Adenoid hypertrophy is a hyperplasia of the pharyngeal tonsils. The pathological hyperplasia of the adenoids due to repeated stimulation of inflammation is called adenoid hypertrophy. This disease is most often seen in children and is often found in combination with chronic tonsillitis.
I. Local symptoms
The nasopharyngeal cavity of children is narrow, and if adenoid hypertrophy blocks the posterior nostril and the pharyngeal orifice of the eustachian tube, it can cause symptoms in the ear, nose, throat and other places.
1.Ear symptoms: obstruction of the pharyngeal orifice of the eustachian tube leads to secretory otitis media, causing hearing loss and tinnitus.
2, nasal symptoms: often complicated by rhinitis and sinusitis, with nasal congestion, runny nose and other symptoms. Speech with occlusive nasal sound.
3. Pharynx, larynx and lower respiratory tract symptoms: Due to the downward flow of secretions and stimulation of the respiratory tract, coughing and coughing are easily complicated by bronchitis.
4. Sleep snoring: Due to the obstruction of airway by adenoids, muscle relaxation during sleep aggravates airway obstruction, causing sleep snoring and labored breathing, and in severe cases, apnea and breath-holding. Long-term lack of oxygen at night leads to intellectual and physical development disorders in children.
5. Due to long-term open-mouth breathing, the facial bone development is impaired, the jaw bone becomes longer, the palate bone is high arched, the teeth are not aligned, the upper incisors protrude, the lips are thick, the lack of expression, and the so-called “adenoid face” appears.
Systemic symptoms
Poor overall development and nutrition, night terrors, teeth grinding, urination, slow reaction, inattention and other reflex symptoms. In addition, long-term airway congestion and insufficient pulmonary ventilation will lead to an increase in pulmonary artery pressure, which may lead to right heart failure in severe cases.
III. Diagnosis
1. Children with open-mouth breathing, sometimes with an “adenoid face”
2, oropharyngeal examination of the hard palate is high and narrow, often accompanied by palatal tonsillar hypertrophy.
3, nasopharyngoscopy in the top and posterior wall of the nasopharynx can be seen on the surface of the longitudinal fissures of lymphatic tissue hyperplasia hypertrophy, like half a small peeled orange.
4.Lateral nasopharyngeal film measurement: the degree of obstruction of the nasopharyngeal airway can be clarified.
5.Palpation: If the nasopharynx is palpated with fingers, soft masses can be found in the roof and posterior wall of the nasopharynx.
6.X-ray nasopharyngeal lateral radiographs can help to diagnose.
7.CT: The nasopharyngeal airway is narrowed, the posterior wall is thickened with soft tissue, uniform density, similar to the long muscle of the head, symmetrical on the left and right side, with smooth or wavy anterior edge, and protruding into the air cavity.
IV. Treatment
If adenoid hypertrophy and the above symptoms appear, adenoidectomy should be performed as soon as possible. If there is tonsillar hypertrophy, it can be performed simultaneously with tonsillectomy. Since secretory otitis media in children is closely related to adenoid hypertrophy, adenoidectomy has become a routine operation for the treatment of secretory otitis media, and at present, the operation mostly adopts low-temperature plasma surgery, which has become a routine operation in our department because of the advantages of small injury, no bleeding, light postoperative reaction and quick recovery.