Publication Details
Abstract
Chronic tonsillitis is a recurrent inflammatory disease of the palatine tonsils that often demonstrates resistance to standard conservative treatment, and growing evidence indicates that gastroesophageal reflux disease (GERD) plays a significant role in its persistence and clinical complexity. This clinical-analytical study aimed to evaluate the clinical, diagnostic, and pathophysiological features of chronic tonsillitis in patients with GERD and to propose an optimized integrated management approach. A qualitative synthesis of peer-reviewed publications indexed in Scopus, PubMed/MEDLINE, and Web of Science between 2021 and 2025 was performed, focusing on symptom profiles, diagnostic challenges, reflux-related mechanisms, and treatment outcomes. The analysis revealed that GERD-associated chronic tonsillitis represents a distinct clinical condition characterized by broader and often atypical symptomatology, more frequent exacerbations, and reduced responsiveness to conventional otorhinolaryngological therapy. Reflux-mediated mucosal injury, particularly involving pepsin and bile acids, contributes to persistent inflammation and biofilm formation within tonsillar crypts, thereby limiting the effectiveness of antimicrobial treatment. Integrated diagnostic evaluation and combined treatment strategies addressing both tonsillar pathology and reflux mechanisms were associated with improved symptom control, reduced recurrence rates, and a decreased need for surgical intervention. These findings highlight the importance of recognizing GERD as a key modifying factor in chronic tonsillitis and support the adoption of an etiology-driven diagnostic and therapeutic approach to optimize clinical outcomes.