A pathological increase in the number of structural elements (hyperplasia) of the lymphadenoid tissues of the tonsil often occurs against the background of allergic, endocrine and infectious diseases. Delayed treatment of adenoid vegetations leads to voice changes, hypoxia and malocclusion.
In the case of surgical excision of hypertrophied tissues, the risk of re-proliferation of the nasopharyngeal tonsil remains. For this reason, enlarged adenoids need to be treated in a complex way, taking drugs with antibacterial, anti-inflammatory and cytotoxic effects.
Anatomy
Adenoid vegetation - what is it? Adenoids or adenoid growths are called pathologies in which there is hypertrophy of the soft tissues of the nasopharyngeal tonsil. It is an integral part of the lymphadenoid ring and performs protective functions. In the lymphoid clusters there are a large number of immune cells that prevent the penetration of pathogenic agents into the mucous epithelium lining the surface of the ENT organs.
Where are the adenoids located? The pharyngeal tonsil is located between the nasal cavity and the fornix of the pharynx. Eustachian tubes and nasal canals are located near the lymphoid accumulations, therefore tissue hyperplasia inevitably leads to hearing loss and difficulty in nasal breathing. If the adenoid vegetation partially or completely blocks the pharyngeal opening of the auditory tubes, this leads to a violation of its drainage function and the accumulation of serous effusions in the middle ear.
Pathological changes entail inflammation of the mucous membrane of the tympanic cavity, as a result of which eustachitis and catarrhal otitis media can develop.
What are adenoids for? The nasopharyngeal tonsil is a protective barrier that prevents the multiplication of opportunistic microorganisms in the respiratory tract. However, inflammation of the adenoids leads to dysfunction of lymphadenoid accumulations, as a result of which they themselves become breeding grounds for pathogenic agents. The lack of local immunity leads to frequent relapses of infectious ENT diseases, which can provoke serious complications.
How old do adenoids grow? The most dangerous for the development of pathology is the age from 3 to 8 years. It is during this period that the nasopharynx is reorganized in the child's body, which can lead to soft tissue hyperplasia. The pharyngeal tonsil can grow and increase in size up to 13 years, after which the risk of developing pathology decreases 2-3 times.
Causes
Are there adenoids in adults and why? Not so long ago, it was believed that adenoid vegetation is a pathology that occurs exclusively in childhood. However, today specialists are increasingly diagnosing the disease in patients aged 25-32 years. The proliferation of lymphoid tissues is facilitated by autoimmune and endocrine disruptions, as well as disturbances in the functioning of the lymphatic system.
The following predisposing factors can provoke inflammation of the adenoids:
- secondary immunodeficiencies;
- lymphatic-hypoplastic diathesis;
- chronic inflammation of the nasopharynx;
- abnormal constitution of the pharyngeal ring;
- frequent relapses of tonsillitis and laryngitis;
- allergic swelling of the nasopharynx;
- curvature of the nasal septum.
Genetic predisposition plays a certain role in the appearance of adenoid vegetations. Lymphadenoid tissue can grow due to abnormal intrauterine development of the fetus or hormonal disruption in a woman in the second or third trimester of pregnancy. Overcoming the placental barrier, toxic substances can enter the child's body and provoke disruptions in the laying of vital organs and systems.
Important! Chronic hypoxia, which occurs against the background of the growth of the amygdala, can lead to mental disorders.
Why are adenoids needed and can they be removed? Hypertrophy of the pharyngeal tonsil entails the development of local and sometimes systemic complications. However, in the absence of serious indications, it is not recommended to remove adenoids, as this will inevitably lead to a decrease in local immunity.
At the initial stages of the development of pathology, treatment is carried out with the help of medicines. And only in the absence of positive dynamics, the patient is prescribed surgery.
