ADENOID HYPERTROPHY (ENLARGED ADENOIDS)
Adenoid hypertrophy is the unusual growth of Adenoid.
ANATOMY AND PHYSIOLOGY
The nasopharyngeal tonsil, commonly called “adenoids”, is situated at the junction of the roof and posterior wall of the nasopharynx. It is composed of vertical ridges of lymphoid tissue separated by deep clefts. Adenoid tissue is present at birth, shows physiological enlargement up to the age of 6 years, and then tends to atrophy at puberty and almost completely disappears by the age of 20.
- Recurrent attacks of rhinitis, sinusitis
- Chronic tonsillitis
- Allergy of the upper respiratory tract
- Viral or bacterial infections
- Bottle feeding (breast feeding is protective)
- Recurrent attacks of common cold, upper respiratory tract infections
- Crowded living conditions
- Poor socioeconomic status
- Smoking by family members in the home
- Siblings having tonsillitis
- Viral infections in the home and daycare centers
- Heredity and genetic factors
- Cleft palate
- Ciliary dyskinesia
- Cystic fibrosis
- Down’s syndrome
- Reduced immunity
- Poor dietary habits
- Too much physical and mental exertion
- Exposure to extremes of climate and temperatures, can affect the overall resistance of the persons and infections can occur easily
- Allergy: Inhalants and foods
- Anatomical obstruction: Enlarged adenoids and nasopharyngeal tumors.
- Recurrent attacks of Adenoiditis
(a) Nasal obstruction is the commonest symptom. This leads to mouth breathing. Nasal obstruction also interferes with feeding or suckling in a child. As respiration and feeding cannot take place simultaneously, a child with adenoid enlargement fails to thrive.
(b) Nasal discharge. It is partly due to choanal obstruction, as the normal nasal secretions cannot drain into nasopharynx and partly due to associated chronic rhinitis.
(e) Voice change. Voice is toneless and loses nasal quality due to nasal obstruction.
- Aural Symptoms
Recurrent attacks of acute otitis media
- Adenoid facies. Chronic nasal obstruction and mouth breathing lead to characteristic facial appearance called adenoid facies. The child has an elongated face with dull expression, open mouth, prominent and crowded upper teeth and hitched up upper lip
- Hard palate in these cases is highly arched
- Pulmonary hypertension.
- Lack of concentration.