Are there any age restrictions for tonsil hypertrophy? Although an increase in the size of these lymphoid formations is more often detected in childhood, the likelihood of the development of hypertrophic processes in adult patients cannot be ruled out. There are many reasons why tonsil hypertrophy occurs; it is not always associated with the presence of inflammation and is more often regarded as an adaptive-compensatory phenomenon. Is it worth considering an increase in the tonsils in adulthood as a pathology and how dangerous is it? What therapies can be offered to the patient?
Causes
Before talking about why the tonsils can increase and how this process is objectively manifested, you need to imagine where these anatomical formations are located and to which functional system of the body they belong. The Pirogov-Valdeyer lymphadenoid ring, localized in the oropharynx, is an immune barrier at the entrance to the respiratory and digestive tract. It is formed by several tonsils:
- paired palatine, or tonsils, localized between the palatine arches;
- paired tubal, located at the pharyngeal opening of the auditory tube;
- unpaired nasopharyngeal (pharyngeal), located in the fornix of the nasopharynx;
- unpaired lingual in the mucous membrane of the root of the tongue.
Tonsils are composed of lymphoid tissue, as the peripheral organs of the immune system are formed at the stage of intrauterine development and persist throughout life. At the same time, some of them (pharyngeal, lingual, tubal) can undergo age-related involution, expressed in a decrease in size and functional activity. Involution, in fact, means the reverse development, the transformation of the organ. This is of great importance for considering the reasons explaining the enlargement of the tonsils in an adult, since age-related functional hypertrophy is characteristic of children, and age-related involution occurs at the age of 13-15 years.
Hypertrophy, that is, an increase in the size of the amygdala, can be provoked by various reasons. Why are glands and other lymphoid formations enlarged? This leads to:
- Congenital malformations.
- Lack of age-related involution.
- Constant trauma to the tissue of the tonsil (for example, rough food).
- Tonsillectomy (removal of the tonsils).
- Frequent infectious diseases, immunodeficiency.
- The presence of foci of chronic infection in the oropharynx.
- Endocrine Disorders.
- Taking hormonal contraceptives by women.
When the tonsils are enlarged, they interfere with adequate breathing, contribute to the formation of pathological changes. If tactics can be expectant in childhood with hypertrophy, measures should be taken in the treatment of adult patients immediately after the diagnosis is made.
Thus, any of the tonsils can be hypertrophied; the process in adults is irreversible and requires treatment.
Classification
Hypertrophy of the tonsils is a process that is classified not only according to the type of enlarged lymphoid formation. The severity of clinical manifestations is directly related to the severity of the change in size, therefore, it is customary to divide the increase in the glands and the pharyngeal tonsil into three degrees. With regard to the rest of the components of the lymphadenoid ring, only the very fact of hypertrophy is considered.
A synonym for hypertrophy of the pharyngeal tonsil is the term "adenoids", "adenoid enlargements" - contrary to the idea of this pathology, it can occur not only in children, but also in adults. The degree of hypertrophy (1, 2 and 3, respectively) is compared with the cover of the vomer with lymphoid tissue - a bone plate located in the nasal cavity:
- covering the upper third;
- covering the upper two thirds;
- covering the entire opener.
When the tonsils are enlarged, anatomical landmarks are used to determine the progress of the pathological process: the edge of the anterior arch and the uvula, which is located along the midline of the pharynx. If the amygdala fills 1/3 of the distance between them, they say about 1 degree of hypertrophy, if 2/3 - about an increase in the tonsils of 2 degrees. It is possible to conclude that the patient has grade 3 hypertrophy if the gland reaches the uvula.
Symptoms
How is the enlargement of the tonsils manifested? Symptoms are due to the anatomical location of the lymphoid formation and the degree of its hypertrophy.
Palatine tonsils
Glandular enlargement in adults is quite rare, and is not always a cause for complaints. Hypertrophied tonsils can be discovered by chance - for example, during a routine examination. At the same time, with a significant increase, violations are formed:
- Nasal breathing.
- Vote.
- Sleep.
Improper nasal breathing leads to a cascade of pathological changes: an increase in the risk of infection, swelling and nasal congestion (vasomotor rhinitis), concomitant damage to the pharyngeal tonsil, auditory tube, and middle ear.
Since the patient is forced to breathe through his mouth (which can also be difficult with an increase in the glands), the mucous membrane of the oropharynx dries up, and his throat may hurt. During sleep, snoring occurs, temporary cessation of breathing - the patient wakes up sluggish, tired, experiences frequent headaches, and is irritated. The voice becomes nasal, it is difficult for the patient to swallow food.
Pharyngeal tonsil
The patient may complain:
- for a persistent runny nose;
- headaches, dizziness;
- snoring while sleeping;
- for bouts of coughing.