Symptomatic picture
How to understand that an adult has adenoids? ENT disease develops gradually, so it is extremely difficult to diagnose lymphoid tissue hypertrophy on your own. Unlike the tonsils, the pharyngeal tonsil is not visible on visual inspection of the oropharynx. With the development of pathology, patients usually complain of:
- obstructed nasal breathing - hyperplasia of the tonsil tissues leads to a complete or partial overlap of the airways in the nasopharynx, as a result of which breathing through the nose becomes difficult;
- voice change - hypertrophy of lymphoid tissues prevents the passage of air through the nasopharynx, which is a resonator that takes part in sound production (phonation); for this reason, the adenoids in the throat provoke a change in voice, which becomes quieter and nasal;
- frequent recurrences of a cold - a violation of the protective function of the nasopharyngeal tonsil increases the risk of developing colds, such as tonsillitis, sinusitis, sinusitis, laryngitis, etc.;
- hearing loss - hypertrophy of the adenoids is the cause of the overlap of the mouth of the Eustachian tube, which communicates between the nasopharynx and the middle ear; blockage of the auditory canal inevitably entails hearing loss, and subsequently - inflammation of the ear cavity;
- snoring - adenoid vegetations even more block the airways when the patient is in a horizontal position, which leads to snoring.
If the above symptoms occur, it is advisable to be examined by a specialist. If soft tissue hyperplasia is not stopped, this can lead to dire consequences. In particular, oxygen starvation (hypoxia) negatively affects the functioning of the brain, and ear inflammation can lead to the development of meningitis.
Adenoiditis - what is it?
Adenoiditis or retronasal angina is called inflammation of the hyperplastic nasopharyngeal tonsil, which most often occurs against the background of the development of respiratory diseases. Infectious and allergic processes in the ENT organs lead to a perversion of immunological reactions in the area of the nasopharyngeal tonsil. Inflammation of the adenoids is caused by a disturbance in the dynamic balance of the processes of epithelialization and alteration of lymphadenoid tissues.
ENT disease is characterized by an acute onset with hyperthermia, barking cough and symptoms of intoxication. In most cases, the temperature with adenoids indicates the development of an infection of a viral or bacterial etiology. Typical clinical manifestations of adenoiditis include:
- hearing loss;
- pain in the throat, radiating to the nose;
- accumulation of phlegm in the throat;
- an obsessive dry cough;
- temperature increase;
- hyperemia of the palatine arches;
- rawness in the throat when swallowing;
- an increase in regional lymph nodes;
- Difficulty nasal breathing;
- pronounced nasal and weakening of the voice.
Important! It is impossible to bring down the temperature and use anti-inflammatory drugs before the diagnosis is made, as symptomatic treatment can lead to "blurring" of the clinical picture.
Inflamed adenoids should be treated with antibacterial or antiviral drugs. As a rule, acute adenoiditis lasts no more than 7 days, after which local and general symptoms of the pathology practically disappear. Untimely relief of catarrhal processes leads to their chronicity and the development of complications - sinusitis, laryngotracheobronchitis, retropharyngeal abscess, etc.
Diagnostics
Why are adenoids dangerous? Hypertrophied organs are breeding grounds for infection and increase the risk of recurrence of respiratory diseases, in particular tonsillitis. Infectious-allergic inflammation of the ENT organs caused by pathogenic bacteria leads to intoxication of the body and disruptions in the functioning of vital systems. Against the background of chronic tonsillitis, the development of cardiovascular and endocrine pathologies is not excluded. To understand whether there are adenoid vegetations or not, the patient must undergo an appropriate examination with an otolaryngologist. For this, the following diagnostic methods can be used:
| Diagnostic methods | The essence of the procedure |
|---|---|
| posterior rhinoscopy | examination of the nasal cavity using a small mirror, thanks to which it is possible to assess the degree of proliferation of lymphadenoid tissues |
| skull radiography | determination of the size of the palatine and pharyngeal tonsils on X-ray images in the lateral projection |
| endoscopic rhinoscopy | introduction into the nasal cavity of a soft endoscope with a built-in camera, with the help of which a three-dimensional image of a hypertrophied organ is obtained on the monitor screen in real time |
| digital examination of the nasopharynx | the introduction of the index finger into the nasopharynx through the oral cavity, which allows you to feel the adenoid vegetation and determine the degree of proliferation of soft tissues |
| CT scan | determination of the anatomical state of the nasopharyngeal tonsil using a clear three-dimensional image obtained during ionizing irradiation of the patient's skull |
| endoscopic epipharyngoscopy | examination of the nasal cavity and pharyngeal tonsil using a fiber optic waveguide, which is introduced into the nasopharynx not through the nasal passages, as with rhinoscopy, but through the oral cavity |
Important! Adenoid vegetation can give serious complications, up to the formation of malignant tumors in the nasopharynx.
