home Calculators Hyperplasia of the lymphoid tissue of the nasopharynx. What is cervical lymph node hyperplasia

Hyperplasia of the lymphoid tissue of the nasopharynx. What is cervical lymph node hyperplasia

Lymph node hyperplasia, what is it and what causes it? Hyperplasia (enlargement) of lymph nodes is a common inflammatory pathology. There are many reasons for this. Therefore, it is important to know about the disease in order to seek medical help in time, receive appropriate treatment and prevent possible complications.

What is lymph node hyperplasia, its forms

The term “hyperplasia” means a pathological process characterized by proliferation (increased intensity of cell reproduction) in any tissue. This phenomenon can occur in any part of the body. It manifests itself in a change in the volume of tissues towards their increase.

Lymph node hyperplasia is not a disease, but a clinical symptom. It is also called lymphadenitis. Most often occurs during various inflammatory processes. There are several forms of lymphadenitis, which include:

Nonspecific lymphadenitis. Inflammation of the nodes occurs against the background of an infectious process with clear clinical manifestations.
Specific lymphadenitis. Groups of lymph nodes become inflamed more often. Hyperplasia develops slowly.
Lymphadenitis in tumors. Hyperplasia of lymphoid tissue can be observed in both benign and malignant oncological processes.

Each form has a different clinical picture and severity of symptoms. Therefore, this division makes it easier to diagnose the disease and make a diagnosis.

Causes of lymph node hyperplasia

Hyperplasia is a common symptom and there can be many reasons for its occurrence. The most common:

Infections. Both specific (tuberculosis, chlamydia) and nonspecific (ARVI, tonsillitis) arise due to the penetration of bacteria into the body. The release of toxins by bacteria activates the body's defenses to neutralize them.
Autoimmune processes. The body produces foreign cells against itself, which also activates the defense system.
tumor processes. Pathological proliferation of tissues of various organs and systems occurs, which is why the lymph nodes also enlarge.

The development of any of the listed pathological processes is accompanied by an increase, proliferation of tissue of groups or individual lymph nodes. It is in the lymph node that the fight against the pathological agent occurs. This is the most important part of the body's defenses. They are the first to be involved in the inflammatory process.

Clinical signs of hyperplasia

A huge number of diseases can lead to hyperplastic lymph nodes. The main thing is to identify the signs of hyperplasia, with which you can make the correct diagnosis.

There are specific symptoms due to which one can suspect damage to the lymph node due to an inflammatory process. These include:

The size of hyperplastic nodes increases rapidly, up to 2 centimeters or more in a short period of time.
When touching the lymph node, pain is detected.
The consistency of the knot is elastic and soft.
A change in the color of the skin over the lymph node is detected in the form of redness.

Also, lymph node hyperplasia is often accompanied by an increase in body temperature and a significant decrease in ability to work.

If the lymph node enlarges slowly, its consistency is dense, and painless when palpated, we can assume the onset of an oncological process. When metastasis occurs, the node is literally “fused” with the surrounding tissues.

Important! If a lymph node is enlarged, you should urgently consult a doctor.

What diseases are accompanied by lymph node hyperplasia

Depending on what pathological process occurs in the body and what organs are affected, hyperplasia of certain groups of nodes will be noted.

Diseases of the upper respiratory tract (nose, mouth, pharynx) will be accompanied by hyperplasia of groups of cervical, submandibular, supraclavicular nodes. Such diseases include ARVI, tonsillitis, stomatitis, caries.
With tuberculosis, the cervical and intrathoracic lymph nodes are usually affected. In a severe process, all groups of nodes of the lymphatic system can be affected.
With various immunodeficiencies, all groups of lymphoid tissue nodes can also become hyperplastic. Most often, with this pathology, the inflammatory process is localized in the iliac nodes.
During oncological processes, hyperplasia of the lymph nodes occurs, which are located closer to the affected organ. But during tumor metastasis to other organs and tissues, several groups of lymph nodes can be enlarged at once.

To identify hyperplasia and determine the severity of the process, a comprehensive examination of the patient is required. You will also need to consult various specialists in order to determine the scope of treatment.

Diagnosis of lymph node hyperplasia

To identify the cause of the disease, track its development and correctly determine the diagnosis, a comprehensive examination of the patient is carried out. The doctor will order the following laboratory tests:

Clinical blood test.
General urine analysis.
Blood chemistry.
Blood test for tumor cell markers.
Immunological blood test.
Throat swab.
Serological blood test (Wassermann reaction).
Mantoux test.

Based on the data of these tests, one can judge the causative agent of the disease and its activity. The doctor can make a presumptive diagnosis.

A number of instrumental studies are also used, including:

Plain radiography of the chest.
Biopsy of the affected lymph node followed by histological examination of its contents.

These methods are aimed at clarifying the diagnosis and studying the structure of the affected node. With their help, you can prescribe the most complete and correct treatment of the disease, and predict the course of the disease.

Important! The most reliable way to judge the pathological process is by performing a biopsy and histological examination.

Which doctors treat hyperplastic lymph nodes?

If there is a suspicion of hyperplasia of the lymph nodes, what it is is best explained by the therapist. This is the first specialist to whom the patient should contact. The doctor collects complaints and conducts a full examination of the patient. In addition to comprehensive laboratory and instrumental examinations, the patient must receive consultations from various specialists. Examinations are carried out by the following doctors:

Otolaryngologist. Examines patients with complaints of damage to groups of lymph nodes in the parotid region, cervical and submandibular groups.
Dermatologist. Consultation of this specialist is required for purulent lesions of the nodes, damage to the skin over them.
Surgeon. Examines a patient with severe disease. Addresses the issue of surgical treatment of hyperplastic lymph nodes.
Oncologist. A doctor's consultation is needed when determining an increase in oncomarkers in the blood, the presence of metastasis to other organs and tissues.

Treatment of lymph node hyperplasia

Depending on what reason led to hyperplasia, therapy will differ. If the disease was caused by an infectious agent, then appoint:

The most common side effects that occur are headache, nausea, and vomiting. If these signs are strongly expressed, then drug treatment should be interrupted.

Important! Before using the proposed drugs, you must always consult with your doctor.

Hello, Anastasia! I am not a doctor, but as far as I understand, hyperplasia of the lymphoid tissue of the pharyngeal vault is the same as adenoids.

Hyperplasia of lymphoid tissue, mainly of the pharyngeal and palatine tonsils, is promoted by past inflammatory diseases of the nose and oropharynx, childhood infectious diseases (scarlet fever, measles, whooping cough, infectious mononucleosis), malnutrition, environmental conditions and other factors that reduce the body's protective functions. Endocrine disorders and hypovitaminosis are of known importance.

The developing hypertrophy of lymphoid (adenoids) tissue leads to an increase in inflammatory processes in the pharynx. During puberty, this hypertrophy reverses, but complications from the ears and respiratory tract remain. Hypertrophied tissue can interfere with normal breathing and eating, and can cause pathological changes in the nose, ears, and larynx.

