I. What is adenoid hypertrophy?
Adenoids, also known as pharyngeal tonsils or value-added bodies, are located at the junction of the top of the nasopharynx and the posterior wall, and are lymphatic tissue with an orange flap-like surface. 6 months have developed, and the most significant at 6-7 years old, and generally gradually shrink after 10 years old. Children’s adenoid hypertrophy is often physiological, if it affects the general health and function of adjacent tissues and organs, it is pathological hypertrophy.
Second, what are the dangers of adenoid hypertrophy?
Children’s nasopharynx is small, adenoid hypertrophy will block the posterior nostril and pharyngeal pharynx, thus affecting the function of the ear, nose, throat and other tissues and organs, causing local symptoms such as otorhinolaryngology and respiratory tract.
If the enlarged adenoids block the pharyngeal orifice of the eustachian tube, they can cause secretory or purulent otitis media, leading to ear congestion, ear pain, hearing loss or tinnitus. Children with adenoid hypertrophy often suffer from rhinitis, sinusitis, and pharyngitis, with symptoms such as nasal congestion and runny nose. They speak with an occlusive nasal sound, snore during sleep, open-mouth breathing, and in severe cases, sleep apnea. Long-term nasal congestion and open-mouth breathing lead to impaired facial bone development, long jaws, high arched palate, uneven teeth, prominent upper incisors, thick lips, and lack of expression, resulting in the so-called “adenoid face”. Adenoid hypertrophy blocks the posterior nasal orifice, causing secretions to flow downward and irritating the respiratory mucosa, causing pharyngeal discomfort and coughing paroxysms, and easily complicating bronchitis.
In severe cases, children are in a state of oxygen deprivation due to long-term respiratory distress, which causes endocrine dysfunction and growth disorders. Severe hypoxia directly leads to insufficient oxygen supply for brain development, resulting in reduced secretion of growth hormone, which not only affects the child’s height, but also decreases the child’s body resistance, which makes the child not only prone to respiratory infections, but also prone to chicken chest and funnel chest, and even induces pulmonary heart disease. It will even affect the child’s intelligence in the future.
Adenoid hypertrophy is one of the most common causes of obstructive sleep apnea hypoventilation syndrome. Excessive snoring and breath-holding during sleep are the two main symptoms. Open-mouth breathing during sleep, excessive sweating, morning headache, daytime drowsiness and learning difficulties are also common symptoms.
Adenoid hypertrophy in children is an obvious danger, parents should pay enough attention to early detection and early intervention.
How to detect adenoid hypertrophy in time?
More children with adenoidal hypertrophy will show snoring at night, even snoring like thunder and open-mouth breathing. Therefore, parents can observe whether their children have the above symptoms at night. In severe cases, children may even hold their breath during sleep, suddenly stop snoring, stop breathing for a short time or even wake up, and fall back to sleep after changing their sleeping position. If this happens, the child should go to the hospital for relevant examination.
However, not all children will have snoring symptoms. Nasal congestion is also the main symptom of the disease, and there may be runny nose and other manifestations. Due to nasal congestion, the child speaks with an occlusive nasal sound. Children with stuffy ears, ear pain, hearing loss, cough, throat-clearing cough, bronchitis, etc. should consider adenoid hypertrophy as a possible cause.
If a child has an “adenoid face”, the jaw bone becomes longer, the palate is high arched, the teeth are not aligned, the upper incisors protrude, the lips are thick, and there is a lack of expression, which is commonly known as a collapsed nose, a shrunken chin, and a piggyback face. Parents should also bring them to the clinic in time.
What tests are often needed to diagnose adenoid hypertrophy?
1, oropharyngeal examination: the posterior wall of the oropharynx can be seen to have secretions from the nasopharynx attached, often accompanied by palatine tonsil hypertrophy.
2. Anterior nasal microscopy: after the nasal mucosa is fully converged, red masses of elevation in the nasopharynx can be seen in some children.
3. Indirect nasopharyngoscopy or electronic fiberoptic nasopharyngoscopy: red mass-like elevation of the posterior wall of the nasopharyngeal apex is seen, and the surface is mostly orange flap-like with longitudinal grooves. Electronic nasopharyngoscopy images are clear, and the obstruction of the posterior nostril and the compression of the pharyngeal orifice of the pharynx can be observed.
4. Acoustic conductance examination: The tympanogram obtained by acoustic conductance examination can be divided into type A (normal middle ear function), type As (low peak type), type Ad (high peak type), type B (flat type), and type C (negative tympanic chamber pressure type). This can objectively reflect the functional status of the middle ear. In children, adenoid hypertrophy often causes negative pressure in the tympanic chamber, leading to the appearance of a “C” tympanogram.