If after the examination it turns out that it is impossible to restore the function of the adenoids, the patient is prescribed surgical treatment. Removal of hyperplastic tissues allows you to eliminate the main manifestations of pathology. However, for the subsequent maintenance of general immunity at the proper level, the patient needs to undergo immunostimulating therapy 1-2 times a year, which reduces the likelihood of developing respiratory diseases.
Conservative treatment
How is adenoid hypertrophy treated? At the initial stages of the development of pathology, the patient is prescribed conservative treatment. The therapy regimen includes drugs that prevent the development of inflammation and inhibit hyperplasia of lymphoid tissues. As a rule, the following types of medications are used to treat adenoid vegetations:
- antibiotics - are prescribed for bacterial inflammation of the adenoids; contribute to the destruction of cellular structures of pathogenic agents, which accelerates the regression of pathological reactions in lymphadenoid clusters;
- vasoconstrictors - reduce the permeability of blood vessels, thereby reducing the swelling of the nasopharynx and facilitating breathing through the nose;
- immunostimulants - increase the activity of immune cells and promote the synthesis of interferon, which prevents the development of pathogenic agents in the ENT organs;
Anti-inflammatory drugs for nasopharyngeal irrigation help to restore the normal function of lymphoid tissues, thereby accelerating the epithelialization of the mucosa. It is recommended to irrigate overgrown adenoids with saline solutions and decoctions based on sage or medicinal chamomile.
During nasopharyngeal irrigation, do not tilt your head back, as this can lead to the penetration of fluid into the Eustachian tube or middle ear.
Physiotherapy
If, after undergoing drug therapy, the hypertrophied amygdala continues to increase in size, the patient is prescribed physiotherapy procedures. Chronic inflammation of lymphadenoid accumulations is often accompanied by allergization of the body, which negatively affects the patient's well-being. It is recommended to undergo physiotherapy at least 2 times a week for 10-14 days.
The most effective methods of physiotherapeutic treatment of adenoid enlargements include:
- electrophoresis - the introduction of antiallergic and antiseptic drugs into the mucous membrane of the ENT organs by means of an electric current;
- magnetotherapy - the effect of magnetic fields on adenoid vegetation, which helps to restore cellular metabolism and increase local immunity;
- EHF-therapy - the effect on the soft tissues of the nasopharynx by electromagnetic fields of ultrahigh frequencies, which stimulates the restoration of tissues affected by inflammation;
- UV therapy - treatment of hypertrophied tonsils with ultraviolet rays, which have bactericidal and wound healing properties.
Physiotherapy is used in the treatment of patients with contraindications to surgery. This method of therapy helps to restore the normal function of the pharyngeal tonsil and reduce the volume of lymphoid tissues.
Surgical treatment and prevention
What if the hyperplasia of the tissues of the nasopharyngeal tonsil does not stop? This can be due to chronic inflammation of the adenoids or autoimmune disruptions in the body. In this case, the pathology can be eliminated only through surgical intervention. In the absence of contraindications, the patient can be assigned:
- adenoidectomy - complete excision of the hypertrophied tonsil;
- laser vaporization - "desiccation" of the nasopharyngeal tonsil under the influence of laser radiation;
- interstitial destruction - destruction of hyperplastic tissues from the inside by a monochromatic flow of laser radiation.
Surgical treatment is carried out under local anesthesia, after which the patient must stay in the hospital for another 2-3 days. In the absence of postoperative complications, complete restoration of tissue integrity occurs within a month. To prevent septic inflammation of the operated nasopharynx, the patient is prescribed antibiotic therapy, which involves taking systemic antibiotics.
What should be the prevention of adenoids? With partial excision of the tissues of the pharyngeal tonsil, relapses of adenoid vegetations are not excluded. To reduce the likelihood of re-development of the disease allows compliance with the following recommendations:
- timely treatment of respiratory diseases;
- avoiding overheating and hypothermia;
- timely vaccination against influenza;
- prevention of infections in anticipation of seasonal ENT diseases;
- good nutrition with the inclusion of foods rich in vitamins and microelements in the diet.
It should be understood that the tactics of treating adenoid enlargements depends not only on the size of the pharyngeal tonsil, but also on concomitant disorders. In patients prone to allergic reactions, surgical treatment should be combined with the passage of desensitizing therapy.
