Don’t put an ugly mask on your child
The adenoids, also known as the proliferative glands (pharyngeal tonsils), are located at the top of the nasopharynx and are a mass of lymphatic tissue with immune function. When repeated inflammatory irritation occurs over a long period of time, it can lead to pathological enlargement of the adenoids. If the enlarged adenoids affect the respiratory and general health, it is called adenoid hypertrophy.
Adenoid face: modern medicine is called one of the four ugly faces (other than cretinism, dwarf disease, mucopolysaccharidosis face), because the nasopharynx of children is relatively small, when adenoid hypertrophy, due to nasal congestion affect breathing and mouth open breathing, long-term breathing with the mouth, airflow impact on the hard palate will make the hard palate deformation, high arch, over time, the development of the face will be deformed, the upper lip is short and thick, the lower jaw sagging In the long run, the facial development will be deformed, the upper lip will be short and thick, the lower jaw will sag, the nasolabial fissure will disappear, the hard palate will be high and arched, the teeth will be misaligned, the upper incisors will protrude, the bite will be poor, the nasal septum will be flat and curved, the facial muscles will not move easily, the expression will be lacking, and the face will look like a piggyback or an ugly duckling. Once formed, it is difficult to recover!
Clinical manifestations
Local symptoms
① Ear symptoms: hearing loss, tinnitus
② Nasal symptoms: nasal congestion, runny nose, nasal sound, snoring
③ Pharynx, throat and respiratory symptoms: cough
④ Adenoid face
Systemic symptoms: The child shows anorexia, vomiting, dyspepsia, followed by malnutrition. Inadequate lung expansion due to poor breathing can lead to thoracic deformities. Poor breathing at night can leave children in a long-term hypoxic state and endocrine dysfunction, causing growth and development disorders. Parents may find that their children have symptoms such as inattention, mood swings, night terrors, teeth grinding, night sweats, and bedwetting.
Adenoid hypertrophy is one of the most common causes of obstructive sleep apnea hypoventilation syndrome (OSAHS). Excessive snoring and breath-holding during sleep are the two main symptoms. Open-mouth breathing during sleep, excessive sweating, morning headache, daytime drowsiness, lack of concentration and irritability, and learning difficulties are also common symptoms.
Prone to bronchitis
Adenoid hypertrophy in children can cause blockage of the nose, resulting in the backflow of snot to the pharynx, which stimulates the mucous membrane of the lower respiratory tract and often causes coughing bouts, making children prone to bronchitis.
Moodiness and unresponsiveness of children
When children breathe through their mouths for a long time and their noses are not ventilated, they are prone to head ischemia and oxygen deprivation, mental depression, headache, dizziness, memory loss and slow reaction.
Affect the growth and development of children
As children need a lot of oxygen for development, snoring will make children seriously lack of oxygen during sleep, which will directly lead to insufficient oxygen supply for brain development and reduce secretion of growth-promoting hormone, which will not only affect children’s height, but also decrease body resistance and affect children’s intelligence in the future.
Therefore, these children are not only prone to respiratory infections, but also prone to chicken chest, funnel chest, and even induce pulmonary heart disease. Therefore, children snoring has more harmful effects than adults.
Related imaging tests.
X-ray nasopharyngeal lateral radiograph
Lateral nasopharyngeal radiograph is a simple and accurate way to observe adenoid hypertrophy, and it is easy to obtain the child’s cooperation and measure the degree of nasopharyngeal airway obstruction.
The nasopharyngeal lateral A/N ratio and PAS width measurements are both simple and practical methods for diagnosing adenoid hypertrophy and provide an objective basis for determining the degree of adenoid hypertrophy, while providing a significant assessment of treatment outcomes.
Direct measurement of airway width (PAS)
PAS refers to the shortest distance between the soft tissues of the nasopharynx and the soft palate, i.e. the smallest airway gap between the soft palate and the adenoids on a lateral nasopharyngeal view.
Normal Airway width 11 mm or more
Moderate hypertrophy airway width 6-10mm
Severe hypertrophy airway width 1-5mm
A/N ratio
The thickness of the apical nasopharyngeal proliferative gland and the width of the nasopharyngeal cavity were measured and the ratio was used to determine whether the proliferative gland was hypertrophic in children.
Ratio ≤ 0.60 Normal;
A ratio of 0.61 to 0.70 is considered mild hypertrophy;
A ratio of 0.71 is considered moderate hypertrophy.
A ratio >0.80 is considered significant hypertrophy of the adenoids.
CT scan
CT is an important tool for the diagnosis of adenoid hypertrophy and complications in children. It compensates for the deficiencies of lateral nasopharyngeal radiographs and accurately shows the hypertrophic adenoids, the deformed and narrowed nasopharyngeal cavity and the degree of narrowing, as well as its complications.
Treatment.
Drug treatment
Some children often have rhinitis and sinusitis, and after proper treatment nasal ventilation improves and clinical symptoms can be reduced.
Surgical treatment
If conservative treatment is not effective, adenoids should be removed surgically as soon as possible, often together with tonsillectomy, or separately if the tonsils are small and rarely inflamed.
Disease prevention.
1, adenoid hypertrophy should not be taken lightly. When a child has poor hearing or frequent nasal congestion or runny nose, think that it may not only be a disease of the ears or nose, but also check whether there is adenoid hypertrophy.
2. In daily life, parents should pay special attention to children’s colds and other conditions. Especially during the period of 2-10 years old, children should improve prevention, such as trying to avoid children with long-term colds, runny nose, nasal congestion, coughing, rubbing nose, rubbing eyes, sneezing and other symptoms, and if they are also accompanied by poor hearing and obvious snoring, they should go to the hospital for diagnosis and treatment.