5. Lateral nasopharyngeal radiograph: The soft tissue of the posterior wall of the nasopharynx is thickened to varying degrees, protruding forward and downward to the nasopharyngeal cavity, with rounded and wavy edges and sharp edges, causing the air chambers to be narrowed by varying degrees of pressure.
V. How to treat adenoid hypertrophy?
Treatment of adenoid hypertrophy can be conservative or surgical. Local application of steroid hormone non-surgical treatment can regulate the immune response of the nasal cavity and make the adenoids atrophy, which can effectively relieve the clinical symptoms of adenoid hypertrophy and help reduce the size of adenoids. However, the long-term use of steroid hormone treatment has adverse effects and significant side effects. At present, the clinical treatment is mostly applied surgically, adenoidectomy. If accompanied by tonsillar hypertrophy, it can be performed simultaneously with tonsillectomy. Although surgical treatment is effective, there are also certain risks and postoperative complications. Parents who are apprehensive about hormonal or surgical treatment can opt for Chinese medicine treatment, which is clinically effective when combined with oral tonics and non-pharmacological Chinese medicine.
Does all adenoid hypertrophy require surgical treatment?
Although adenoidectomy is recognized as a very safe procedure, like all surgical procedures, it has certain risks. The surgery requires local or general anesthesia, and the anesthesia itself can be dangerous. And, although the removal of tonsils and proliferators is relatively simple and easy compared to other surgical procedures, removal of the tonsils will cause a sore throat for about 14 days, sometimes so severe that it will be unbearable for the child. Many parents are apprehensive about having their child’s adenoids removed. Moreover, the tonsils and adenoids play an important role in the local immune function of the pharynx and the entire upper respiratory tract in children, especially in children aged 3 to 5 years old, and the effect of surgery on the immune function of the child should not be ignored; in a very small number of children, some serious complications may occur after surgery, and the completeness of the surgical removal is also related to the operator’s skills.
Adenoid hypertrophy in children under 6 years of age is mostly physiological, and the lymphoid tissues within the adenoids are the most obviously developed and participate in the immune activities in the body, so it is not advisable to remove the adenoids too early to avoid affecting the important role of this immune organ. For older children, because of adenoid hypertrophy, severe nasal obstruction symptoms, accompanied by sensorineural hearing loss, recurrent secretory otitis media, recurrent nasopharyngeal inflammation, recurrent bronchitis or bronchitis, even with unexplained fever and obstructive sleep apnea syndrome and other pathological changes in the tissues and organs surrounding the adenoids, the adenoids become pathogenic foci or affect swallowing and respiratory function, and conservative treatment is ineffective or ineffective. Surgery should be considered only after conservative treatment has failed or is ineffective.
As a lymphatic tissue, adenoids participate in local immunity of the respiratory tract, playing an anti-infective, neutralizing and immunomodulatory role. Therefore, early and accurate assessment of the exact degree of adenoid enlargement and its impact on general health and the function of surrounding tissues and organs is necessary to decide whether surgery is needed.
Seven, the advantages of Chinese medicine treatment of adenoid hypertrophy
The use of Chinese medicine treatment is clinically effective and can significantly improve the symptoms caused by airway pressure, such as snoring during sleep, open-mouth breathing and sleep apnea. It not only reduces the danger of adenoid hypertrophy in children, but also saves children from the pain of surgery.
Most of the tonics used for treating adenoid hypertrophy are herbs that activate blood circulation, soften blood stasis, disperse knots, detoxify and reduce swelling, which can quickly relieve symptoms while regulating the child’s constitution and reducing the recurrence and occurrence of tonsillitis.
For some children with tonsillar hypertrophy, Chinese physical therapy, such as acupuncture and bloodletting, can be used in conjunction with tonics for better results.
Chinese medicine treatment of adenoid hypertrophy has few side effects, high safety, simple and convenient treatment, and high cooperation of children, so it is worth promoting.
Eight, daily care prevention
1, parents should first strengthen the usual protection of the child, pay attention to the nasal warmth, to prevent colds. At the same time, we should pay attention to diet, eat more vegetables and fruits, and appropriately restrict the intake of allergy-prone foods such as sea fish and shrimp. Enhance physical fitness, so as to prevent the disease before it happens.
2, adenoid hypertrophy should not be taken lightly, early detection, early treatment. In daily life, parents should pay special attention to children’s colds and other conditions. In particular, children between the ages of 2 and 10 should be prevented early, such as trying to avoid children with long-term colds, runny nose, nasal congestion, coughing, rubbing nose, rubbing eyes, sneezing and other symptoms, if also accompanied by poor hearing, obvious snoring and other symptoms, you should go to the hospital for diagnosis and treatment.