Until recently, hypertrophy of the nasopharyngeal tonsil was considered exclusively a pediatric pathology. However, today otolaryngologists are increasingly diagnosing adenoids in patients after the age of 20 years. Modern medical technology makes it possible to painlessly and with high accuracy determine the presence of benign neoplasms in almost any hard-to-reach cavity of the human body, including the nasopharynx. What are the symptoms of adenoids in adults?
Nasal congestion, dry cough, difficulty breathing through the nose, and hearing loss are typical manifestations of pharyngeal tonsil hyperplasia. According to statistics, 1 out of 5 patients with similar symptoms are diagnosed with adenoids. Timely pharmacotherapy prevents the proliferation of lymphoid tissue and the development of complications.
Are adenoids a disease?
Adenoids are pathologies in which there is an expansion (hypertrophy) of the lymphadenoid tissue of the pharyngeal tonsil. In the absence of pathological processes in the ENT organs, it performs a protective function. In the cells of lymphadenoid formations, immunoglobulin is synthesized, which prevents the development of pathogenic agents not only in the respiratory tract, but also in the gastrointestinal tract.
Experts in the field of immunology believed that after puberty, the pharyngeal tonsil regresses and is almost completely absorbed. And only with the advent of endoscopic examination methods did doctors find out that adenoids still occur in adults. The key reason for the development of pathology is the deterioration of the environment and the rapid increase in the number of allergens in nature, which is associated with the production of synthetic materials.
Allergization of the body and poor environmental conditions "force" the lymphadenoid tissues to grow, as this makes it possible to accelerate the synthesis of antibodies that prevent the development of infectious and allergic reactions in the ENT organs. Scientists suggest that endocrine disorders and malfunctions of the gastrointestinal tract contribute to hypertrophy of the nasopharyngeal tonsil.
Etiological factors
Why do adenoids appear in adults? It should be noted that the disease is most often diagnosed in those patients who are faced with hypertrophy of adenoid tissues in childhood. The newborn is more susceptible to pathology, since it is during this period that the active development of the nasopharyngeal tonsil is observed.
The main reasons for the pathological proliferation of the immune organ are:
- allergic reactions;
- poor nutrition;
- frequent relapses of ENT diseases;
- hereditary predisposition;
- autoimmune disorders;
- instability of hormonal levels;
- pathology of pregnancy;
- unfavorable ecological situation;
- irrational intake of antibiotics.
In infants, the proliferation of adenoid tissue is most often associated with the development of lymphatic diathesis. Disturbances in the work of the endocrine and lymphatic systems lead to lymphatic-hypoplastic anomalies of lymphadenoid clusters (tonsils). The development of pathology is often preceded by thyroid dysfunction and autoimmune diseases.
In adulthood, hypertrophy of the nasopharyngeal tonsil is promoted by frequent exacerbations of chronic diseases, diabetes mellitus, addictions, work in hazardous enterprises, etc. Failure to undergo therapy leads to severe complications, in particular conductive hearing loss, otitis media and hypertrophic rhinitis.
Important! Hyperplasia of the nasopharyngeal tonsil increases the risk of developing inflammatory processes in the lymphadenoid tissues.
Pathological proliferation of the immune organ negatively affects its protective functions. Hypertrophied tissue produces dysfunctional immune cells, which causes a decrease in local immunity. A decrease in tissue reactivity stimulates the reproduction of opportunistic microorganisms in the respiratory organs, which can lead to inflammation of the pharyngeal tonsil and surrounding tissues.
Clinical picture
How do adenoids manifest in an adult? The symptoms of ENT pathology differ from the clinical manifestations of adenoids in children. The skeleton of an adult is completely formed, therefore, even an advanced form of the disease cannot lead to bone deformation and the development of an "adenoid face". The classic manifestations of hyperplasia of the pharyngeal tonsil in adult patients are:
- nasal congestion;
- dry cough;
- Difficulty nasal breathing;
- hearing loss;
- frequent inflammation of the respiratory tract;
- changing the timbre of the voice;
- heavy snoring while sleeping;
- chronic rhinitis;
- discomfort in the throat;
- postnasal flow syndrome;
- mucous discharge from the nasal passages.
Important! Septic inflammation of the nasopharyngeal tonsil is evidenced by purulent nasal discharge and hypertrophy of the submandibular lymph nodes.
