Anterior pillar flushing is considered as one of the diagnostic signs of chronic tonsillitis. Why and how does it persist even after medical management in chronic tonsillitis?
Anterior pillar flushing is not a diagnostic sign alone of chronic tonsillitis as it can occur also with other systematic disease like severe GERD associated with pharyngolaryngeal reflux disease (PLRD) when it is severe. Answering your question why there is this anterior pillar flushing in chronic tonsillitis, because there is chronic inflammation affecting the neighbor tissues leading to its congestion & hence its flushing. Medical management treats only the acute on top of chronic tonsillitis & chronicity will be treated by tonsillectomy when indicated. So medical management alone will not cure the anterior pillar congestion but it will reduce it.