Adenoid vegetations: Difference between revisions
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The term '''adenoid vegetation''' (AV) refers to the '''pathological enlargement of the nasopharyngeal tonsil''' (''tonsilla pharyngea''), which occurs most often as a result of chronic rhinosinusitis. It is a childhood disease affecting both sexes. | The term '''adenoid vegetation''' (AV) refers to the '''pathological enlargement of the nasopharyngeal tonsil''' (''tonsilla pharyngea''), which occurs most often as a result of chronic rhinosinusitis. It is a childhood disease affecting both sexes. | ||
'''The nasopharyngeal tonsil''' is also referred to as the so-called '''third tonsil''' (next to the palatine tonsils). It is part of Waldeyer's lymphoepithelial circuit. Its function is to participate in '''the body's defense against infection''' . It is most developed in children aged 4–7 years, after which it gradually involves. | '''The nasopharyngeal tonsil''' is also referred to as the so-called '''third tonsil''' (next to the palatine tonsils). It is part of Waldeyer's lymphoepithelial circuit. Its function is to participate in '''the body's defense against infection'''. It is most developed in children aged 4–7 years, after which it gradually involves. | ||
* If it is '''pure hyperplasia''' , the tonsil is uniformly enlarged and there is no secretion in the nasopharynx. | * If it is '''pure hyperplasia''', the tonsil is uniformly enlarged and there is no secretion in the nasopharynx. | ||
* As for '''the''' '''enlargement caused by infection''' , the enlargement is irregular, the surface of the tonsil is furrowed and covered with secretion, which is also present in the nasopharynx and the nose. | * As for '''the''' '''enlargement caused by infection''', the enlargement is irregular, the surface of the tonsil is furrowed and covered with secretion, which is also present in the nasopharynx and the nose. | ||
== Meaning and development of AV == | == Meaning and development of AV == | ||
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* [[Sleep Apnea|sleep apnea syndrome]] | * [[Sleep Apnea|sleep apnea syndrome]] | ||
* '''[[facies adenoidea]]''' – characteristic facial expression (open mouth, indistinct nasolabial fold, upper lip retraction, exposed upper incisors, flattened cheeks, arched and narrow hard palate – Gothic palate); | * '''[[facies adenoidea]]''' – characteristic facial expression (open mouth, indistinct nasolabial fold, upper lip retraction, exposed upper incisors, flattened cheeks, arched and narrow hard palate – Gothic palate); | ||
* recurrent diseases from colds , [[rhinosinusitis]] ; | * recurrent diseases from colds , [[sinusitis|rhinosinusitis]]; | ||
* recurrent [[mesotitis]] ; | * recurrent [[Classification of otitis media|mesotitis]]; | ||
* [[Hearing Loss|hearing loss]] – an enlarged tonsil covers the mouth of the Eustachian tube, a negative pressure will be created in the middle ear, the eardrum will be pushed in and there will be catarrhal inflammation with exudation; | * [[Hearing Loss|hearing loss]] – an enlarged tonsil covers the mouth of the Eustachian tube, a negative pressure will be created in the middle ear, the eardrum will be pushed in and there will be catarrhal inflammation with exudation; | ||
* may be '''bedwetting''' | * may be '''bedwetting''' | ||
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== Diagnostics == | == Diagnostics == | ||
* anterior [[rhinoscopy]] ; | * anterior [[rhinoscopy]]; | ||
* posterior rhinoscopy; | * posterior rhinoscopy; | ||
* [[endoscopy]] of the nose; | * [[endoscopy]] of the nose; | ||
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== Differential diagnosis == | == Differential diagnosis == | ||
Benign tumors and cysts of the epipharynx, especially '''juvenile angiofibroma''' and '''antrochoanal polyp''', must be differentiated in terms of differential diagnosis . | Benign tumors and cysts of the epipharynx, especially '''juvenile angiofibroma''' and '''antrochoanal polyp''', must be differentiated in terms of differential diagnosis. | ||
== Treatment == | == Treatment == | ||
* '''adenotomy''' - curettage of the nasopharynx with a curette under general inhalation or intubation general anesthesia; endoscopic adenotomy; | * '''adenotomy''' - curettage of the nasopharynx with a curette under general inhalation or intubation general anesthesia; endoscopic adenotomy; | ||
* '''remediation of HCD inflammations ;''' | * '''remediation of HCD inflammations;''' | ||
* '''nose breathing rehabilitation .''' | * '''nose breathing rehabilitation.''' | ||
<noinclude> | <noinclude> | ||
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</noinclude> | </noinclude> | ||
[[Category: | [[Category:Paediatrics]] | ||
[[Category:Otorhinolaryngology]] | [[Category:Otorhinolaryngology]] | ||
Latest revision as of 11:51, 26 March 2023
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The term adenoid vegetation (AV) refers to the pathological enlargement of the nasopharyngeal tonsil (tonsilla pharyngea), which occurs most often as a result of chronic rhinosinusitis. It is a childhood disease affecting both sexes.
