An enlargement of the tonsils is called adenoid or adenoid vegetation . They are a typical problem in childhood and can lead to various health disorders. It is not uncommon for the adenoids to be surgically removed.
What are adenoids?
The Waldeyer’sche throat ring consists of tongue almond, palatine almond and pharyngeal almond.
Adenoid or adenoid vegetation is the name given to the enlargement of the tonsils , for which doctors also use the term hyperplasia. Enlarged tonsils can become a mechanical problem by constricting the nasopharynx and / or leading to chronic inflammatory changes that affect not only the pharynx, but also the lungs and middle ear.
Children between the ages of 3 and 7 are almost exclusively affected, as the pharyngeal tonsil tissue regresses with puberty ; in adults it has often completely disappeared. Adenoids are not a disease in and of themselves; they only become problematic when they cause health problems. Popularly, adenoids are mistakenly called polyps .
The pharyngeal tonsils are located on the roof of the nasopharynx and, together with the palatine tonsils, belong to the lymphatic pharyngeal ring, which serves to ward off pathogens that have penetrated through the nose and mouth.
The defense function is taken over by lymph follicles, which are located in the tissue of the tonsils and become active as soon as they come into contact with pathogens.
The enlargement of the pharyngeal tonsils is due to the enlargement and increase in number of the active lymph follicles, a complicated immunological process that starts a vicious circle:
The defensive inflammatory reaction leads to the enlargement of the pharynx, which leads to a build-up of secretion in the almond tissue, which in turn favors further inflammatory reactions.
Symptoms, ailments & signs
Adenoids can cause various symptoms and ailments in the nasopharynx. People who have tonsils enlarged tend to snore and wake up more often. The disturbed sleep can lead to chronic fatigue. Affected children are often unable to concentrate and perform less well in school than children without enlarged tonsils.
Often there is also a nasal language that is wrongly assessed as mumbling. Another outward feature is the slightly open mouth. This phenomenon also occurs during the day and promotes inflammation of the oral cavity and the airways. Those affected are also more prone to runny nose and cough. In some cases, adenoids can cause hearing problems, such as hearing loss in one or both ears.
In addition, there is an increased risk of otitis media and chronic inflammation in the nasopharynx. In the worst case, chronic bronchitis develops, which manifests itself among other things as breathing difficulties, sputum, cough , pain in the throat and general malaise. Based on this diagnosis, adenoid vegetation can be recognized and treated at an early stage. Failure to surgically remove the adenoids can lead to developmental delays and problems with language development, which often persist into adulthood.
Diagnosis & course
Adenoids can lead to an obstruction of nasal breathing and discharge of secretion through the nose, snoring and breathing disorders or respiratory pauses during sleep.
The disturbed sleep causes the children to become chronically tired and unable to concentrate. Most people breathe 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 up to bronchitis and also affects the middle ear, for whose proper function normal nasal breathing is important.
The consequence is frequent otitis media , which in the worst case can lead to hearing loss, which hinders the children’s speech development.
The general development of children is also impaired by the frequent infections and sleep disorders . The diagnosis is made through a clinical ENT examination during which the pharynx is inspected.
Diseases such as choanal atresia and juvenile nasopharynx must be excluded .
When should you go to the doctor?
Adenoids are a natural phenomenon and usually do not require any further medical clarification. However, if health problems arise as a result of the enlarged tonsils, a doctor should determine the cause and remove the polyps if necessary.
Overgrowths of the tonsils require clarification as soon as symptoms such as nasal language, intense snoring or infection in the mouth and throat occur. If these side effects persist for more than a month, a doctor should be consulted.
You should see a doctor immediately if you experience flu-like symptoms such as fever or earache. It is possible that an acute otitis media has already developed and must be treated immediately. From then on, adenoids must be seen by the doctor if the enlarged tonsils affect the general condition or otherwise have a negative effect on the state of health.
The symptoms mentioned usually appear 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 and any previous illnesses. In general, if you suspect adenoid vegetation, you should speak to the pediatrician responsible so that further steps can be taken.
