Benign lymphoid hyperplasia (adenoid vegetations)

If adenoids are detected in adults, the symptoms may be mild. Most often, adenoids are found in children. This is explained by the fact that the nasopharyngeal tonsils atrophy with age. In children under 12 years of age they are most pronounced. Despite this, the presence of adenoids in adults is often detected. What is the etiology, symptoms, consequences and treatment of this pathological condition in adults?

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Adenoids in adults

Adenoids are formations that form against the background of the proliferation of connective and lymphoid tissue in the oropharynx. If the adenoids become inflamed, adenoiditis develops. Nasal growths are much less common in adults than in children. This is explained by anatomical features. There are 3 degrees of severity of adenoids. At grade 1, these formations cover no more than a third of the choanae and vomer. Breathing problems are possible only at night. At grade 2, 50% of the lumen of the choanae and vomer is blocked. Human breathing occurs primarily through the mouth. Often such people snore at night. The most severe is grade 3.

Why adenoid hypertrophy develops quickly: the third dangerous degree of the disease

Children with strong immunity, good physical health and positively developing psychosomatics (cheerful, active, cheerful) tolerate the beginning stages of adenoid vegetative hypertrophy much easier.

But, in general, the experience of constantly practicing, leading pediatric specialists in the field of diagnosing and treating adenoiditis in children says that immediately, when the described symptoms are recorded, children should be connected to the most intensive medical care. Delay threatens that adenoid pathogenesis will begin to rapidly decline. And in just a few days of “calm” the situation can develop into a violent epicrisis - grade 3 adenoid hypertrophy .

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What is the difference between the painful manifestations of the initial phase of the disease and the last stage, which is as close as possible to the operative (surgical) removal of adenoid formations?:

• The difference lies in the factor of the speed of spread of intoxication through the blood and lymphatic channels of the child’s body. Each pathogen (virus, bacillus, microbes or bacteria) has its own “generic” signs of pathoetiology, its various modifications of pathoreproduction. For example, streptococci, staphylococci, Pseudomonas aeruginosa, Escherichia coli, and Koch bacillus most quickly invade the vital organs of children. Angina-like adenoviruses that cause a sharp increase in temperature, congestion of the upper respiratory tract (catarrhal infection). Meningococcus also, almost instantly, affects the brain structures of the gray matter: the choroid, the smallest and branched membrane of the brain and the brain in the spine.
• The herpes virus (cytomegavirus) and HPV (human papillomavirus) are characterized by slower, but no less formidable dynamics. Adenoid hypertrophy has an evil property. When creating especially favorable conditions for it (cold exacerbations of seasonal respiration, children who have undergone intracavitary operations of the gastrointestinal tract, chronicles of cardiac pathologies), “skip” the 1st, 2nd degree and stages of adenoid hypertrophy in children . Or reduce the incubation period by hundreds of times by these degrees, immediately switching to an operable treatment - adenotomy. This is a form of adenoid hypertrophy, characteristic of the 3rd, last stage of adenoid growth, dangerous to the life and health of the child.
• In many ways, an extremely negative “service” in promoting the worsening of the condition of nasal adenoids in children is played by the factor that we know as a popular warning - “Self-medication threatens your health!” Time was lost due to the fault of the parents. The family members of sick children decide to treat them with familiar, proven means, without drugs. Soar your feet, make the children breathe over the steamed potatoes (covering your head with a towel). Drink hot tea with raspberries, honey, linden flowers, or fresh milk with butter and soda. Instill the nose with well-known (normal and inexpensive drops) “Naphthyzin”, “Nock-spray”, “Pinosol”.

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This, of course, is not bad – to take such urgent and urgent measures against colds. It may be possible to relieve painful manifestations and stabilize the children’s calm state of health for a short period. But, the adenovirus is not destroyed during such procedures. It lurks in the visceral folds of the nasopharynx, awaiting its “hour of recovery.”

And, believe me, it will wait. At the first draft, infection with influenza airborne droplets in the surrounding home, kindergarten, school and yard environment. After all, the child’s body is practically defenseless: it has expended significant energy efforts and immune leukocyte reactions to fight the previous painful condition. Please take these warnings into account, dear mothers and fathers! Contact official pediatrics, pediatric visceral area ENT. This would be the absolutely right action!

