. Toxic-Allergic Form Type II (TAF-II): Thisis themost severe form and may present with: - Persistentsubfebrile state, - Rheumatoid-likejoint pain, - Myocarditis, nephritis, orotherorgan complications[3] Diagnostic investigations often reveal changes in ECG, increased ESR, C-reactive protein, and positive findings in renal function tests. This form usually requires surgical intervention due to therisk ofserious complications. In differential diagnosis, it is essential to distinguish chronic tonsillitis from other conditions such as chronic pharyngitis, Epstein-Barr virus infection, and autoimmune diseases. This requires a combination of clinical, laboratory, and, in some cases, histopathological evaluation. Understanding the differences between these clinical forms allows for personalized treatment planning, reduces therisk ofcomplications, and improves long-term outcomes forpatients. Chronic tonsillitis represents a significant clinical challenge due to its potential to affect both local and systemic health. The accurate differentiation between its clinical forms is essential in determining theoptimal manag