Treatment & Therapy
Adenoids can only be removed through an operation in which the enlarged almond is peeled off with a special instrument. The procedure usually only takes a few minutes and is performed under general anesthesia .
In contrast to the surgical removal of the 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 do not have any serious underlying illnesses or coagulation disorders , that reliable care by guardians is guaranteed throughout the first 24 hours after the operation and that the journey to the surgeon is not too far in the event of problems.
In the first few days, swallowing difficulties and swelling-related obstruction of nasal breathing and ear pressure are possible. With 0.8% of all interventions, rebleeding is extremely rare and requires even less medical attention. Surgery is only performed if the affected children actually have serious health problems, frequently suffer from infections, have trouble sleeping and thriving , or if they suffer from severe respiratory diseases regardless of adenoids, such as: B. Asthma .
The operation is also not without controversy: Since the revenge almond tissue recedes by the beginning of puberty at the latest, it is quite possible that the problems caused by the adenoids will also disappear.
Outlook & forecast
As a rule, inflammation of the tonsils and colds are relatively common with this disease . The affected person suffers from flu , cough , runny nose and thus from a reduced quality of life. It is not uncommon for the disease to affect snoring and make it worse. In some cases, increased snoring can also lead to discomfort in a relationship and problems with the partner.
In some cases, speech also becomes less clear, which can lead to social problems and problems in everyday life. Furthermore, in the course of the disease there is pressure on the ears and thus often also hearing problems. However, the patient does not suffer a complete loss of hearing. Middle ear infections also often occur, which make everyday life difficult. The illness often makes children look tired and exhausted and can no longer concentrate.
In most cases it is possible to remove the adenoids through surgery without any further complications or discomfort. The symptoms disappear completely after the procedure. Postoperative bleeding can only occur in rare cases .
The development of adenoids and their secondary diseases cannot be prevented by preventive measures, because ultimately they are the result of the normal immune defense of the lymphatic ring of the pharynx. Frequent infections of the nasopharynx, otitis media, mouth breathing and sleep disorders should persuade parents to clarify the cause through an ENT medical examination and to seek advice.
With this disease, the person affected is primarily dependent on a quick and, above all, an early diagnosis. This is the only way to avoid and limit further complications or complaints. If there is no treatment, the symptoms of this disease usually continue to worsen.
For this reason, a doctor should be consulted at the first signs and symptoms of this disease so that there are no further complications or complaints. As a rule, the earlier the doctor is contacted, the better the further course of the disease. The treatment itself is usually carried out by a surgical procedure, which usually takes place without complications.
After the procedure, the person affected should definitely rest and take care of their body. Exertion or stressful activities should be avoided in any case, in order not to unnecessarily burden the body. Those affected are mostly dependent on the help and care of the family or relatives so that there are no further complaints. As a rule, the life expectancy of the person affected is not reduced with successful treatment.
Outlook & forecast
After the tonsils have been surgically removed, most children have no further symptoms. Eventually, the regrowth of the tonsils should be surgically removed again during follow-up treatment. In the case of tympanic effusions, it may be necessary to treat with long-term tympanic drainage.
You can do that yourself
The formation of adenoids can best be prevented by a well-functioning immune system. A healthy lifestyle is particularly useful for people with previous stresses. This should include sufficient exercise, a varied diet and plenty of sleep .
This gives the body the opportunity to effectively fight viral and bacterial pathogens and thus prevent the symptoms. If painful swellings occur, it is advisable to see a doctor as soon as possible. Early treatment may prevent the chronic course of the disease and its associated complications.
If symptoms already exist, those affected should prefer to eat soft and cool food. This helps not to irritate inflamed areas any more. The strong seasoning of dishes should be avoided as well as the consumption of acidic products. Both can lead to a sore throat. Ice cream, on the other hand, can help relieve swallowing pain. Since smoking promotes the formation of inflammation, it should definitely be avoided.
When choosing a drink, fruit juices should be avoided as the acid they contain irritates the throat. Anti-inflammatory liquids such as sage or peppermint tea are better suited .