Among the probable symptoms should also be noted absent-mindedness, impaired ability to concentrate, persistent fatigue, which does not go away even after prolonged sleep. The patient may be pale, he has a nasal voice, his mouth is open to facilitate breathing. Frequent rhinitis, sinusitis and otitis media are noted. Some patients experience urinary incontinence, migraine, nightmares with sudden awakening.
Lingual tonsil
The increase manifests itself:
- attacks of unproductive coughing;
- discomfort in the throat;
- swallowing disorder;
- change of voice;
- loud snoring.
If, along with an increase in the volume of lymphoid tissue, there is an overgrowth of venous plexuses in the region of the root of the tongue, a strong paroxysmal cough can lead to a violation of the integrity of the vessels and the occurrence of bleeding.
The cough is caused by pressure on the epiglottis and irritation of the superior laryngeal nerve.
Tubal tonsils
The key complaint is hearing impairment. There is a conductive type of hearing loss - it is associated with the difficulty of conducting sound waves. This hearing loss is persistent and difficult to treat. Enlarged tonsils in adults are an expanding lymphoid tissue, which causes a progressive decrease in hearing acuity and a gradual increase in changes. Play Fortune online casino is very popular not only among ordinary players, but also among casino streamers. First of all, the site offers customers an excellent bonus program: the local reward system is the best possible motivation for the game. You can find out about all the details on the official website https://cimacollina.com Play Fortuna. There you will find a section with information and a user agreement: we recommend that you study it before using the services of an online casino. The same applies to the rules for using bonuses.
Unilateral enlargement is accompanied by pathological changes on the right or on the left - so, if the right amygdala is enlarged, the right auditory tube suffers and, accordingly, the middle ear cavity on the right. Adenoids and chronic adenoiditis often become a prerequisite for the occurrence of hypertrophy of tubal lymphoid formations.
Hypertrophy of any of the tonsils does not mean the simultaneous presence of inflammation.
The throat with hypertrophy of the tonsils does not change if there are no concomitant infectious and inflammatory changes. If it is red, there are plaques on the mucous membrane, and the patient is worried about pain when swallowing, fever - you need to think about the infection.
Treatment approaches
Treatment for hypertrophy is mandatory if clinical symptoms occur. How are enlarged tonsils treated in adults? A combination of surgical and conservative methods is used, with the main one being surgical intervention, other methods make it possible to consolidate the result, prevent relapses (repeated episodes) and complications.
If the patient does not experience difficulty breathing, does not complain of poor sleep, snoring, does not indicate other characteristic signs, hypertrophy is not dangerous for him. However, regular observation is mandatory - and it is desirable that the same attending physician examines the throat. This makes it easier to compare changes over time.
If we are talking about paired lymphoid formations, but one amygdala is enlarged, differential diagnosis is carried out before starting treatment - chronic inflammatory processes, the presence of a cold abscess, and the presence of a neoplasm are excluded.
How are enlarged tonsils treated? For this, methods of mechanical and physical impact are used:
- Tonsillotomy.
This is a surgical cutting off of a part of the tonsils - during the operation, tissue is removed within the anterior palatine arches. The issue of tonsillotomy is considered at grade 3 of hypertrophy.
- Diathermocoagulation.
Heating of tissues with the help of a high frequency current - in this case, irreversible coagulation of proteins occurs. The method is also called curative moxibustion. It can be shown at 2 degrees of magnification.
Severe hypertrophy of the tonsils in adults is an indication for surgery.
Adenoids in an adult patient must be removed, since they cannot undergo involution and provoke irreversible changes in the nasal cavity. Adenotomy is performed using a special instrument - an adenotome. Removal with a laser is also practiced today.
For hypertrophy of the lingual tonsil, surgical excision is not used because it can increase the risk of bleeding. Preference is given to safer methods - cryosurgical treatment or diathermocoagulation. Radiation therapy is also used.
If we are talking about hypertrophy of tubal lymphoid formations, the left amygdala is enlarged and / or the amygdala on the right, curettage (scraping) of growths, radiation therapy is performed. At the same time, measures are taken to restore the patency of the auditory tube, as well as sanitize the throat, nasal cavity, eliminate foci of chronic infection in the area of the teeth and gums.
Conservative therapy is carried out mainly in the postoperative period and may include the appointment of drugs:
- antibacterial;
- antiseptic;
- vasoconstrictor;
- anti-inflammatory, etc.
The list of medicines is determined in accordance with the assessment of indications and contraindications, it is individual in each case. The drugs can be used systemically (tablets, injections), topically (lozenges, sprays, drops). During treatment, it is required to periodically examine the throat.
An otolaryngologist (ENT doctor) is involved in the treatment of tonsil hypertrophy in adults. Timely seeking medical help will allow you to choose the most gentle methods of exposure, to avoid the formation of irreversible changes associated with an increase in glands and other lymphoid formations.