Adenoid growths - hyperplasia of the pharyngeal tonsil. The pharyngeal tonsils are located on the roof of the nasopharynx. The dimensions are determined by digital examination and X-ray data of the nasopharynx. By size they distinguish between I, II, III, IV degrees.

Adenoids are an obstacle to the passage of air and cause congestion in the mucous membrane of the nasal cavity and paranasal sinuses. Frequent, recurrent runny nose is the cause of the development of otitis media. Constant mouth breathing leads to disruption of the growth of the facial skeleton - an incorrect bite is formed. There is a characteristic sluggish, apathetic facial expression: a half-open mouth, eyes inactive, slightly protruding. Constant nasal discharge causes irritation of the skin of the nasal vestibule; ingestion of the discharge leads to disorders of the gastrointestinal tract. Prolonged shallow oral breathing causes improper development of the chest, and in some cases anemia develops. Inhaling cold air through the mouth leads to the development of sore throat and prolonged bronchitis in children. If the adenoids are large, there is a change in the sonority of the voice. There is restless sleep, accompanied by snoring. With severe hypertrophy, there is a weakening of memory, attention, headaches, which affects school performance. Absent-mindedness is often associated with hearing loss due to impaired ventilation of the tympanic cavity.

Reflex disorders include bedwetting, laryngospasm, asthma attacks, which weaken or disappear after removal of the adenoids.

For the treatment of such patients, they use: washing the nose with antiseptic solutions, laser therapy, immunocorrection, ozone therapy. If ineffective, the adenoids are removed surgically.

Additionally

Hypertrophy of the palatine tonsils- an increase in the size of lymphoid formations located between the anterior and posterior arches of the soft palate, without signs of inflammatory changes. Clinical manifestations - discomfort when swallowing, deterioration of nasal and oral breathing, snoring, nasal, speech distortion, dysphagia. The main diagnostic criteria include anamnestic information, complaints, results of pharyngoscopy and laboratory tests. Therapeutic tactics depends on the severity of hypertrophy and consists of medication, physiotherapy or tonsillectomy.

General information

Hypertrophy of the palatine tonsils is a common disease that occurs in 5-35% of the total population. About 87% of all patients are children and adolescents aged 3 to 15 years. Among middle-aged and older people, such changes are extremely rare. Often this condition is combined with an enlargement of the nasopharyngeal tonsil - adenoids, which indicates general hyperplasia of lymphoid tissue. The prevalence of pathology in the pediatric population is associated with a high incidence of ARVI. Hyperplasia of the lymphoid tissue of the pharynx is detected with equal frequency among males and females.

Causes

In modern otolaryngology, hypertrophy of the palatine tonsils is considered as a compensatory reaction. The proliferation of lymphoid tissue may be preceded by conditions accompanied by immunodeficiency. As a rule, enlarged tonsils are caused by:

Inflammatory and infectious diseases. The palatine tonsils are the organ in which primary contact with the antigen occurs, its identification, as well as the formation of a local and systemic immune response. Most often, hypertrophy is caused by ARVI, a recurrent course of inflammatory pathologies of the mouth and pharynx (adenoiditis, stomatitis, caries, pharyngitis, etc.), infectious diseases of childhood (measles, whooping cough, scarlet fever, and others).
Decreased immunity. This includes all diseases and factors that can reduce local immunity and general body defenses - hypovitaminosis, poor nutrition, poor environmental conditions, hypothermia of the tonsils during mouth breathing and endocrine diseases. Among the latter group, the greatest role is played by insufficiency of the adrenal cortex and the thymus gland.
Lymphatic-hypoplastic diathesis. This variant of the anomaly of the constitution is manifested by a tendency to diffuse hyperplasia of the lymphoid tissue. Also, this group of patients is characterized by immunodeficiency, impaired reactivity and adaptation of the body to the effects of environmental factors.

Pathogenesis

Children under the age of 3-4 years are characterized by insufficiency of cellular immunity in the form of T-helper deficiency. This, in turn, prevents the transformation of B lymphocytes into plasma cells and the production of antibodies. Constant contact with bacterial and viral antigens leads to excessive production of functionally immature T-lymphocytes by lymphoid follicles of the tonsils and their hyperplasia. Infectious and inflammatory diseases of the nasopharynx are accompanied by increased mucus production. It, flowing down the back wall of the pharynx, has an irritating effect on the palatine tonsils, causing their hypertrophy. With lymphatic-hypoplastic diathesis, in addition to persistent hyperplasia of the entire lymphoid tissue of the body, its functional insufficiency is observed, which causes an increased susceptibility to allergies and infectious diseases. An important role in the pathogenesis of the disease is played by allergic reactions, which cause degranulation of mast cells and the accumulation of a large number of eosinophils in the parenchyma of the palatine tonsils.

Classification

According to the diagnostic criteria of Preobrazhensky B.S., there are 3 degrees of enlargement of the palatine tonsils:

I Art. - tonsil tissues occupy less than 1/3 of the distance from the edge of the anterior palatine arch to the uvula or the midline of the pharynx.
II Art. - hypertrophied parenchyma fills 2/3 of the above-mentioned distance.
III Art. - tonsils reach the uvula of the soft palate, touch each other or go behind each other.

According to the mechanism of development, the following forms of the disease are distinguished:

Hypertrophic form. Due to age-related physiological changes or constitutional anomalies.
Inflammatory form. Accompanies infectious and bacterial diseases of the oral cavity and nasopharynx.
Hypertrophic-allergic form. Occurs against the background of allergic reactions.

Symptoms

The first manifestations of the disease are a feeling of discomfort when swallowing and a sensation of a foreign body in the throat. Since enlargement of the palatine tonsils is often combined with adenoids, difficulty in nasal breathing occurs, especially during sleep. Further proliferation of lymphoid tissue is manifested by a whistling noise when inhaling and exhaling through the nose, night cough and snoring, and deterioration of mouth breathing.

With hypertrophy II-III degree. there is a violation of the resonating properties of the extension tube (cavities of the pharynx, nose and mouth) and a decrease in the mobility of the soft palate. As a result, dysphonia occurs, which is characterized by closed nasality, unintelligibility of speech and distortion of the pronunciation of sounds. Nasal breathing becomes impossible, the patient is forced to switch to breathing with an open mouth. Due to insufficient oxygen supply to the lungs, hypoxia develops, which is manifested by a deterioration in sleep and memory, attacks of sleep apnea. A pronounced increase in the tonsils leads to the closure of the lumen of the pharyngeal opening of the auditory tube and hearing loss.

Complications

The development of complications of hypertrophy of the palatine tonsils is associated with impaired patency of the nasopharynx and oropharynx. This leads to blocking the outflow of secretions produced by goblet cells of the nasal cavity and disruption of the drainage function of the auditory tube, which causes the development of chronic rhinitis and purulent otitis media. Dysphagia is accompanied by weight loss, vitamin deficiencies and gastrointestinal pathologies. Against the background of chronic hypoxia, nervous disorders develop, since brain cells are most sensitive to lack of oxygen.

