bubble_chart Overview

Pharyngeal tonsil hypertrophy, also known as adenoid vegetation, refers to the pathological hyperplasia and enlargement of the pharyngeal tonsil, often caused by pharyngeal infections and repeated inflammatory stimuli. It is more common in cold, humid, and climatically variable regions. Childhood acute infectious diseases, malnutrition, and constitutional factors can also trigger this condition. Although it is a childhood disease, it has a profound impact on normal physical development and health.

bubble_chart Clinical Manifestations

1. Ear symptoms Due to hypertrophy of the pharyngeal tonsil and inflammatory secretions in the nasopharynx abdominal mass, the pharyngeal opening of the Eustachian tube is obstructed, which can lead to non-suppurative or suppurative otitis media, resulting in hearing loss and tinnitus, ear fullness.

2. Nasal symptoms Hypertrophy of the pharyngeal tonsil is often complicated by rhinitis and sinusitis. Patients may experience stuffy nose, runny nose, mouth breathing, drooling, closed nasal speech, and snoring during sleep.

3. Respiratory infection symptoms Due to persistent inflammation, secretions irritate the respiratory mucosa, often causing pharyngitis, tracheitis, and bronchitis. Therefore, patients may exhibit throat discomfort, voice changes, cough with sputum, panting, and low-grade fever.

4. "Adenoid facies" Long-term mouth breathing affects facial bone development, leading to a narrow and elongated maxilla, a high-arched and constricted hard palate. Teeth protrude, dental misalignment, poor occlusion, drooping mandible, thick lips, upturned upper lip, hanging lower lip, downward-slanting outer canthus, and flattened nasolabial folds. Combined with lethargy, dull facial expressions, and sluggishness, this forms the so-called "adenoid facies."

5. Systemic symptoms Mainly manifest as chronic toxic symptoms and neuroreflex symptoms. These include poor nutritional development, pigeon breast, anemia, emaciation, low-grade fever, indigestion, easy lack of strength, headache, poor concentration, restless, irritability, nocturnal teeth grinding, enuresis, etc.

6. Local examination May reveal pharyngeal congestion with inflammatory purulent secretions on the posterior pharyngeal wall. Digital examination of the nasopharynx may detect soft lymphoid tissue masses on the posterior nasopharyngeal wall without bleeding. Enlarged lymph nodes may be palpable in the neck. {|105|}

bubble_chart Diagnosis

Diagnosis is straightforward based on medical history, symptoms, and physical signs. Pediatric fiber nasopharyngoscopy, lateral X-ray imaging of the nasopharynx, or CT scans can aid in diagnosis. It is important to differentiate it from nasopharyngeal tumors such as lymph fleshy tumors.

bubble_chart Treatment Measures

1. General Treatment Pay attention to nutrition, prevent common cold, and improve the body's immunity, such as injecting placental globulin, common bletilla tuber, transfer factor, etc. Use 0.5% Ephedrine nasal drops to alleviate stuffy nose symptoms. Actively treat the disease causes of sexually transmitted diseases. If accompanied by hypertrophic tonsils, consider performing a tonsillectomy first. As age increases, the pharyngeal tonsils gradually atrophy, so the condition may improve or symptoms may completely disappear.

2. Surgical Treatment For severe nasopharyngeal obstruction symptoms with poor response to general treatment and hearing impairment, a pharyngeal tonsillectomy should be performed as early as possible. Before surgery, conduct a thorough examination to rule out contraindications. Prior to removal, insert the index finger into the nasopharynx to assess the size and extent of the pharyngeal tonsils and check for abnormal vascular pulsations. Then, under general anesthesia, use a pharyngeal tonsillectome or pharyngeal tonsil curette to remove the pharyngeal tonsils along the posterior wall of the nasopharynx. During the procedure, ensure no residual tissue is left and avoid injury to the tissues around the eustachian tubes.