Enlarged Pharyngeal Tonsils (adenoids) - Causes - Symptoms

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Enlarged Pharyngeal Tonsils (adenoids) - Causes - Symptoms
Enlarged Pharyngeal Tonsils (adenoids) - Causes - Symptoms

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Video: What is Adenoids and Tonsillitis? (Complete Video) 2023, January
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Enlarged Pharyngeal Almond: Causes & Symptoms

The pharynx is located on the roof of the pharynx (epipharynx) and is part of the body's own defense system. In childhood it is often physiologically enlarged - a sign that the immune system is working at full speed in this phase of life. However, excessive enlargement of the pharynx can lead to various symptoms and require surgical removal.

Pharyngeal tonsils are called adenoid vegetations or adenoids for short. Also Rachenmandelhyperplasie or adenoids overgrowth are common names. The term pharyngeal polyps is sometimes used colloquiallyused. However, this is misleading because it is not a question of polyps (tissue growths) in the actual sense, but an enlargement of the pharynx itself.

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  • What is the function of the pharynx?
  • What are the causes of an enlargement of the pharynx?
  • Which symptoms and secondary diseases can occur?

What is the function of the pharynx?

The pharyngeal tonsil (tonsilla pharyngea) is located on the roof of the nasopharynx, in the area behind the nose. It is not visible when the mouth is open. It is included in the so-called Waldeyer throat ring; This also includes the two palatine tonsils (tonsillae palatinae), the tongue tonsil (tonsilla lingualis), the lateral cords in the lateral pharynx wall and isolated lymph follicles on the posterior pharynx wall. All of these structures are made up of lymphoid tissue. Their common task is to protect the upper respiratory tract from pathogens.

This is made possible by their special structure: the surface of the lymphatic organs is laid in innumerable deep folds (so-called crypts), inside are cells of the immune system. Germs and foreign substances that are ingested through food or breathing get caught in the crypts and thus come into direct contact with the immune cells. As a result, various responses from the immune system are triggered, such as the production of antibodies.

Especially in childhood, the immune system is confronted with a multitude of previously unknown substances. It works at high pressure to produce the appropriate immune response to each of these foreign substances. Therefore, the structures of the pharynx are often physiologically enlarged in this phase of life. With increasing age - from about the onset of puberty - they decrease in size again and slowly regress.

Under certain circumstances (such as inflammatory processes) there may be an excessive enlargement (hyperplasia) of individual structures or a delay in natural regression. Depending on which structure of the pharynx is affected, different symptoms arise. In the following, only the enlargement of the pharynx will be discussed.

What are the causes of an enlargement of the pharynx?

The most common cause of almond hyperplasia are repeated infections in the nasopharynx. These lead to inflammatory reactions within the pharynx, which are used for defense. The pharynx increases in size. In the enlarged pharynx, germs can subsequently implant themselves again more easily, which in turn leads to an infection. This creates a vicious circle.

In addition, a diet that is very rich in carbohydrates also seems to favor hyperplasia.

Which symptoms and secondary diseases can occur?

An enlarged pharynx in itself is not a disease and is very common, especially between the ages of two and six years. However, space in the nasopharynx is relatively limited in childhood. An overgrowth of the pharynx can therefore easily lead to a disproportion and cause different complaints.

Difficult nasal breathing

An enlarged pharynx obstructs the nasopharynx and leads to an obstruction of nasal breathing. The nose appears permanently blocked. The affected children develop a nasal language, often suffer from restless sleep and snore. Under certain circumstances, breathing pauses (sleep apnea) can occur. The children are often tired, unable to concentrate and less productive during the day. The appetite is also often reduced.

The misplaced nose causes the children to breathe primarily through their mouths. This results in a typical facial expression with a permanently open mouth and a visible tongue, which is also known as “facies adenoida”. It is often a guideline for the diagnosis of an enlarged pharynx.

Long-term jaw and tooth misalignments can result from permanent mouth breathing. In addition, the mucous membranes of the upper respiratory tract are dried out and the nose does not have a filter function. The susceptibility to infections in the area of ​​the nasopharynx and the bronchial system (e.g. sinusitis, bronchitis) is increased.

Relocation of the tuba auditiva

The connecting duct between the pharynx and ear, the Eustachian tube or Tuba auditiva, is located near the pharynx. A growth of the pharynx can obstruct this connection. As a result, the middle ear is no longer properly ventilated, and a negative pressure develops, as is known from flying, for example. Earache is the common consequence. In addition, it is easier for pathogens from the nasopharynx to penetrate the middle ear, and the children affected are more susceptible to otitis media.

Due to the permanent negative pressure, fluid accumulates behind the eardrum over time, and a so-called tympanic effusion occurs. As a result, the eardrum and ossicles can no longer vibrate sufficiently - the result is hearing loss (sound conduction disorder). If this is not noticed for a long time in small children, speech development disorders can occur.

In general it can be said: the younger the child, the more serious the effects of a pharyngeal tonsil hyperplasia. In adulthood, the pharynx is usually so regressed that it can no longer cause symptoms.

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