Diagnostics

To make a diagnosis of tonsil hypertrophy, an otolaryngologist performs a comprehensive analysis, comparison of anamnestic data, patient complaints, results of an objective examination, laboratory tests and differentiation with other pathologies. Thus, the diagnostic program includes:

Collection of medical history and complaints. Tonsil hyperplasia is characterized by respiratory failure, discomfort during the act of swallowing without concomitant intoxication syndrome and the development of sore throats in the past.
Pharyngoscopy. With its help, symmetrically enlarged palatine tonsils of a bright pink color with a smooth surface and free lacunae are determined. Their consistency is densely elastic, less often soft. There are no signs of inflammation.
General blood analysis. Detectable changes in peripheral blood depend on the etiopathogenetic variant of tonsil enlargement and can be characterized by leukocytosis, lymphocytosis, eosinophilia, and increased ESR. Often the data obtained is used for differential diagnosis.
X-ray of the nasopharynx. It is used in the presence of clinical signs of concomitant hypertrophy of the pharyngeal tonsils and low information content of posterior rhinoscopy. Allows you to determine the degree of obstruction of the nasopharynx lumen by lymphoid tissue and develop further treatment tactics.

Differential diagnosis is carried out with chronic hypertrophic tonsillitis, lymphosarcoma, sore throat due to leukemia and cold intratonsilal abscess. Chronic tonsillitis is characterized by a history of episodes of inflammation of the tonsils, hyperemia and purulent plaque during pharyngoscopy, and intoxication syndrome. In most cases, lymphosarcoma affects only one tonsil. Sore throat in leukemia is characterized by the development of ulcerative-necrotic changes on all mucous membranes of the oral cavity, the presence of a large number of blast cells in a general blood test. With a cold abscess, one of the tonsils takes on a rounded shape, and when pressed, a symptom of fluctuation is determined.

Treatment of hypertrophy of the palatine tonsils

Therapeutic tactics directly depend on the degree of proliferation of lymphoid tissue, as well as the severity of the disease. If the severity of clinical manifestations is minimal, treatment may not be carried out - with age, involution of the lymphoid tissue occurs, and the tonsils independently decrease in volume. To correct grade I-II hypertrophy. physiotherapeutic measures and pharmacological agents are used. An increase in degree II-III in combination with severe respiratory distress and dysphagia is an indication for surgical removal of the palatine tonsils.

Medical treatment. As a rule, it involves treating the palatine tonsils with silver-based antiseptic astringents and plant-based immunomodulators. The latter can also be used to rinse the nose. For systemic effects, lymphotropic drugs are used.
Physiotherapeutic agents. The most common methods are ozone therapy, short-wave ultraviolet irradiation, inhalation with carbon dioxide mineral waters and mud solutions, electrophoresis, mud applications to the submandibular area.
Tonsillectomy. Its essence lies in the mechanical removal of the overgrown parenchyma of the palatine tonsils using a Mathieu tosillotome. The operation is performed under local application anesthesia. In modern medicine, diathermocoagulation and cryosurgery, which are based on coagulation of tonsil tissue under the influence of high-frequency current and low temperatures, are gaining popularity.

Prognosis and prevention

The prognosis for tonsil hypertrophy is favorable. Tonsillectomy leads to the complete elimination of dysphagia, restoration of physiological breathing, and normalization of speech. Moderate hyperplasia of lymphoid tissue undergoes independent age-related involution, starting from 10-15 years of age. There are no specific preventive measures. Nonspecific prevention is based on timely treatment of inflammatory and infectious diseases, correction of endocrine disorders, minimizing contact with allergens, spa treatment and rational vitamin therapy.

However, this is not the worst thing; the bigger problem happens when a patient comes to the doctor who has already formed hypertrophy of the lymphoid tissue of the throat and nasopharynx, or, more precisely, its vault. In simple terms, hypertrophy of the pharyngeal vault is nothing more than the well-known adenoids.

Problems with adenoids usually consist of the fact that as a result of frequent colds, hypertrophy covers the nasopharyngeal tonsil and the entire nasopharyngeal vault, covered with lymphoid tissue.

Risk group

Hyperemia of the tonsils and back of the throat, which leads to problems with the adenoids, most often affects children aged 3–10 years. It is at this age that active hypertrophy of the lymphoid tissue of the throat and nasopharynx can begin. This is expressed in the fact that the lymphoid tissue begins to pathologically increase in size, hyperplasia occurs, not only of the pharynx, but also of the back wall of the throat.

If the patient is not at risk and does not suffer from frequent colds - hyperemia of lymphoid tissue, he is usually not at risk. With the achievement of 10 years of age, hyperemia of the lymphoid tissue of the throat and nasopharynx becomes less common. On the contrary, it begins to decrease and by the time the patient reaches adulthood, only a small area of lymphoid tissue remains in the area of the nasopharynx and posterior wall, which can no longer be involved in any pathological processes. To put it simply, if adenoids did not cause problems at a young age, then after adulthood this is completely unlikely. At this age, the patient may suffer only from enlarged tonsils, diseases of the nasopharynx and the back of the throat, but not from the adenoids.

Causes of hypertrophy

Why a patient at one time or another experiences hypertrophy of the pharynx or its posterior wall has not yet been fully studied. Experts identify only predisposing factors, namely:

Hypertrophy of the lymphoid tissue of the back wall of the throat and nasopharynx may occur due to frequent colds. The tonsils experience enormous stress due to constant infectious attacks. First, the patient experiences hyperemia of the throat and its posterior wall, and then the hypertrophy of the lymphoid tissue of the nasopharyngeal tonsils gradually increases. Lymphoid tissue disorders can be caused by problems with the endocrine system. Severe hypovitaminosis also often causes the proliferation of lymphoid tissue and problems with the adenoids. Unfavorable living conditions. If a child spends most of his time in a room with dry or excessively polluted air, he will in any case often suffer from throat and pharynx ailments. Also, hypertrophy of the lymphoid tissue of the children's nasopharynx can occur if the baby's room is rarely ventilated and there is musty air, which often happens in dysfunctional families.

If a child has already developed hypertrophy of the lymphoid tissue of the back wall of the throat or nasopharynx, the protective functions of the tonsils practically disappear.

Inflammatory processes in the throat and pharynx become very frequent and protracted, immunity declines pathologically. However, the most unpleasant thing is that hyperplasia of the lymphoid tissue can later cause problems not only in the back of the throat, but also in the ears and nose.

As a result, if hypertrophy of the lymphoid tissue of the throat and pharynx remains without proper attention in a child for a long time, the gas composition of the blood may change, ventilation of the lungs will weaken and hypoxemia may occur. If the disease progresses further, hemoglobin decreases, an inflammatory process begins and the number of leukocytes increases pathologically. Hence, disturbances in the functioning of the digestive system, decreased function of the liver, thyroid and adrenal glands. In other words, neglected adenoids lead to metabolic failure, which can lead to unpredictable consequences.

As you already understand, hypertrophy of the lymphoid tissue of the back wall of the throat and nasopharynx is far from a joke and treatment should begin as soon as possible. However, first let's learn to recognize this disease.

