What Causes Enlarged Adenoids?

Common causes of this disease are repeated episodes of inflammation such as acute and chronic rhinitis, tonsillitis, and influenza, which cause pathological hyperplasia of adenoids. As a result, nasal obstruction is increased, nasal drainage is hindered, and rhinitis and sinusitis secretions stimulate adenoids to continue to proliferate, forming a vicious cycle of mutual cause and effect. The disease also often has a family genetic history.

Zhang Yamei

(Chief physician)

Department of Otolaryngology, Beijing Children's Hospital

Adenoids, also called pharyngeal tonsils or proliferative bodies, are located at the top of the nasopharynx and the posterior pharyngeal wall. They are lymphoid tissues with orange petals on the surface. Adenoids, like tonsils, gradually grow up with age after birth. The age of proliferation is 2-6 years old, and gradually shrinks after 10 years. Adenoid hypertrophy adenoids undergo pathological hyperplasia due to repeated stimulation of inflammation, which leads to symptoms of nasal obstruction and open mouth breathing, especially at night, with sleep snoring and disturbed sleep. Children often turn over from time to time, even more when supine Obviously, apnea may occur in severe cases. The disease is most commonly seen in children and is often associated with chronic tonsillitis and tonsil hypertrophy.

Western Medicine Name: Adenoidal hypertrophy
The main symptoms: Rhinitis, sinusitis, hearing loss and tinnitus, adenoid face, etc.

Main cause: Repeated inflammation, genetic factors

Causes and Pathophysiology of Adenoid Hypertrophy

Clinical manifestations of adenoidal hypertrophy

Local symptoms of adenoidal hypertrophy

Children's nasopharyngeal cavity is narrow, such as the adenoid hypertrophy blocked the nostril and eustachian tube throat, can cause ear, nose, pharynx, throat and other symptoms.

(1) Ear symptoms: The eustachian tube of the eustachian tube is blocked, causing secretory otitis media, leading to hearing loss and tinnitus.

(2) Nasal symptoms: rhinitis and sinusitis often occur, and there are symptoms such as nasal congestion and runny nose. Occlusive nasal sounds when speaking, snoring sounds when sleeping, and severe cases of sleep apnea.

(3) Symptoms of pharynx, larynx and lower respiratory tract: secretions flow downward and stimulate the mucous membranes of the respiratory tract, often causing nocturnal cough, and prone to tracheitis.

(4) Adenoid face: due to long-term mouth breathing, the development of facial bones is impaired, the jaw becomes longer, the sacrum is arched, the dentition is uneven, the upper incisors are protruding, the lips are thick, and the expression is lacking. Body appearance. "

Adenoidal hypertrophy systemic symptoms

The child presented with anorexia, vomiting, indigestion, and malnutrition. Due to poor breathing and insufficient lung expansion, chest deformities can result. Poor breathing at night can cause children to be in a state of hypoxia for a long time, endocrine dysfunction, and cause growth and development disorders. Parents can find that the child has symptoms of inattention, mood change, night terrors, bruising, night sweats, bedwetting and other symptoms.

Adenoidal hypertrophy is one of the most common causes of obstructive sleep apnea-hypopnea syndrome (OSAHS). Excessive snoring and belching during sleep are the two main symptoms. Open mouth breathing during sleep, excessive sweating, headaches in the morning, daytime sleepiness, and learning difficulties are also common symptoms.

The main harm of adenoidal hypertrophy

Adenoid hypertrophy easily forms "adenoid face"

Because children's nasopharynx is relatively small, when adenoids are hypertrophic, because of nasal congestion, they breathe and open their mouths to breathe. If they breathe for a long time, the air will impact the hard palate and deform the hard palate. The upper lip is short and thick, the mandible is drooping, the nasolabial sulcus disappears, the hard palate is high, the teeth are not aligned, the upper incisors are protruding, the occlusion is poor, the nasal septum is flat, etc. Pig Bajie or ugly duckling is medically called "adenoid face".

Adenoidal hypertrophy is prone to bronchitis

Adenoid hypertrophy in children can cause blocked noses, causing children's snot to flow back to the pharynx, irritating the lower respiratory tract mucosa, often causing bursts of cough, and prone to tracheitis.

Hypertrophy of adenoids can easily lead to children's mental retardation and unresponsiveness

Children with long-term breathing through the mouth and no ventilation of the nose are likely to cause head ischemia and hypoxia, and suffer from mental weakness, headache, dizziness, decreased memory, and unresponsiveness.

Adenoid hypertrophy affects child growth and development

Because children need a large amount of oxygen for development, snoring will cause the child to be severely hypoxic during sleep, which will directly lead to insufficient oxygen supply to the brain development and cause a decrease in growth hormone secretion. It will also affect your child's future intelligence.

Therefore, these children are not only susceptible to respiratory infections, but also chicken breasts, funnel chests, and even pulmonary heart disease. Therefore, children snoring is more harmful than adults.

Diagnosis of adenoidal hypertrophy

(1) The child opens his mouth to breathe, sometimes showing a typical "adenoid face."

(2) Oropharyngeal examination showed that the hard palate was high and narrow, and viscous secretions from the pharyngeal wall flowed down from the nasopharynx, often accompanied by palatine tonsil hypertrophy.

(3) Anterior rhinoscopy revealed a large amount of secretions in the nasal cavity and swelling of the mucosa.

(4) Fiber nasopharyngoscopy shows lobulated lymphoid tissue with longitudinal slits on the top and back wall of the nasopharynx, like a small peeled orange. More than two-thirds of the nostrils are often blocked. This is currently the most commonly used method for adenoid examination.

(5) Nasopharyngeal lateral film measurement: It can measure the degree of obstruction of nasopharyngeal airway.

(6) Palpation with fingers for nasopharyngeal palpation. Soft lumps can be formed on the top and back of the nasopharynx.

(7) CT: CT axial image shows that the deformation of the nasopharyngeal air cavity is narrowed, the soft tissue of the back wall is thickened and the density is uniform.

Treatment of adenoidal hypertrophy

Conservative treatment of adenoidal hypertrophy

Pay attention to nutrition, prevent colds, improve the body's immunity, and actively treat the primary disease. With age, the adenoids will gradually shrink, and the condition may be relieved or the symptoms completely disappear.

Adenoid hypertrophy drug medical

Some children often have rhinitis and sinusitis. After proper treatment, nasal ventilation improves, and clinical symptoms can be reduced.

Adenoidal hypertrophy surgery

If conservative treatment is not effective, the adenoid should be surgically removed as soon as possible. Surgery is often performed in conjunction with tonsillectomy. If the tonsils are small and rarely inflamed, adenoidectomy can be performed alone. ^[1-2]

Prevention of adenoidal hypertrophy

1. Don't despise adenoidal hypertrophy. Early detection and early treatment are needed when the child has poor hearing or frequently has stuffy nose or runny nose.

Think of a condition that may be more than just an ear or nose, but also check for adenoidal hypertrophy.

2. In daily life, parents should pay special attention to children's colds. Especially when children are 2-10 years old, prevention should be improved, such as avoiding children's chronic cold, runny nose, stuffy nose, cough, rubbing nose, rubbing eyes, sneezing, etc., if accompanied by poor hearing, snoring Symptoms, you should go to the hospital for diagnosis and treatment.