Over time, the signs of adenoids only worsen, as the overgrown lymphadenoid tissues increasingly overlap the choanas (nasal passages), which interferes with normal breathing. If benign neoplasms are not removed in time, this will lead to blockage of the mouth of the Eustachian tube and the appearance of inflammatory processes in the auditory analyzer.
The degree of development of adenoids
Clinical manifestations of ENT pathology largely depend on the degree of proliferation of the adenoid tissue. A slight increase in the immune organ practically does not cause discomfort, pathological symptoms such as dry cough and snoring appear only at night. The second and third degree of hypertrophy of the nasopharyngeal tonsil significantly impairs the patient's quality of life and entails complications.
The degree of hyperplasia of lymphadenoid tissues can be determined by the following clinical manifestations:
| Symptoms | 1 degree of hypertrophy | 2 degree of hypertrophy | 3 degree of hypertrophy |
|---|---|---|---|
| pharyngeal tonsil size | adenoid vegetation only 1/3 overlap the choanas (nasal passages) and the vomer (bone that is part of the nasal septum) | hyperplastic tissues cover up to 50% of the opener and choanas | an enlarged nasopharyngeal tonsil almost completely overlaps the nasal passages and the mouth of the Eustachian tube |
| hearing impairment | absent | slight hearing loss | due to the overlap of the auditory canal, a sharp decrease in hearing is observed, which entails a decrease in pressure in the tympanic cavity; accumulation of effusion in the middle ear often causes the development of catarrhal otitis media |
| violation of nasal breathing | difficulty in nasal breathing is observed only at night when the patient takes a horizontal position | snoring while sleeping, difficulty breathing through the nose | the patient is forced to breathe through the mouth all the time, as the overgrown adenoid vegetations almost completely block the nasal canals |
| accompanying symptoms | dizziness immediately after sleep, lethargy, headaches | frequent rhinitis, runoff of mucus along the walls of the pharynx, sore throat, dry cough | constant mouth opening, difficulty swallowing, frequent relapses of respiratory diseases, mucous discharge from the nasal passages, headaches, eustachitis, nasal voice |
| features of therapy | drug treatment | drug and physiotherapy treatment | excision of hypertrophied tissues |
Adenoids can cause chronic inflammation of the mucous membranes in the nasal cavity and laryngopharynx, which leads to the development of sinusitis, bacterial pharyngitis, laryngotracheitis, etc.
Adenoids in adults very often occur against the background of chronic rhinitis and sinusitis. Inflammation of the tissues of the nasopharynx stimulates the activity of the nasopharyngeal tonsil, which begins to produce an excess of phagocytes and T-lymphocytes. Prolonged irritation of the immune organ by pathological mucus leads to an increase in its size and the development of ENT pathology.
Inflammation of the adenoids
Inflammation of the adenoids (adenoiditis) is an infectious disease in which the hypertrophied tonsil is affected by pathogenic bacteria or viruses. Septic inflammation of the overgrown adenoid tissues leads to the appearance of general symptoms of intoxication, hyperthermia and pain at the site of localization of the pathogenic flora.
How is adenoid inflammation diagnosed? The symptoms of ENT disease are similar to the manifestations of purulent tonsillitis and pharyngitis. Therefore, if you experience discomfort in the larynx and nasal cavity, you should seek help from a doctor. If you do not stop pathological reactions in soft 
tissues, this can lead to the generalization of inflammation and the development of an abscess or sepsis.
Adenoiditis (retronasal angina) occurs on its own or as a result of the development of respiratory diseases. Allergic rhinitis, tonsillitis, scarlet fever, infectious mononucleosis, flu and other colds can provoke inflammation of adenoid vegetations. The main symptoms of the development of adenoiditis include:
- fever;
- dysphagia;
- hypersalivation;
- temperature increase;
- enlarged lymph nodes;
- hyperemia of the laryngopharyngeal mucosa;
- Difficulty nasal breathing;
- pain in the soft palate, radiating to the ear and nose;
- muscle weakness and drowsiness.
Inflammatory reactions in the nasopharyngeal tonsil and surrounding tissues lead to hypersecretion of nasal mucus. For this reason, patients may complain of a lingering runny nose, sore throat, and discomfort caused by nasal mucus draining down the larynx. Treatment of retronasal sore throat is accompanied by the administration of antiphlogistic, anti-edematous and anti-allergic medications. To eliminate foreign agents in lesions, drugs with antiseptic, antimicrobial and antiviral properties are used.