Hypertrophy of lymphoid tissue

Symptoms and diagnosis

Most often, the disease is accompanied by pronounced hyperemia of the tonsils of the throat and nasopharynx. Moreover, sometimes the entire pharyngeal lymphoid ring is involved in the pathological process, especially if the hypertrophy or swelling of the pharyngeal lymphoid tissue is already very strong. In this case, the child may not suffer from any colds, and during a routine medical examination, the doctor will not even detect pathological changes in the tonsils. However, if the inflammatory process has already gone very far, the patient will experience the following symptoms:

Severe hypertrophy of the nasopharynx usually causes a child to cough. However, this is not the main symptom of adenoids. Snoring at night may also indicate that the baby has nasopharyngeal hypertrophy. If a child constantly breathes through his mouth, it is often open and especially pronounced during sleep, most likely, hypertrophy of the nasopharynx occurs. A long-term runny nose that cannot be treated also indicates pathology of the adenoids. Very often in children there is such a sign of the disease as an adenoid type of face. As a result of structural changes in the lymphoid tissue of the pharynx and its posterior wall, the child’s facial expression takes on a certain apathetic or indifferent appearance. This is facilitated by: a slightly open mouth, smoothed nasolabial folds and a sagging lower jaw. As a result, the baby’s formation of facial muscles and bones is disrupted, pathologies arise in the development of teeth and jaws, and malocclusion is the least of the problems. The general condition of the child, who has constant hyperemia of the tonsils and the back wall of the throat and pharynx, has led to hypertrophy of the lymphoid tissue of the nasopharynx, is far from ideal. The baby is irritable, whiny, and apathetic. He has a poor appetite and the child gets tired very quickly.

There are usually no problems with making a diagnosis. The research method that identifies problems with the adenoids is called rhinoscopy. The analysis makes it possible to determine the size of pathologically altered lymphoid tissue and determine the method of its treatment.

Treatment

Adenoids in children are divided into 3 degrees depending on the severity of the disease. It is on them that the treatment of adenoids depends. In addition to surgical intervention, the following therapeutic techniques are used today:

Drug therapy. The conservative treatment method does not completely get rid of adenoids, but it can reduce the lymphoid tissue in size. Laser therapy is one of the most effective methods. If the main goal is to completely defeat the disease. Such treatment not only has a beneficial effect on the adenoids, but also generally improves immunity. Physiotherapy – electrophoresis, etc. This therapy is only indicated outside of an exacerbation, but it helps very well. Homeopathy is the most gentle and at the same time dubious method of treatment. Combines well with any other techniques. Climatotherapy is that same useful trip to the sea or treatment in a sanatorium, nothing more than a way to relieve acute symptoms.

Surgical treatment of adenoids has recently become extremely unpopular among specialists. It is carried out only if the patient is completely healthy and his adenoids are not exacerbating. The manipulation is certainly carried out under local or general anesthesia and, like any surgical intervention, it has an extremely negative impact on the functioning of the immune system in the future.

After the operation, the child will have to undergo a recovery period during which he will have to take antibiotics in order to eliminate the risk of complications. However, if the doctor insists on surgery, you should not refuse. Most likely, this is already an extreme measure and there is a direct danger to the child’s health. The main thing is to protect the baby from infections for about 2-3 months after the operation until the immune system is weakened. In the future, everything will return to normal, and the protective functions will be restored. As a result, the protective functions of the adenoids will be taken over by other tonsils, and they will now protect the body from infection.

Hypertrophy of lymphoid tissue of the pharynx photo

Hypertrophy of pharyngeal lymphoid tissue

Hypertrophy of lymphoid tissue

Hypertrophy of the tonsils, grade 3. The enlarged tonsil is highlighted with green arrows, on the opposite side the tonsil has just been removed by laser, .

This is what an enlarged sublingual tonsil looks like

After that, I started gargling with a solution of soda and salt, taking Faringosept and smearing my throat with Lugol's solution. A week's treatment did not produce any results.

Photo of my throat 2 years after the operation((((((((((((When examined, all the doctors are interested in who did such a careful job, and why they cut me off at all.

Catarrhal or simple pharyngitis:

In the thickness of the mucous membranes in the pharynx area there are large accumulations of lymphoid cells. Their concentration is shaped like an almond.

Congenital malformations of the pharynx

Adenoids or hypertrophy of the pharyngeal tonsil is a common pathology in children's groups. The pharyngeal tonsil is an accumulation of lymphoid tissue,.

Hypertrophy of pharyngeal lymphoid tissue

What is Hypertrophy of the lymphoid tissue of the pharynx -

Hypertrophy of the lymphoid tissue of the pharynx (mainly the nasopharyngeal and palatine tonsils) is not accompanied by a violation of its function.

What provokes / Causes of Hypertrophy of the lymphoid tissue of the pharynx:

Etiology unknown. Predisposing factors may be inflammatory diseases of the pharynx, various childhood infectious diseases, endocrine disorders, hypovitaminosis, constitutional anomalies, unfavorable social and living conditions and other influences that reduce the body's reactivity.

Pathogenesis (what happens?) During Hypertrophy of the lymphoid tissue of the pharynx:

Hypertrophy of the palatine tonsils, degree I - the tonsils occupy the outer third of the distance from the palatine arch to the midline of the pharynx; II degree - occupy 2/3 of this distance; III degree - the tonsils are in contact with each other.

Symptoms of Hypertrophy of pharyngeal lymphoid tissue:

Hypertrophy of the palatine tonsils is often combined with hypertrophy of the entire pharyngeal lymphoid ring, especially with hypertrophy of the pharyngeal tonsil. Children do not suffer from sore throats or acute respiratory diseases; upon examination, there are usually no inflammatory changes in the palatine tonsils.

Diagnosis of Hypertrophy of pharyngeal lymphoid tissue:

Diagnosis of adenoids is not difficult. Their size and consistency are determined using a number of methods. With posterior rhinoscopy: the adenoids look like a pale pink formation with a wide base, an uneven surface, divided by longitudinally spaced slits, and are located on the roof of the nasopharynx. X-ray and digital examination of the nasopharynx are used. Anterior rhinoscopy reveals mucopurulent discharge in the nasal passages, swelling or hypertrophy of the nasal turbinates. After anemization of the mucous membrane during phonation, one can see the movement of the adenoids upward.

Treatment of Hypertrophy of pharyngeal lymphoid tissue:

For hypertrophy of the palatine tonsils, physical methods, climatic and restorative treatment are used.

Which doctors should you contact if you have Hypertrophy of the pharyngeal lymphoid tissue:

Is something bothering you? Do you want to know more detailed information about Hypertrophy of the lymphoid tissue of the pharynx, its causes, symptoms, methods of treatment and prevention, the course of the disease and diet after it? Or do you need an inspection? You can make an appointment with a doctor - the Eurolab clinic is always at your service! The best doctors will examine you, study external signs and help you identify the disease by symptoms, advise you and provide the necessary assistance and make a diagnosis. You can also call a doctor at home. The Eurolab clinic is open for you around the clock.

Phone number of our clinic in Kiev: (+3 (multi-channel). The clinic secretary will select a convenient day and time for you to visit the doctor. Our coordinates and directions are listed here. Look in more detail about all the clinic’s services on its personal page.