The nasopharyngeal tonsil is also referred to as the so-called third tonsil (next to the palatine tonsils). It is part of Waldeyer's lymphoepithelial circuit. Its function is to participate in the body's defense against infection. It is most developed in children aged 4–7 years, after which it gradually involves.
- If it is pure hyperplasia, the tonsil is uniformly enlarged and there is no secretion in the nasopharynx.
- As for the enlargement caused by infection, the enlargement is irregular, the surface of the tonsil is furrowed and covered with secretion, which is also present in the nasopharynx and the nose.
Meaning and development of AV[edit | edit source]
- Lymphatic tissue rich in secretory glands;
- Meaning: participation in the formation of immunity, production of immunoglobulins and lymphocytes, part of the lymphoepithelial barrier;
- Hyperplasia corresponds to the immunobiological activity of childhood (natural hypertrophy from the activity of lymph tissue and the secretory apparatus);
- Hyperplasia is stimulated by stress on the immunological system, poor nutrition, repeated inflammation of the upper respiratory tract, hormonal influences (inflammatory hypertrophy with proliferation of fibrous stroma);
- Greatest between 3 and 5 years of age;
- From the age of 7 it involutes and disappears, but it can persist;
- For the formation of overall immunity, the importance of the nasal tonsil is marginal and it can be replaced by other organs of the Waldeyer circuit;
- The most common infectious focus in children in the ENT area.[1]
Clinical signs[edit | edit source]
- nasal obstruction - children breathe through their mouths (especially during sleep), night snoring, rhinolalia clausa;
- sleep apnea syndrome
- facies adenoidea – characteristic facial expression (open mouth, indistinct nasolabial fold, upper lip retraction, exposed upper incisors, flattened cheeks, arched and narrow hard palate – Gothic palate);
- recurrent diseases from colds , rhinosinusitis;
- recurrent mesotitis;
- hearing loss – an enlarged tonsil covers the mouth of the Eustachian tube, a negative pressure will be created in the middle ear, the eardrum will be pushed in and there will be catarrhal inflammation with exudation;
- may be bedwetting
- mechanical dysphagia and failure to thrive.
Diagnostics[edit | edit source]
- anterior rhinoscopy;
- posterior rhinoscopy;
- endoscopy of the nose;
- audiometry;
- tympanometry.
Differential diagnosis[edit | edit source]
Benign tumors and cysts of the epipharynx, especially juvenile angiofibroma and antrochoanal polyp, must be differentiated in terms of differential diagnosis.
Treatment[edit | edit source]
- adenotomy - curettage of the nasopharynx with a curette under general inhalation or intubation general anesthesia; endoscopic adenotomy;
- remediation of HCD inflammations;
- nose breathing rehabilitation.
Links[edit | edit source]
Related Articles[edit | edit source]
Source[edit | edit source]
- BENEŠ, Jiří. Studijní materiály [online]. ©2007. [cit. 2009]. <http://jirben2.chytrak.cz/materialy/orl_jb.doc>.
References[edit | edit source]
- KLOZAR, Jan, et al. Speciální otorinolaryngologie. 1. edition. Prague : Galén, 2005. 224 pp. ISBN 80-7262-346-X.
- HAHN, Aleš, et al. Otorinolaryngologie a foniatrie v současné praxi. 1. edition. Prague : Grada, 2007. 390 pp. ISBN 978-80-247-0529-3.
- KOŇÁKOVÁ, Blanka. „Třetí mandle“ neboli adenoidní vegetace. Zdravotnické noviny [online]. 2009, vol. 11, p. 69, Available from <https://zdravi.euro.cz/clanek/sestra/treti-mandle-neboli-adenoidni-vegetace-448196>. ISSN ISSN 1214-7664.
- ↑ KOLÍN, Jan. Adenoidní vegetace. Vox Pediatriae [online]. 2003, y. 3, vol. 2, p. 28, Available from <http://www.detskylekar.cz/cps/rde/xbcr/dlekar/2003_vox2.pdf>.
