Adenoid hypertrophy
Introduction
Introduction to adenoid hypertrophy The adenoid body is also called the pharyngeal tonsil or proliferative body. It is located at the top of the nasopharynx and the posterior pharyngeal wall. It belongs to the lymphoid tissue and has an orange petal surface. Adenoids, like tonsils, grow up with age as they grow older, and proliferate at 2-6 years of age, and gradually shrink after 10 years of age. Adenoidal mastoid adenoids undergo pathological hyperplasia due to repeated stimulation of inflammation, which causes symptoms of nasal blockage and mouth breathing, especially at night, and sleep snoring and restless sleep. Children often turn over from time to time. Obviously, apnea may occur when severe. basic knowledge The proportion of illness: the incidence rate is about 0.005% - 0.007% Susceptible people: children Mode of infection: non-infectious Complications: malnutrition
Cause
Adenoid hypertrophy
Inflammatory factors (50%):
The common cause of this disease is inflammation, such as acute and chronic rhinitis, tonsillitis, influenza and other recurrent episodes, causing pathological hyperplasia of adenoids. It causes aggravation of nasal obstruction and hinders nasal drainage. The secretion of rhinitis and sinusitis stimulates the adenoid to continue to proliferate, forming a vicious circle of mutual causality.Genetic factors (20%):
The disease also often has a family history. Polygenic genetic diseases are caused by the combination of genetic factors and environmental factors. Among them, the magnitude of the effect of genetic factors can be measured by heritability. Heritability is the contribution of genetic factors in the formation of polygenic diseases.Prevention
Adenoid hypertrophy prevention
1, can not be underestimated for adenoid hypertrophy. Early detection, early treatment, when the child has poor hearing or frequent nasal congestion, runny nose, think about the disease that may not only be the ear or nose, but also check for adenoid hypertrophy.
2. In daily life, parents should pay special attention to children's colds and other situations. Especially when children are 2-10 years old, prevention should be improved, such as avoiding children with long-term colds, runny nose, stuffy nose, cough, rubbing nose, rubbing eyes, sneezing and other symptoms, if accompanied by poor hearing, obvious snoring, etc. Symptoms should go to the hospital for diagnosis and treatment.
Complication
Adenoid hypertrophy Complications malnutrition
A small number of chronic nasal obstruction, long-term hypoxia and pulmonary heart disease, and even acute heart failure, prolonged adenoid hypertrophy, the child's nose becomes flat, the nose is not well developed, the eye distance is widened, the mouth is breathing, the facial expression is sluggish , showing a special adenoid face, when the child's physical development and mental development are greatly affected.
Symptom
Adenoid hypertrophy symptoms common symptoms chest tightness adenoid face sputum cough mouth breathing movement disorder expression dull
(A) local symptoms: children with adenoid hypertrophy after occlusion of the nostrils and eustachian tube pharynx, can occur otolaryngeal and other symptoms, manifested as a mouth breathing when sleeping, tongue roots often snoring, night sputum restless, nasal secretion More, there is an occlusive nasal sound when speaking, the voice is vague, due to long-term mouth breathing, resulting in facial bone development disorders, maxillary bone lengthening, hard sputum high arch, dentition is not complete, upper incisor exposed, thick lips, facial lack of expression, dementia Performance, the formation of "adenoid face", between the swallowing and breathing between the joint movement disorders, often cough, secretions downstream stimulation of the respiratory mucosa, susceptible to tracheitis, due to obstruction of the eustachian tube is likely to cause suction caused by non-suppurative otitis media Decreased, the tympanic membrane is invaginated.
(B) systemic symptoms: often have systemic nutrition and developmental disorders, mainly manifested as chronic poisoning reflex neurological symptoms, such as slow expression, chest tightness, poor lung expansion, long-term chicken chest or flat chest, a small number of chronic nasal obstruction, Long-term hypoxia and pulmonary heart disease, and even acute heart failure.
Examine
Adenoid hypertrophy
(1) The child has a mouthful of breathing, sometimes showing a typical "adenoid face".
(2) Oropharyngeal examination showed that the hard palate was high and narrow, and the visceral wall saw viscous secretions flowing down from the nasopharynx, mostly accompanied by hypertrophy of the tonsil.
(3) The anterior nasal examination showed a large amount of secretions in the nasal cavity, and the mucosa was swollen.
(4) Fiber nasopharyngoscopy A lobular lymphoid tissue with longitudinal fissures on the top and posterior wall of the nasopharynx is seen, like a half peeled small orange. Often blocked more than two-thirds of the nostrils. This is currently the most common method of adenoid examination.
(5) Nasopharyngeal lateral radiograph measurement: The degree of obstruction of the nasopharyngeal airway can be measured.
(6) Palpation with a finger for nasopharyngeal palpation, which can be soft and lumpy on the apical and posterior wall of the nasopharynx.
(7) CT: CT axial image shows that the nasopharyngeal air cavity is deformed narrowly, the posterior wall soft tissue is thickened, and the density is uniform.
Diagnosis
Diagnosis and differentiation of adenoid hypertrophy
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis
(1) Nasopharyngeal carcinoma: The age of onset is relatively large, and there is a history of sputum with bloodshot. CT examination shows the soft tissue shadow of the posterior pharyngeal wall thickening. The left and right sides are more asymmetrical, the asymmetry of the pharyngeal recess disappears, and the parapharyngeal space is blurred. , narrowed or even occluded, may have skull base bone destruction,
(2) posterior pharyngeal wall abscess: more pharyngeal foreign body stab wound history, local thickening soft tissue shadow is more extensive, can be seen in the nasopharynx, oropharynx, throat and anterior vertebrae, uneven density, visible low-density abscess Shadow, visible air shadow in the abscess, enhanced examination can be seen that the abscess wall is more uniform and obvious enhancement,
(3) pharyngeal cyst: located between the left and right head long muscles, round gas or liquid low-density stove, the edge is clear.