If you have previously performed any studies, be sure to take their results for a consultation with a doctor. If the studies have not been performed, we will do everything necessary in our clinic or with our colleagues in other clinics.

You? It is necessary to take a very careful approach to your overall health. People do not pay enough attention to the symptoms of diseases and do not realize that these diseases can be life-threatening. There are many diseases that at first do not manifest themselves in our body, but in the end it turns out that, unfortunately, it is too late to treat them. Each disease has its own specific signs, characteristic external manifestations - the so-called symptoms of the disease. Identifying symptoms is the first step in diagnosing diseases in general. To do this, it is simply necessary to be examined by a doctor several times a year in order not only to prevent a terrible disease, but also to maintain a healthy spirit in the body and the body as a whole.

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Growth of lymphoid tissue of the tonsils

Hyperplasia of the palatine tonsils

Moderate enlargement of the tonsils due to the proliferation of lymphatic tissue and in the absence of an inflammatory process in them is more often observed in children. Hyperplasia of the palatine tonsils manifests itself as a compensatory process in response to a large number of attacks from infectious agents.

The main threat from hypertrophied tonsils is the complete closure of the airway. To avoid this, at a certain stage it is necessary to surgically remove part of the organ, which ensures adequate breathing.

Hyperplasia of the palatine tonsils is characterized by an immunoreactive process that occurs in response to the negative impact of environmental factors. In addition, the proliferation of lymphatic tissue is facilitated by breathing through the mouth in the presence of enlarged adenoids.

As a result of adenoiditis, increased secretion of infected mucus is possible, which affects the palatine tonsils. Hypertrophy is also promoted by infectious diseases, allergies and frequent inflammatory processes in the nasal cavity and oropharynx.

Among the accompanying factors, it is worth highlighting living conditions that are unsuitable for the baby, poor nutrition with insufficient amounts of vitamins, hormonal imbalance due to pathology of the thyroid gland or adrenal glands, as well as small radiation doses that have an effect for a long time.

Enlarged palatine tonsils are characterized by a pale pink tint, a smooth surface, formed lacunae and a loose consistency. They protrude slightly from behind the anterior palatine arches. Children experience coughing and difficulty swallowing and breathing.

Speech impairment occurs due to disturbances in the upper resonator, which is manifested by a nasal voice. Hypoxic changes in the brain cause restless sleep, insomnia and cough. At night, periods of lack of breathing (apnea) are possible due to relaxation of the pharyngeal muscles.

In addition, tubular dysfunction can cause the development of exudative otitis media with a further decrease in hearing function.

Hyperplasia of the lingual tonsil

In children, the lingual tonsil is very well developed and is located in the root of the tongue. At the age of one hundred years, its reverse development is observed, as a result of which it is divided into 2 parts. However, sometimes this process does not occur, and the lymphatic tissue continues to enlarge.

Thus, hyperplasia of the lingual tonsil can reach such a size, occupying the space between the root and the pharynx (posterior wall), resulting in a foreign body sensation.

Hypertrophic processes can last up to 40 years, the cause of which is most often a hereditary developmental anomaly. Symptoms of enlarged tonsils include difficulty swallowing, a feeling of additional formation in the oral cavity, a change in voice timbre, the appearance of snoring and frequent periods of lack of breathing (apnea).

Hyperplasia of the lingual tonsil during physical activity is manifested by noisy bubbling breathing. A cough that occurs for no reason is dry, loud and often leads to laryngospasm. Drug therapy does not bring improvement, so the cough has been bothering me for years.

In some cases, bleeding is observed due to hacking cough due to the pressure of the enlarged gland on the epiglottis and irritation of the nerve endings.

It is generally accepted that the nasopharyngeal tonsils are involved in the body’s immune defense mainly up to 3 years of age. The proliferation of lymphatic tissue is provoked by frequent childhood illnesses, for example, measles, cold viral diseases or scarlet fever.

Hyperplasia of the nasopharyngeal tonsil is also observed in children living in houses with poor living conditions (high humidity, insufficient heating) and receiving poor nutrition. As a result, the body loses its protective abilities and is subject to aggression from infectious agents, which leads to inflammatory processes in the respiratory organs.

Depending on the size of the tonsils, there are 3 degrees of proliferation. When the adenoids cover the top of the plate (vomer) that forms the nasal septum, it is worth talking about the first degree. If the vomer is closed by 65%, this is the second, and by 90% or more, this is the third degree of enlargement of the tonsils.

Hyperplasia of the nasopharyngeal tonsil is manifested in the baby by almost constant nasal congestion with strong discharge that closes the nasal passages. As a result, there is a violation of local blood circulation in the nasal cavity and nasopharynx with the further development of the inflammatory process.

The baby's mouth may be open, the lower jaw droops, and the nasolabial folds are smoothed out. In the future, this can cause facial deformation.

Hyperplasia of the pharyngeal tonsil

In relation to the other glands of the pharyngeal ring, it is the pharyngeal one that develops the fastest. Its increase in size most often occurs before the age of 14, especially in infancy.

Hyperplasia of the pharyngeal tonsil is a sign of lymphatic diathesis. In addition, a hereditary predisposition to its hypertrophy is possible, but do not underestimate poor nutrition, frequent hypothermia and exposure to viral pathogens.

In some cases, chronic inflammation of the glands is the trigger for their hyperplasia, since the lack of proper treatment leads to an increase in lymphatic tissue cells to carry out the protective function of the body.

Hyperplasia of the pharyngeal tonsil is characterized by difficulty in nasal breathing, which contributes to the constant opening of the mouth to perform the act of breathing. As a result, sometimes even by facial expression one can suspect the desired diagnosis, because in addition to the open mouth, there is a raised upper lip, the face is slightly elongated and swollen, and visually it seems that the child has a reduced intellectual level.

Due to the lack of physiological nasal breathing, the brain suffers from a lack of oxygen in the form of hypoxia. In addition, periods of apnea at night become more frequent. In the morning the baby looks sleep deprived, which manifests itself in whims and tearfulness during the day.

The oral mucosa is dry, and cold air entering the larynx and trachea contributes to the development of a hoarse voice with the appearance of a cough. In addition, with hyperplasia, prolonged rhinitis with a complication - sinusitis, as well as otitis and tubotympanitis is observed.

Among the general manifestations, it is necessary to note the possibility of an increase in temperature to low-grade levels, decreased appetite, psycho-emotional lability and cognitive impairment (deterioration of memory and attention).

Tonsils are a collection of lymphatic tissue compactions; these tissues perform the functions of the immune defense of our body. There are several types of tonsils in the human body, they are distinguished by location. Depending on the age and development of the body, some tonsils practically atrophy. And some can cause diseases such as lingual tonsil hyperplasia or pharyngeal tonsil hyperplasia.

Causes of the disease

If negative factors influence the tonsils, they lose their protective function and infectious processes begin in them. An activated infection provokes an increase in the size of the tissues of the tonsils, which leads to a deterioration in the patency of the larynx, and this, in turn, makes breathing difficult. Further development of the process can cause hypoxia, which affects the brain. It can also cause frequent diseases of the respiratory tract and lungs. Tonsil hyperplasia can be caused by a viral pathogen, allergic exposure, as well as chlamydial or mycoplasma infection.