Etiological factors

The appearance of adenoids in the nose in adults can be due to several reasons. They include hereditary predisposition, the presence of chronic infectious diseases of the nasopharynx, endocrine disorders, and changes in hormonal levels. Risk factors for the development of this pathology include alimentary (primary) obesity, poor nutrition (overeating), poor environment, hypothermia, contact with various allergens, and bad habits (smoking, drinking alcohol).

Most often, the causes lie in inflammatory diseases. In acute infections, inflammation quickly disappears. If left untreated, lymphoid tissue can grow. A condition such as adenoiditis often develops. It occurs in both men and women. Sometimes adenoiditis is diagnosed during pregnancy. This can be facilitated by taking medications and changing hormonal levels.

Adenoid hypertrophy in children: causes, symptoms and treatment

Babies often get sick, this is not surprising, since at this stage the immune system is just being formed. The fact is that lymphoid tissue, which performs the body’s protective functions, is subject to constant attacks by viruses. Over time, inflammation of the tonsils occurs, and the organ stops working in its usual mode.

Not so long ago, the only way to overcome the disease was surgery, which involved removing the adenoids. Now other ways have been invented to cope with the disease without negatively affecting the immune system.

Complex therapy allows you to reduce the size of the tissue and relieve all the symptoms that cause a lot of problems for the child.

In this regard, parents should know how adenoid hypertrophy is treated and what are the causes of the disease.

Clinical manifestations

Symptoms of adenoids may not appear for a long time. Often the disease occurs in a latent form. A person is bothered by difficulty breathing through the nose. Many patients do not pay attention to this and do not go to the doctor, mistaking adenoids for rhinitis or sinusitis. Adenoids in the nose in adults are manifested by the following symptoms:

• purulent nasal discharge;
• difficulty breathing through the nose;
• headache;
• cough;
• snore;
• hearing loss;
• dysphonia;
• bad breath;
• feeling of nasal congestion;
• hoarseness of voice.

The most common symptom is difficulty breathing. In case of severe obstruction of the nasal passages, the supply of oxygen to the brain is disrupted, which results in constant headaches. Various respiratory diseases often occur against the background of impaired nasal breathing. Such people often suffer from ARVI and influenza. Adenoids are a predisposing factor in the development of sinusitis (sinusitis, sinusitis, ethmoiditis). In severe cases, damage to the bronchi and lungs is possible.

Without proper treatment, hearing and speech may be impaired. In this situation, otitis media and internal otitis may develop. The presence of adenoids in adults is dangerous because when the body is weakened, pathogenic microorganisms can penetrate various organs (kidneys, heart), causing inflammation in them (glomerulonephritis, myocarditis).

Clinic

In children with adenoids, nasal breathing becomes difficult, the voice becomes nasal, and speech is unintelligible.

A sore throat appears during sleep and a reflexive, dry cough. Sick children sleep poorly at night and often suffer from acute respiratory infections, etc. They quickly get tired, become lethargic and apathetic. When the adenoids become inflamed, intoxication occurs with severe sweating, headache, heart and joint pain, persistent low-grade fever, and loss of appetite. The mouth of a sick child is constantly open, he is often bothered by a runny nose and mucopurulent discharge.

Adenoids can change the shape of the face.

At the same time, the nasolabial folds are smoothed out, the hard palate becomes roof-shaped, and the incisors protrude forward. “External adenoidism” becomes the reason for regular ridicule from peers. Such children usually have few friends. Over time, they withdraw into themselves and stop communicating with others. This factor affects the child’s psyche and the rest of his life. It is necessary to eliminate the problem at this stage, rather than later deal with a protracted disease and developed deficiencies and complexes.

Sick children have problems with bite and speech:

it is difficult for them to speak, their voice changes and loses its sonority. Often there is a change in the cellular composition of the blood, disruption of the intestines and stomach, gall bladder and digestive glands. In patients, the spine is curved, the chest is deformed, the shoulders become narrow, and the chest becomes sunken. Subsequently, renal dysfunction and bedwetting develop. Symptoms of adenoids in children also include anemia, burning in the nasopharynx, lack of appetite, diarrhea or constipation. When the pituitary gland is damaged, the child's growth and sexual development are delayed.

