Adenoids or adenoid vegetations are an enlargement of the pharyngeal tonsils. They are a typical childhood problem and can lead to various health disorders. Not infrequently the adenoids have to be surgically removed.

What are adenoids?

The Waldeyer's throat ring consists of tongue almond, palatine tonsil and throat almond.

Adenoid or adenoid vegetation is the enlargement of the pharyngeal tonsils, for which the physicians also use the term hyperplasia. Enlarged pharyngeal tonsils can become a mechanical problem by narrowing the nasopharynx and / or causing chronic inflammatory changes that affect not only the pharynx but also the lungs and the middle ear.

Almost all children between the ages of 3 and 7 are affected, as the pharyngeal tonsil tissue recedes with puberty, but in adults it is often completely gone. Adenoids are not a disease in itself, they only become problematic if they cause health problems. Popularly adenoids are falsely referred to as polyps.

causes

The pharyngeal tonsils are located on the roof of the nasopharyngeal space and, together with the palatine tonsils, belong to the lymphatic pharyngeal ring, which serves to ward off pathogens that have entered the nose and mouth.

The defense function is taken over by lymphoid follicles, which are located in the tissue of the tonsils and become active as soon as they have contact with pathogens.

The enlargement of the tonsils is due to the enlargement and increase in the number of active lymphoid follicles, a complicated immunological process that sets off a vicious cycle:

The defense inflammatory reaction leads to the enlargement of the tonsil, resulting in a secretion of congestion in the almond tissue, which in turn favors further inflammatory reactions.

Symptoms, complaints & signs

Adenoids can cause various symptoms and complaints in the nasopharynx. People who suffer from enlargement of the tonsils usually snore more and wake up more often. The disturbed sleep can lead to chronic tiredness. Affected children are often unfocused and perform worse at school than children without enlarged tonsils.

Often there is also a nasal language that is falsely considered to be a mumbo-jumbo. An external feature is also the slightly open mouth. This phenomenon also occurs during the day and favors inflammation of the mouth and the respiratory tract. Those affected are also more prone to runny nose and cough. In some cases, adenoids can cause hearing problems, such as hearing loss to one or both ears.

Accompanying this there is an increased risk of middle ear inflammation and chronic inflammation in the nasopharynx. In the worst case, chronic bronchitis develops, which is manifested among other things by difficulty in breathing, expectoration, coughing, pain in the throat and general malaise. Based on this diagnosis, an adenoid vegetation can be detected and treated early. If the adenoids are not surgically removed, there may be developmental delays and language development problems that often persist into adulthood.

Diagnosis & History

Adenoids may interfere with nasal breathing and secretion discharge via the nose, snoring and respiratory disorders or respiratory failure during sleep.

Due to the disturbed sleep, the children become chronically tired and unfocused. Breaths are mainly breathed through the mouth, which is why the affected children often have their mouths open.

The obstruction of nasal breathing promotes chronic inflammation in the nasopharynx to bronchitis and also affects the middle ear, for whose proper function normal nasal breathing is important.

The result is frequent middle ear infections, which can lead in the worst case to the deafness, whereby the language development of the children is obstructed.

The general development of children is also affected by the frequent infections and sleep disorders. The diagnosis is made by a clinical ENT examination, in which the pharynx is inspected.

differential diagnosis

Diseases such as choanal atresia and juvenile nasopharyngeal fibroma must be excluded.

When should you go to the doctor?

Adenoids are a natural phenomenon and usually require no further medical clarification. However, if there are health problems as a result of the enlarged tonsils, a doctor should determine the cause and remove the polyps if necessary.

Growths of the tonsils need to be clarified as soon as complaints such as a nasal language, intense snoring or infection in the mouth and throat occur. If these symptoms persist for more than one month, a doctor should be consulted.

An immediate visit to a doctor is needed if flu-like symptoms such as fever or earache are added. It may have already formed an acute otitis media, which must be treated promptly. Thereafter, adenoids must be used as a doctor if the enlarged tonsils affect the general condition or otherwise have a negative effect on the state of health.

These symptoms usually occur between the ages of three and six and are an indicator of enlarged tonsils. Whether treatment is necessary depends on the type and intensity of the symptoms as well as possible pre-existing conditions. In general, suspected adenoid vegetations should be discussed with the responsible pediatrician so that further steps can be taken.