Consequences of adenoids and adenoiditis
The nasopharyngeal tonsil is located in the fornix of the nasopharynx, so its enlargement negatively affects the work of not only the respiratory system, but also the hearing aid. Congestion in the nasal passages and the Eustachian tube provokes septic inflammation in the middle ear and sinuses. Common complications of adenoids include:
- sinusitis;
- sinusitis;
- acute pharyngitis;
- sphenoiditis;
- tracheitis;
- eustachitis;
- otitis media;
- paratonsillar abscess;
- rhinosinusitis.
Constant inhalation of cold air through the nose leads to local hypothermia of the ENT organs and a decrease in immunity. Therefore, patients with adenoids often develop respiratory diseases. In addition, due to hypertrophy of the pharyngeal tonsil, reflex disorders can occur - laryngospasm, attacks of suffocating cough and urinary incontinence.
Important! Septic inflammation of hyperplastic adenoid tissue can cause systemic inflammation of the body.
Diagnostic methods
Modern diagnostic methods can reveal the slightest proliferation of the tissues of the nasopharyngeal tonsil. The timely passage of drug therapy prevents the development of severe complications, thereby eliminating the need for surgical treatment. The most informative methods for diagnosing adenoids and retronasal angina include:
- X-ray of the nasopharynx - determination of the degree of development of adenoid vegetations according to images of the nasopharynx obtained using an X-ray machine;
- endoscopic examination - an assessment of the degree of tissue proliferation, the shape and color of the nasopharyngeal tonsil, carried out using a fibroscope;
- posterior rhinoscopy - visual examination of the state of adenoid vegetations using a laryngeal mirror.
In case of infectious inflammation of hypertrophied tissues, a specialist takes a puncture from the nasopharyngeal tonsil for bacterial and virological analysis. After identifying the causative agent of the infection, the patient is prescribed appropriate medication.
Conservative treatment
It is advisable to carry out drug treatment of adenoid vegetations in adults in the case of a slight proliferation of lymphoid tissues. It should be understood that with 2 and 3 degrees of hypertrophy of the pharyngeal tonsil, there are practically no chances of its reduction. If, due to the patient's health condition, surgical intervention is contraindicated, the treatment of ENT pathology is carried out with the help of the following drugs:
- anti-inflammatory and antibacterial agents - Poviargol, Bioparox, Protargol;
- antiallergic drugs - "Erius", "Zirtek", "Suprastin";
- vasoconstrictor nasal drops - "Naphtizin", "Sanorin", "Galazolin";
- preparations for extinguishing the oropharynx - "Faringosept", "Ingalipt", "Geksoral";
- immunostimulating drugs - "Bicyclovir", "Copaxone", "Laferon".
Important! The drug treatment regimen can only be prescribed by a specialist and only after a diagnosis has been made.
At the stage of regression of inflammatory reactions in the nasopharyngeal tonsil, physiotherapy methods of therapy can be used. Magnetotherapy, UHF therapy and ozone therapy increase local immunity, thereby reducing the risk of recurrence of septic inflammation of the upper respiratory tract.
Surgery
Surgical intervention is a radical method of treatment, during which a specialist removes adenoid vegetation. If drug therapy brings only temporary relief of the symptoms of ENT pathology, the patient is prescribed an adenotomy. The absolute indications for a surgical operation are:
- 2 or 3 degrees of development of adenoid vegetation;
- lack of a therapeutic effect from drug therapy;
- hearing impairment, leading to the development of conductive hearing loss;
- frequent relapses of tonsillitis and retronasal sore throat.
It is impossible to carry out the operation on patients suffering from diabetes mellitus, blood diseases and cardiovascular pathologies, as this can be fatal.
Before the operation, the nasopharynx is cleaned of pathological secretions and pathogenic agents with antiseptic solutions. The overgrown tonsil is excised with an adenotome under local anesthesia. During the operation, a thin round knife is inserted into the nasal cavity, with the help of which the surgeon captures and cuts off the adenoid vegetation.
It takes no more than 20 minutes to complete all the necessary manipulations, after which the operated tissues are treated with an antimicrobial drug. To reduce the likelihood of developing a pathogenic flora in the nasopharynx, the patient should take antibiotics and immunostimulating drugs for 2 weeks. In the absence of postoperative complications, the patient is discharged from the hospital on the 3rd day after adenotomy.