1. Lack of therapeutic effect from conservative therapy,
2. Frequent exacerbations of adenoiditis - inflammation of the nasopharyngeal tonsil,
3. The development of complications - rheumatism, arthritis, vasculitis, glomerulonephritis,
4. Night,
5. Frequent ARVI and otitis media.

The operation is carried out in a classical way using a special instrument - an adenotom. Traditional adenotomy has a number of disadvantages, so modern techniques have been introduced into pediatric otolaryngology: aspiration and endoscopic adenotomy.

Under local anesthesia in an outpatient setting, the operation is quick and painless. General anesthesia is indicated for children with increased excitability, as well as in cases where the adenoids are located close to the mouth of the auditory tube. The operation is performed under general anesthesia only in a hospital.

Symptoms of adenoiditis

In adults, as in children, the adenoids can become inflamed. There are acute, subacute and chronic adenoiditis. Acute inflammation of the adenoids is characterized by the following symptoms:

• increased body temperature;
• nasal congestion;
• runny nose;
• moderate pain in the nose;
• paroxysmal cough at night.

The disease begins acutely with an increase in body temperature. Enlargement of the lymph nodes is often observed. With a complicated course of acute adenoiditis, the development of purulent otitis and hearing impairment is possible. The subacute form of adenoiditis lasts longer (2-3 weeks). Low-grade fever may occur. Such people are bothered by a runny nose and cough. In the absence of therapeutic measures, the disease becomes chronic.

Chronic adenoiditis can be simple catarrhal, mucopurulent, exudative-serous. The most common signs of chronic inflammation of the adenoids are as follows:

• constant runny nose;
• violation of nasal breathing;
• headache.

What are adenoids

Adenoids are a pathological growth of tissue of the tonsil located in the nasopharynx. The tonsil is one of the important organs that controls the immune system, but its growth in the nasopharyngeal region, instead of the expected protection of the body from viruses and bacteria, leads to the opposite result. The child often catches colds, suffers from a runny nose, snoring at night, and his hearing deteriorates.

More details about runny nose with adenoids in the review Runny nose with adenoids: causes and treatment features

Most often, children aged 3 to 10 years are susceptible to this disease. In adults, this problem is extremely rare, since as the child grows older, the pharyngeal tonsil decreases and by the age of 16 it becomes barely noticeable.

Diagnostic measures

Against the background of chronic inflammation of the adenoids, sinusitis and otitis media often develop. During the acute phase, symptoms become more pronounced.

To detect vegetations in the nose in adults, an examination by a specialist is required. Diagnosis of adenoids includes:

• detailed survey;
• visual inspection;
• performing posterior rhinoscopy;
• X-ray examination of the nose and paranasal sinuses;
• endoscopic examination;
• general analysis of urine and blood;
• finger examination;
• examination of mucopurulent nasal discharge to identify the causative agent.

The most accessible and simple diagnostic method is rhinoscopy. It is performed by an otolaryngologist. This method allows you to identify adenoids using special mirrors. The procedure is carried out through the mouth. In this situation, redness of the mucous membrane, enlargement of the tonsils in the pharynx, and the presence of mucus or pus can be detected. To rule out sinusitis, an X-ray examination is performed. An endoscopic examination involves inserting a flexible probe into the nasal passages. This method allows you to determine the size of the adenoids and their shape.

A patient interview and examination are of no small importance in making a diagnosis. When examining a sick person, you can detect an opening of the mouth, drooping of the lower jaw, and slight swelling of the face. During the survey, the state of hearing and speech function is determined. If a person complains of hearing loss, an otoscopy (examination of the external auditory canal and eardrum) may be performed.

Inflammation of the adenoids

Septic inflammation of the adenoids in children (adenoiditis) is an infectious disease that occurs due to the development of pathogenic flora in the hypertrophied pharyngeal tonsil. The inflammatory process in the ENT organs is provoked by pathogenic viruses, fungi or microbes. Most often, adenoiditis is preceded by influenza, acute tonsillitis, pharyngitis, rhinitis, sinusitis and sinusitis.

In otolaryngology, there are two forms of ENT disease:

• 
  acute adenoiditis (retronasal tonsillitis) - acute inflammation of adenoid vegetations, resulting from a decrease in local immunity;

• chronic adenoiditis is a sluggish inflammation of the hypertrophied tonsil, which most often appears as a result of previous retronasal tonsillitis.