Treatment of hyperplasia in the early stages is carried out using medications. It is recommended to relieve swelling and inflammation with anti-inflammatory drugs. The infection itself is treated with antibiotics. In case of insufficient effect of treatment or its absence, surgical intervention is recommended. To increase effectiveness, local immunostimulating drugs are prescribed for prevention. Why does tonsil hyperplasia occur?

Hyperplasia is characteristic mainly of children, but sometimes the disease occurs at an older age and for various reasons:

The cause of the disease may be mechanical damage to the throat. In this case, in addition to the tonsils themselves, the larynx or mouth is also damaged.
Thermal damage can be caused by exposure to boiling water or aggressive substances. Acid or alkali causes a chemical burn to the throat. In this case, you must immediately contact a medical facility.
Another provoking cause is sometimes a foreign body that damages the lymphatic tissue during a meal (fish bone, sharp bone fragments).
It is worth remembering the general condition of the body, its immune resistance to various types of infections, since it is this that responds to the aggression of surrounding factors.
The disease can be provoked by prolonged exposure to low temperatures on the throat when breathing through the mouth, frequent inflammatory diseases of the respiratory system, including echoes of childhood diseases.

Indirect reasons for the occurrence of hyperplasia of the pharyngeal tonsil are considered to be poor nutrition, poor environment, and the influence of bad habits that reduce the body's defenses. Also an important role in enlarged tonsils is played by disturbed hormonal balance, lack of vitamins and increased background radiation. The beginning of the development of tonsil hyperplasia is the activation of immature lymphatic cells.

Symptoms and diagnosis

Considering that increased growth of lymphatic tissue is more often observed in children, the main thing for parents is to detect the problem, followed by contacting a specialist. Timely diagnosis will completely stop the subsequent growth of the tonsils and eliminate the further development of complications.

Often the disease occurs with inflammation of not just one type, but several, for example, the pharyngeal and lingual tonsils. Therefore, the symptoms of the disease have a wider range of manifestations, in contrast to the enlargement of one tonsil. When palpated, the tonsils are often of medium density or soft; they acquire a yellow or reddish tint.

During the active phase of the disease, enlarged tonsils interfere with the normal process of breathing and the passage of food. As a result, breathing problems occur, especially during periods of sleep or rest. When forming speech, minor problems appear, such as voice distortion, unintelligible speech and incorrect pronunciation. Impaired breathing prevents the full supply of oxygen to the lobes of the brain, which can lead to hypoxia. Apnea occurs due to relaxation of the pharyngeal muscles. In addition, problems with the ears appear; otitis media and hearing impairment due to tubular dysfunction may develop.

In addition to the listed manifestations, complications in the form of colds are possible; this is caused by inhaling cold air while constantly breathing through the mouth. Otitis media can cause systematic hearing loss and other diseases of the middle ear.

In children, the lingual tonsil develops systematically until adolescence; it is located in the area of the root of the tongue. After 15 years, it begins the reverse process and is divided into two parts. It happens that this does not happen, but the lymph cells continue to grow. Thus, tonsil hyperplasia enlarges and grows between the root of the tongue and the pharynx, which creates the sensation of a foreign body.

Such processes can last up to 40 years due to the development of a hereditary anomaly. Symptoms of enlarged lingual tonsils include difficulty swallowing, a sensation of formation behind the tongue, distortion of the voice timbre, the appearance of snoring and apnea. Hyperplasia of the tonsil during exercise is manifested by bubbling, unreasonable coughing and uncharacteristic noise. Drug treatment does not always help, so symptoms may persist for years. In certain cases, bleeding occurs due to irritation of the nerve endings of the larynx.

Treatment options

Treatment of tonsil hyperplasia must begin with treatment with antibiotics and anti-inflammatory drugs.
The use of local steroid drugs is allowed, which makes it possible to avoid adenotomy (only in the absence of true hyperplasia).
In difficult cases, adenotomy is performed, after which prophylaxis with immunostimulating drugs is recommended.

The first two methods are effective in the early stages of the disease and in the presence of strong immunity in humans. In the case of such treatment, the basis is a local effect on the mucous membrane of the nasopharynx and tonsils using drugs with a wide range of effects on the bacterial flora. The most common method is surgery, or adenotomy.

Adenatomy is also often used for recurrent otitis media and infectious diseases of the upper respiratory tract, in order to eliminate foci of chronic infection. Unfortunately, such actions do not always solve problems of the nose and ear, because the removal of pharyngeal tonsils disrupts the mucous membrane of the upper respiratory tract. Considering this, surgical intervention is suitable only in the presence of true hyperplasia of 2-3 degrees.

Methods for preventing the disease

Considering the reasons for the development of tonsil hyperplasia, it is worth identifying the main preventive directions that make it possible to avoid the disease or sharply reduce the likelihood of its occurrence. Prevention of hyperplasia is based on ensuring favorable living conditions. This means cleanliness in the home, optimal humidity and temperature. It is also necessary to adhere to proper nutrition, since the lack of a complex of vitamins and minerals sharply reduces the protective function of the human body.

Make sure to dress warmly during the cold season, monitor breathing through your nose so that cold air does not enter the nasopharynx, but passes through the nose well moistened and warmed. Strengthening the body through hardening and physical exercise has a great effect on the condition of the nasopharynx. It is also advised to periodically visit health facilities, carrying out complex procedures, taking vitamins and minerals.

Prevention of hyperplasia involves timely treatment of respiratory diseases, acute respiratory and inflammatory processes. If you have the first signs of the disease, you must consult a specialist in order to start therapy in a timely manner and exclude surgical intervention or chronic pathology. Gargling with cool water and sea salt has a positive effect on disease prevention. Since the occurrence of hyperplasia is typical at an early age, it is advisable to harden children.

The nasopharyngeal tonsil is a peripheral organ of the human immune system. It is represented by lymphoid tissue, where mature lymphocytes multiply, protecting the body from infections. Pathological processes within it can cause frequent sore throats, snoring, tonsil hyperplasia and chronic tonsillitis. To check the condition and monitor the pharyngeal tonsil, contact an ENT specialist, as well as an immunologist.

The amygdala is an important peripheral organ of the human immune system.

Location

This gland is unpaired and is located in the mucous membrane of the pharynx and nasal sinuses. It is on the periphery of the digestive and respiratory system that the greatest accumulation of harmful microorganisms that enter with air or food is noted. Therefore, such a compact arrangement, together with the palatine tonsils, helps the body cope quite effectively with germs and viruses. It happens that the tonsil slightly increases in size due to various reasons, which leads to difficult airway patency and rhinolalia.

Structure

The pharyngeal tonsil has a porous surface and consists of several fragments of the mucosa, transversely located and enveloped in multilayered epithelium. It has peculiar cavities (lacunae) in the amount of 10-20 pieces, which are designed to filter microorganisms that get inside. The deepest lacuna is called the “pharyngeal bursa” (Lyushka).

