Adenoids: photo, symptoms, diagnosis, treatment
The content of the article:
- What are adenoid vegetations, and why do they occur?
-
Classification
- Degree 1
- Degree 2
- Grade 3
- Symptoms of the adenoids
- Diagnostics
- Treatment
- Video
Adenoids, or adenoid vegetations, can occur both in children (this happens in most cases due to the weak immunity of the child) and in adults. This is a chronic sluggish disease, which is characterized by the proliferation of lymphoid tissue so much that over time, the nasopharyngeal tonsils (namely, from which adenoids are formed) close the nasal passages. Despite the fact that the disease can last for many years and not show any pronounced signs, the consequences of a neglected pathological process can be quite serious.
Adenoid growths are more common in childhood
In modern tactics for the treatment of adenoid vegetations, priority is given to conservative therapy, which is preceded by an exhaustive diagnosis. After clarifying the diagnosis, he prescribes a complex of pharmacological agents that break the links of the pathological mechanism of the disease. Surgical intervention in the classical form is rarely resorted to, although this method is quite effective. It is performed according to strict indications.
What are adenoid vegetations, and why do they occur?
Immunity is a coherent system that has many components. One of these components is cellular immunity - special cells are produced in the lymphoid tissue. The largest accumulations of this tissue are the tonsils - nodes that are located on the border between the body and the external environment. They protect the upper respiratory tract from infections that can enter through the inhaled air. But if the immune system fails, inflammation of this tissue may begin.
There are two main causes of the disease: compensatory hypertrophy of the lymphoid tissue and adenoiditis (inflammation of the hypertrophied nasopharyngeal tonsil, i.e., adenoids). If the appearance of a painful condition is associated with chronic infectious diseases or allergic reactions, which constantly stimulate an increase in the tissue of the tonsils in size, compensating for the immune response to any pathogen, they speak of compensatory hypertrophy. Normally, the accumulation of lymphoid tissue diminishes immediately after the immune response stops. But if its size does not decrease, and the lymphoid tissue, being depleted, is overgrown with connective tissue, this indicates the appearance of adenoids. This is the main reason.
If the disease is acute and develops quickly, against the background of a systemic inflammatory reaction to the infection (fever, chills, redness of the mucous membrane in the nose and nasopharynx, soreness, sensation of local heat), then there is inflammation of the tonsils - adenoiditis. It passes faster, it is easier to treat hypertrophy, usually a course of anti-inflammatory and antibacterial agents is enough. The quality of life of a person with this form does not deteriorate in the long term, which cannot be said about chronic growth.
The prerequisites for the disease are past viral or bacterial infections, in particular, childhood diseases - measles, rubella, chickenpox. A prolonged allergic process also leads to hypertrophy of the nasopharyngeal tonsil.
What do adenoids look like? The photo of the adenoids shows that these are lumps of mucous tissue, of a rather soft consistency, about a centimeter in size, loose. Their mucous membrane is full-blooded during inflammation, and the vascular pattern on the surface is pronounced. With significant hypertrophy, connective tissue nodes, an uneven and bumpy surface of formations can be found.
Adenoids in the photo look like knots of loose tissue
Since the tonsils are located in the nose, where there are thin partitions that form the nasal passages (turbinates), their enlargement becomes the cause of the main problem - complete or partial overlap of the airways. The main symptoms of the disease are associated with this.
Classification
The disease has a code according to ICD 10 (International Classification of Diseases 10th revision) in the category Chronic tonsil diseases - J35. Pathology is regarded as potentially dangerous and requiring compulsory treatment.
Clinical manifestations and therapeutic tactics depend on which part of the lumen of the nasal passages is closed by enlarged tonsils. Depending on the hypertrophy, there are three degrees of adenoid growths:
Degree 1
The enlarged amygdala covers 1/3 of the opener and the height of the nasal passages. Clinically, this is not much different from the norm, in general, nasal breathing is preserved, however, during a night's sleep, the child can snore, puff or breathe with an open mouth.
Degree 2
The pharyngeal tonsil occupies 2/3 of the nasal passages and the vomer. At this stage, the first pronounced symptoms appear. It is at this stage that the diagnosis is most often made. Active conservative treatment of second-degree adenoids can provide regression of hypertrophy.
Grade 3
The enlarged amygdala covers almost the entire opener, completely blocks the nasal passages and makes nasal breathing impossible. Signs of the disease are obvious, in addition to constant mouth breathing, the patient suffers from prolonged hypoxia, which is especially dangerous for children (in particular, for their nervous system). At this stage, conservative treatment may be ineffective, in which case they resort to surgical removal of the tonsils.
Each degree has its own clinical manifestations.