Important! Obstruction of the airways due to the development of adenoiditis can lead to asphyxia and death.

The pharyngeal tonsil can become inflamed due to a violation of the outflow of mucus from the nasopharynx. The viscous secretion contains proteins, which are a suitable substrate for the development of opportunistic microorganisms. It should be understood that inflamed adenoids in children provoke melting of soft tissues and accumulation of pathological exudate in the nasopharyngeal cavity. Over time, this can lead to the formation of abscesses, which impede the passage of air through the hypopharynx.

Clinical picture

• difficulty in nasal breathing, nasal voice, frequent persistent runny nose, frequent ARVI;
• mouth breathing, snoring during sleep, episodes of sleep apnea (breath holding during sleep), hearing loss;
• irritability, tearfulness, absent-mindedness, memory loss.

Inspection:

• Adenoid type of face: apathetic expression, pale skin, half-open mouth, smoothed nasolabial folds, exophthalmos, drooping lower jaw, malocclusion (narrowing, wedge-shaped protrusion of the upper jaw, improper development of the upper incisors), Gothic palate.
• Enlargement of adenoids 1, 2, 3 degrees.
• Pink adenoid vegetations of soft elastic consistency.
• Hypertrophy of the palatine tonsils, granulosa of the posterior pharyngeal wall (indirect sign).
• Slow growth, speech formation, lag in physical and mental development.

Adenoids grade 2

The adenoid growths have increased and cover more than half of the vomer. Problems with nasal breathing occur not only during sleep, but also during the day. If before this such manifestations as snoring and runny nose did not bother the patient, then at this stage they definitely appear. The symptoms of stage 2 adenoids certainly cannot be called severe, but it is difficult to live with them.

Mouth breathing occurs more often than at night. The timbre of the voice changes, nasality appears. A person begins to get sick often because his immune system is weakened. At this time, adenoiditis may occur, that is, inflammation of the tonsil tissue. This is accompanied by intoxication of the body and the occurrence of symptoms such as fever, drowsiness, and sore throat.

A side symptom of grade 2 adenoid hypertrophy is hearing impairment. This is explained by the fact that the Eustachian tube, which is necessary for ventilation and drainage of the middle ear, exits into the nasopharynx. Vegetations can partially close it, thereby affecting the pressure in the middle ear.

Causes of hypertrophy of adenoids and tonsils: why is this happening to your child?

Excessive load of infection.

Bacteria and viruses, and often a combination of both. The body cannot cope with the load, the lymphoid tissue increases, but does not completely fulfill its function.

Heredity.

If you suffered from the same disease as a child, unfortunately, your child is at a higher risk of developing adenoid hypertrophy. The special structure of the lymphatic system - the so-called lymphatic-hyperplastic diathesis - is a predisposing factor to hypertrophy of the adenoids and tonsils.

Unfavorable microclimate conditions.

Dry, especially during the heating season, warm air, lack of fluid, “accumulators” of dust and other allergens do not contribute to free breathing through the nose. And this is a direct path to frequent colds and adenoids.

Lymphotropic viruses.

In particular, the infectious mononucleosis virus (Epstein-Barr), cytomegalovirus, in which lymphoid tissue, liver and spleen enlarge.

Development of adenoids at 1, 2, 3 and 4 degrees

Adenoids are the tonsil, that is, an organ designed to protect the body from infections. The air, passing through the lymphoid tissue, is cleared of microbes and warmed up. But those microbes that the tonsil has “filtered” can cause inflammation in it. As a result, protective functions are activated and the organ increases in size to remove infection from the body. After recovery, the adenoids should return to their original volume.

Adenoids in children

If the immune system does not perform its function and cases of respiratory infections occur very often, a large load is placed on the amygdala. It does not have time to return to normal and remains enlarged. This is the first stage. If nothing is done during this period, the disease will progress. The organ gradually enlarges and can eventually completely block the nasopharynx. This condition corresponds to stage 4.

It is noteworthy that an overgrown tonsil does not protect the body, but becomes a source of infection in the mouth. As a result of inflammation, blood supply and lymphatic flow are impaired, leading to a weakened immune system in the throat.

This causes many unpleasant and dangerous symptoms, the same for adults and children. Manifestations of the disease depend only on the degree of adenoids. Let's look at the symptoms of adenoids by stage.