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Treatment & Therapy

Adenoids can only be cleared by surgery, in which the enlarged vengeance is cut off with a special instrument. The procedure usually lasts only a few minutes and is performed under general anesthesia.

In contrast to the surgical removal of the palatine tonsils, which is associated with a certain risk of rebleeding, the removal of the tonsils is usually possible on an outpatient basis. The prerequisite is that the affected children have no serious underlying diseases or coagulation disorders, a reliable care by caregivers in the first 24 hours after the procedure consistently ensured and in case of problems the way to the surgeon is not too far.

Dysphagia and a swelling-related obstruction of nasal breathing and ear pressure are possible in the first few days. Bleeding with 0.8% of all interventions is extremely rare and requires even less frequent medical attention. Surgery is only carried out if the affected children actually have serious health problems, often suffer from infections, have sleep and failure to thrive or, regardless of adenoids, suffer from severe respiratory diseases such as: Asthma.

The operation is also not without controversy: Since at the latest with the beginning of puberty, the adenocarpus tissue regresses, it is quite possible that the problems with the adenoids disappear as well.

Outlook & Forecast

As a rule, it is relatively common in this disease to inflammation of the tonsils and colds. The affected person suffers from flu, cough, runny nose and thus a reduced quality of life. Not infrequently, the disease also affects the snoring and strengthens this. If necessary, the increased snoring can also lead to complaints in a relationship and to problems with the partner.

In some cases, the language becomes less clear, which can lead to social problems and problems in everyday life. Furthermore, in the course of the disease there is a pressure on the ears and thus often also to hearing problems. However, the patient does not suffer a complete loss of hearing. Also, middle ear infections often occur, which make everyday life more difficult. Children often feel tired and chipped off due to the illness and can no longer concentrate.

In most cases, it is possible to surgically remove the adenoids without any further complications or discomfort. The symptoms disappear completely after the procedure. Only in rare cases, postoperative bleeding may occur.

prevention

The development of adenoids and their sequelae can not be prevented by preventive measures, because ultimately it is the result of the normal immune defense of the lymphatic pharyngeal ring. However, frequent infections of the nose and throat, middle ear infections, mouth breathing and sleep disturbances should induce parents to clarify the cause by an ENT medical examination and to be advised.

aftercare

In the case of this disease, the person concerned is primarily dependent on a quick and above all on an early diagnosis. Only then will further complications or complaints be avoided and limited. Should it not come to a treatment, usually continue to worsen the symptoms of this disease.

For this reason, should be consulted with this disease at the first signs and symptoms, a doctor, so there are no further complications or complaints. The sooner the doctor is contacted, the better is usually the further course of the disease. The treatment itself is usually performed by a surgical procedure, which usually takes place without complications.

After the procedure, the affected person should rest in any case and spare his body. Efforts or stressful activities should definitely be foreseen in order not to burden the body unnecessarily. The victims are usually dependent on the help and care of the family or by relatives, so there are no further complaints. In general, the life expectancy of the person affected is not reduced in a successful treatment.

Outlook & Forecast

After the tonsillectomy has been surgically removed, most children are without further discomfort. If necessary, the regrowth of almonds should be surgically removed. In case of tympani it may be necessary to treat with long-term ragged drainage.

You can do that yourself

The development of adenoids can best be prevented by a well-functioning immune system. Especially for people with pre-stress offers a healthy lifestyle. This should include sufficient exercise, a varied diet and plenty of sleep.

This gives the body the ability to fight viral and bacterial agents effectively and thus to prevent the symptoms. If painful swelling occur, we recommend a timely visit to the doctor. Early treatment may help to avoid the chronic course of the disease, with the associated complications.

For existing symptoms, sufferers should take priority soft and cool food. It does not irritate inflamed areas any more. The strong seasoning of food should be avoided as well as the consumption of acidic products. Both can lead to pharyngeal burning. Ice cream, on the other hand, can help relieve sore throat. Since smoking promotes the formation of inflammation, it should be avoided in any case.

When choosing the beverage, fruit juices should be avoided, as the acid contained in them irritates the pharynx. Better own anti-inflammatory liquids such as sage or peppermint tea.

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