But under the influence of certain factors, pathogenic microorganisms can begin to multiply in the area of lacunae, which leads to the occurrence of chronic tonsillitis. On the entire surface of the gland there are follicles that produce lymphocytes. They enter the circulatory system thanks to a dense network of capillaries passing at the base of the lacunae.

Hyperplasia of the nasopharyngeal tonsil

Hyperplasia (increase in size) of the gland is called adenoiditis. This is one of the most common abnormalities in children. The proliferation of adenoids occurs in early preschool age and up to 15 years, but cases of the disease occur in both adults and one-year-old children.

Adenoids can be either single or represented by a branched conglomerate. They are located at the base of the mucous membrane of the nasopharynx and nasal sinuses. They are an oval, soft to palpation, of irregular shape and pink color with longitudinal slits dividing each fragment into 2-3 parts.

With adenoiditis, the symptoms are pronounced and are presented in the form of snoring, difficulty in nasal breathing, constant discharge from the nasal cavity, hearing impairment and frequent inflammatory processes in the nasopharynx. Another symptom is chronic rhinitis.

Congestive hyperemia in the mucous membrane of the gland and in the surrounding soft tissues leads to chronic hypoxia and oxygen starvation of the brain, which can even lead to a delay in the development of the child. Patients suffering from this kind of illness often suffer from viral and bacterial infections, since the overgrown gland can no longer cope with its function normally and, instead of protecting itself, it becomes a permanent source of infection.

Inflammation of the nasopharyngeal tonsil

Inflammation of the tonsil (nasopharyngeal tonsillitis or acute adenoiditis) is provoked by a viral or microbial infection and begins with a rise in temperature, which can range from 37.5-39.5 °, and a feeling of dryness and sore throat.

The symptoms are similar to purulent and catarrhal tonsillitis, in which a whitish coating is noted on the surface of the tonsils, only pain and inflammation are localized behind the soft palate. In such cases, the patient will feel the accumulation of secretion behind the walls of the sky, which is difficult to cough up. In acute adenoiditis, inflamed lymphoid tissue can block the passages of the pharyngeal-tympanic tube, which can lead to inflammation of the middle ear. There is a sharp deterioration in nasal breathing in a vertical position and its virtual absence in a horizontal position of the body.

At the onset of the disease, a runny nose, paroxysmal cough, mainly at night, and a feeling of congestion in the ears are noted. Quite often, such inflammation becomes the cause of stenosing laryngitis. With proper treatment, the disease lasts about 5 days. Young children often experience digestive system disorders in the form of vomiting and loose stools.

The gland has many nerve endings, so its inflammation is often painful for the patient. It is supplied with arterial blood from branches of the carotid artery and transmits lymphocytes to the body. In case of pathology of the nasopharyngeal tonsil in the form of purulent tonsillitis, the danger is the breakthrough of abscesses with the possible development of sepsis or meningitis caused by streptococcus.

Surgery to remove the third tonsil

The decision to perform this type of operation is made by the doctor, after weighing the pros and cons when conservative treatment methods do not bring the desired results. Direct indications for surgical intervention are:

frequent sore throats;
critically difficult nasal breathing;
complications from internal organs.

The nasopharyngeal tonsil is removed under general anesthesia through the oral cavity. It is usually recommended to be observed in the hospital for another 6 days after the operation, but the use of radiosurgical methods minimizes the occurrence of side effects, and the patient can be discharged home within a few hours after recovery from anesthesia for home observation.

After surgery, the patient needs to stay at home for at least three days. On the first day, you definitely need cold drinks and warm, soft food. Side effects requiring re-hospitalization are:

nose bleed;
bleeding from the mouth;
temperature increase over 38°.

The third (or pharyngeal) tonsil, which is part of the conglomerate of nasopharyngeal tonsils (palatine and lingual), is designed to protect a person from pathogenic microorganisms penetrating from the external environment. However, under the influence of a number of factors, it can grow and become inflamed, undermining protection and reducing immunity. If there is no desired result from conservative treatment, surgical intervention is recommended. Thanks to modern technologies and qualified doctors, both children and adults can be relieved of problems such as snoring, chronic runny nose, constantly difficult breathing, rhinolalia and frequent inflammation in the larynx in one day.

Hypertrophy of pharyngeal lymphoid tissue(mainly nasopharyngeal and palatine tonsils) is not accompanied by a violation of its function.

Prevalence. It is usually observed in children aged 3-10 years. Hypertrophied lymphoid tissue undergoes physiological involution and decreases during puberty. Pathological hypertrophy of the lymphoid tissue - hypertrophy of the adenoids occurs more often in children aged 2 to 8 years. Hypertrophy of the palatine and pharyngeal tonsils is characteristic of young children as a manifestation of general hyperplasia of lymphoid tissue and the body's defense reactions.

What provokes / Causes of Hypertrophy of the lymphoid tissue of the pharynx:

Hypertrophy of lymphoid tissue in response to an infectious disease leads to an increase in inflammatory processes in the pharynx. While maintaining its function, hypertrophied lymphoid tissue can, however, cause pathological changes in the nose, ears and larynx.

Hypertrophy of the tonsils is promoted by acute respiratory diseases, and latent infection in the lacunae causes further fibrous degeneration, and, under certain circumstances, chronic tonsillitis.

As a result of impaired nasal breathing due to hyperplasia of the nasopharyngeal tonsil, the gas composition of the blood changes, ventilation of the lungs is weakened, hypoxemia and hypercapnia occur. Impaired oxygenation of organs leads to organ failure. The number of red blood cells and the amount of hemoglobin in the blood decreases, the number of leukocytes increases. The functions of the gastrointestinal tract are disrupted, the function of the liver, thyroid gland and adrenal cortex is reduced. Metabolism is disrupted, the child's growth slows down and sexual development is delayed.

Pathogenesis (what happens?) During Hypertrophy of the lymphoid tissue of the pharynx:

Adenoids (adenoidis), or hyperplasia of the pharyngeal tonsil, degree I - the tonsils cover the upper third of the vomer; II degree - cover half of the vomer; III degree - cover the vomer completely, reaching the level of the posterior end of the inferior nasal concha.

Symptoms of Hypertrophy of pharyngeal lymphoid tissue:

With severe hypertrophy (the palatine tonsils converge along the midline and serve as an obstacle to breathing and swallowing), coughing at night and snoring are noted; difficulty speaking, incorrect pronunciation of some consonants; difficulty eating.

Adenoids in most children form the adenoid type of face (habitus adenoideus): apathetic expression and pallor of the face; half-open mouth; smoothness of nasolabial folds; slight exophthalmos; drooping of the lower jaw.

The formation of facial bones is disrupted, the dentofacial system develops incorrectly, especially the alveolar process of the upper jaw with its narrowing and wedge-shaped protrusion anteriorly; the narrowing and high standing of the sky is pronounced (Gothic sky); the upper incisors are incorrectly developed, protrude significantly forward and are located randomly.