Symptoms of the adenoids
At an early stage, the disease is asymptomatic or completely asymptomatic. The first signs of illness in children are night snoring, susceptibility to respiratory infections. In adult patients, the disease can also manifest itself as night snoring, however, as a rule, this does not raise any suspicion.
Symptoms of the second stage are worsening of nasal breathing, frequent colds and a general decrease in resistance to pathogens, a change in the timbre of the voice, distinct snoring, restless sleep, dizziness, a cough is possible, during physical exertion, the patient breathes through his mouth. Uncharacteristic weakness, drowsiness, decreased appetite, decreased motor activity may appear.
In adults, adenoids are manifested by snoring, headaches
In the third stage, nasal breathing is absent, and the patient is constantly breathing through the mouth - this is the main symptom. This type of breathing cannot provide the body with oxygen in full, the shortage is about 20%. Hypoxia, or oxygen starvation, develops. Prolonged hypoxia is manifested in adults by a decrease in cognitive abilities, a deterioration in general well-being, headaches, and sleep disorders. For children, this condition is extremely dangerous and can have far-reaching consequences, since the nervous system lacks nutrition during the period of its active development.
This is manifested by a lag in mental and physical development, a deterioration in attention and memory. If treatment is not prescribed on time, cognitive impairment can become irreversible. Progressive vegetation leads to hearing impairment.
Due to constant breathing through the mouth, an adenoid type of face is formed in children (since the skull has not yet completely ossified) - the mouth is slightly open, the bite is changed, the teeth are curved, pushed forward, the upper jaw is elongated, drooping, and the sky is high “Gothic”.
The third stage requires an immediate appeal to a specialist, since structural and functional disorders of many systems can become irreversible, cause developmental abnormalities and serious diseases.
Diagnostics
In children, the clinical picture is usually more pronounced, while adenoids in adults may not appear for a long time. In any case, the diagnosis requires examination by an ENT doctor.
They resort to such studies:
- Finger examination. The doctor probes the tonsil with a sterile gloved hand, assessing its size and consistency. An unpleasant procedure, therefore, it is rarely used in practice and only in adults.
- Examination with a nasopharyngeal speculum. A special mirror surface made of sterile metal is inserted into the oral cavity, in which the tonsils are reflected.
- Endoscopic examination (rhinoscopy). A thin probe with a camera can penetrate into the tightest spaces, assess the condition of the surrounding tissues and auditory tubes. In addition, it allows you to take material for histological examination.
- X-ray diagnostics - is more often used before surgery.
In difficult cases, they resort to computed tomography.
Differential diagnosis of adenoids is carried out with other disorders of the airway patency - curvature of the nasal septum, rhinoscleroma.
Treatment
How to reduce the size of the growths? For this, drug therapy is used. Treatment is always preceded by the lavage of the nasal cavity, i.e., its sanitation. For this purpose, pharmacy saline solutions, nasal sprays with a disinfectant effect are used. Dr. Komarovsky advises rinsing your nose with saline, an inexpensive remedy that is an isotonic saline solution.
It is necessary to rinse the nose before instilling medicines into it
In the inflammatory process, anti-inflammatory, local antiseptic agents are used. To alleviate the symptoms of the disease, vasoconstrictor nasal drops, general antihistamines are used. Shown are inhalation of drugs using a nebulizer. If a bacterial infection is detected, a course of antibiotic therapy is prescribed.
Hypertrophy of the nasopharyngeal tonsil of 1-2 degrees is treated quite effectively without surgery. Grade 3 adenoid vegetations also require active conservative treatment (medication, physiotherapy), but it may be ineffective. If several courses of anti-inflammatory therapy did not lead to a result, and hypertrophy continues to progress, if hearing loss, manifestations of oxygen starvation are detected, the question of surgical removal of the adenoids is raised.
The operation is called adenotomy. It consists in the fact that under local or general anesthesia, hypertrophied tonsils are cut out with a special instrument - a semicircular adenotome. It is optimal to carry out the manipulation under endoscopic supervision, so that during removal there are no particles of lymphoid tissue that can contribute to relapse.
An advanced method of treatment is the removal of adenoid vegetations with a laser, which allows you to effectively get rid of the disease, avoiding the risks of classical surgery.
Video
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Nikita Gaidukov About the author
Education: 4th year student of the Faculty of Medicine No. 1, specializing in General Medicine, Vinnitsa National Medical University. N. I. Pirogov.
Work experience: Nurse of the cardiology department of the Tyachiv Regional Hospital No. 1, geneticist / molecular biologist in the Polymerase Chain Reaction Laboratory at VNMU named after N. I. Pirogov.
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