Children's growth slows down, speech formation is disrupted, children lag behind in physical and mental development. The voice loses sonority, nasality appears; decreased sense of smell. Enlarged adenoids interfere with normal breathing and swallowing. Nasal discharge with a constant runny nose causes irritation of the skin of the vestibule of the nose and upper lip. Restless sleep, with an open mouth, accompanied by snoring. Absent-mindedness, weakening of memory and attention affect school performance. Inhaling unpurified cold air through the mouth leads to sore throat, chronic tonsillitis, laryngotracheobronchitis, pneumonia, and less often to dysfunction of the cardiovascular system. Stagnant changes in the mucous membrane of the nasal cavity with impaired aeration of the paranasal sinuses and the outflow of secretions from them contribute to their purulent damage. Closure of the pharyngeal opening of the auditory tubes is accompanied by decreased hearing and the development of recurrent and chronic diseases of the middle ear.

At the same time, the general condition of children is disturbed. Irritability, tearfulness, and apathy are noted. Malaise, pale skin, decreased nutrition, and increased fatigue appear. A number of symptoms are caused not only by difficulty in nasal breathing. They are based on a neuro-reflex mechanism. These are psychoneurological and reflex disorders (neuroses): epileptiform seizures; bronchial asthma; bed-wetting; obsessive cough; tendency to spasms of the glottis; visual impairment.

The overall immune reactivity of the body decreases, and adenoids can also be a source of infection and allergization. Local and general disorders in the child’s body depend on the duration and severity of difficulty in nasal breathing. During puberty, the adenoids undergo reverse development, but the resulting complications remain and often lead to disability.

Diagnosis of Hypertrophy of pharyngeal lymphoid tissue:

Indirect signs of adenoids are also hypertrophy of the palatine tonsils and lymphoid elements on the posterior wall of the pharynx.

Differential diagnosis. When differentially diagnosing hyperplasia of the palatine tonsils, it is necessary to keep in mind the enlargement of the palatine tonsils in leukemia, lymphogranulomatosis, and lymphosarcoma.

Adenoid growths must be differentiated from angiofibroma of the nasopharynx (it is characterized by density, uneven surface, increased bleeding), choanal polyp (has a smooth surface, grayish color, lateral location on a pedicle, comes from one choana), hypertrophy of the posterior ends of the inferior nasal conchae, which cover the choanae from the side of the nasal cavity, and the nasopharyngeal vault remains free, a cerebral hernia (has a smooth surface, grayish-bluish color, comes from the upper wall of the nasopharyngeal vault).

Treatment of Hypertrophy of pharyngeal lymphoid tissue:

For hypertrophy of the palatine tonsils, physical methods, climatic and restorative treatment are used.

If there is a sharp increase in the palatine tonsils and conservative therapy is unsuccessful, they are partially removed (tonsillotomy), in most cases simultaneously with the removal of the adenoids.

The operation is performed on an outpatient basis under local anesthesia. After applying a tonsillotome to the part of the tonsil protruding from behind the arches, it is fixed with a fork and quickly removed. The postoperative regimen and prescriptions are the same as after adenotomy. The disadvantages of tonsillotomy include incomplete removal of the tonsil, especially when hyperplasia and inflammation of the tonsil are combined. The most common complications include bleeding, suppuration of the surgical wound, cervical lymphadenitis, and injury to the soft palate.

Conservative treatment of adenoids is usually ineffective, and the physiotherapeutic procedures used in this case help to stimulate their growth. Timely removal of the adenoids (adenotomy) eliminates the irritating effect of infected mucus from the nasopharynx on the tonsils, nasal breathing is restored, which often leads to shrinkage of the tonsils.

Indications for adenotomy: frequent colds, severe disruption of nasal breathing, hypertrophy of the II and III degrees of adenoids (and if the ear is affected, also grade I adenoids, since it is necessary to free the mouth of the auditory tube), recurrent and chronic tracheobronchitis, pneumonia, bronchial asthma, recurrent and chronic diseases of the paranasal sinuses, hearing loss, secretory, recurrent and chronic otitis media, speech impairment, psychoneurological and reflex disorders (enuresis, epileptiform disorders).

Contraindications to adenotomy: acute infectious diseases, their precursors or contact with patients with childhood infections.

After a sore throat, an acute respiratory disease, surgery can be done after 1 month, after the flu - after 2 months, after a preventive vaccination - after 2-3 months, after chicken pox - after 3 months, after rubella, scarlet fever - after 4 months, after measles, whooping cough , mumps, infectious mononucleosis - after 6 months, after infectious hepatitis - after 1 year (after a blood test for bilirubin), after meningitis - after 2 years.

Contraindications are also blood diseases (acute and chronic leukemia, hemorrhagic diathesis, immune hemopathy), carriage of toxigenic measles, non-bacteria diphtheria, acute diseases of the ENT organs or exacerbation of chronic diseases, acute diseases of internal organs or exacerbation of chronic diseases, decompensated conditions in diseases of the heart, kidneys , liver and lungs; dental caries, thymogaly, pharyngeal vascular abnormalities.

Before the operation, children undergo examination, the minimum of which ensures the safety of the operation: general blood test, coagulation, bleeding time, tests to detect HIV, Australian antigen; Analysis of urine; dental sanitation, throat and nasal smear to identify toxigenic corynebacterium diphtheria bacilli; pediatrician's conclusion on the possibility of surgical intervention; lack of contact with infectious patients.

The child is prescribed drugs that increase blood clotting.

The operation is performed in a one-day hospital setting, under local anesthesia, using a ring-shaped knife - Beckmann's adenotome. Basket adenotome is also used.

The adenotom is inserted into the nasopharynx strictly along the midline, then moved upward and anteriorly to the posterior edge of the nasal septum, and the upper edge of the instrument is pressed against the dome of the nasopharynx. In this case, the adenoid tissue enters the adenoid ring (Fig. 4.3, see color insert). The adenoid is quickly and sharply moved anteriorly and downward, cutting off the adenoids.

In children, adenoid growths are often combined with hypertrophy of the palatine tonsils. In these cases, tonsillotomy and adenotomy are performed simultaneously.

After 3 hours, if there is no bleeding after a follow-up examination, the child is discharged home with a recommendation of a home regimen, a gentle diet, and taking blood clotting agents and sulfonamide drugs.

In recent years, endoscopic adenotomy under anesthesia has been introduced into practice, under conditions of suspended pharyngoscopy with visual control of an endoscope inserted into the posterior sections of the nasal cavity.

With adenotomy, the following complications are possible: anaphylactic reaction to an anesthetic, bleeding. The severity of bleeding after adenotomy is assessed by the level of hemoglobin, hematocrit, blood pressure and pulse. If there is bleeding after adenotomy, a repeat adenotomy is performed to remove remnants of the adenoids, and general and local hemostatic measures are carried out.

Complications also include suppuration of the surgical wound with the development of regional lymphadenitis, retropharyngeal, parapharyngeal abscess, mediastinitis, sepsis, asphyxia during aspiration of a removed adenoid, injury to the soft palate with the subsequent development of its paralysis and symptoms of dysphagia and dysphonia, injury to the root of the tongue, which is usually accompanied by severe bleeding, aspiration pneumonia.