hypertrophy

Introduction

Introduction to proliferative hypertrophy Proliferative hypertrophy is a common disease in children due to repeated episodes of acute or subacute inflammation of the nasopharynx, causing pathological hypertrophy of the lymphoid follicles of the proliferator and the nasopharyngeal mucosa. Proliferative hypertrophy often coincides with chronic tonsillitis. The disease occurs in cold and humid areas. Proliferative hypertrophy is a pathological hyperplasia of the proliferator. The proliferator is also called adenoid or pharyngeal tonsil. It is the lymphoid tissue at the top of the nasopharynx. It gradually enlarges after birth and reaches its maximum level at about 6 years old. It gradually degenerates at the age of 10 years. . Generally, when the adenoid is hypertrophied, the CT axial image shows that the nasopharyngeal air cavity is deformed narrowly, the posterior wall soft tissue is thickened, the density is uniform, and the head long muscle is similar, the left and right sides are symmetrical, and the leading edge is smooth or wavy, protruding into the air cavity. The pharyngeal crypt and the eustachian tube are faintly visible or unclear. After different degrees of obstruction, the nostril gap is clear and the adjacent bone is not damaged. basic knowledge Sickness ratio: 0.1% Susceptible people: children Mode of infection: non-infectious Complications: pharyngeal tonsil hypertrophy

Cause

Proliferative hypertrophy

1, chronic inflammation repeated stimulation to proliferate secondary infection, hypertrophy hypertrophy, more common in children, often with chronic tonsillitis, nasopharyngitis, sinusitis coexist.

2, nasal resistance, runny nose, mouth breathing, snoring when sleeping, can affect the body, intellectual development, sometimes "proliferation face", more serious can occur "chicken chest."

3, blocking the eustachian tube mouth can cause secretory otitis media.

4, due to inflammatory secretions, can be associated with laryngitis, bronchitis, pneumonia and gastrointestinal disorders.

Prevention

Proliferative hypertrophy prevention

In normal people, at the age of 3-4, the proliferating body is very large, not morbid, and often shrinks and disappears after puberty. For example, after 5 years of age, proliferative hypertrophy and obvious clinical symptoms are often the root cause of many diseases in pediatrics and otolaryngology. Such as proliferative hypertrophy, nasal obstruction and sinus drainage blocked, can induce rhinitis and sinusitis and make it worse, and because of increased sinusitis secretions stimulate the proliferation of body to make the proliferator more hypertrophy, so the two are causal, forming Vicious circle.

Therefore, patients with proliferative hypertrophy and more obvious symptoms should be treated early. After 5 years of age, the sooner you perform surgery, the better. Symptoms can be significantly improved or disappeared, and developmental and nutritional status can be normal.

Complication

Proliferative hypertrophy Complications pharyngeal tonsil hypertrophy

Proliferative hypertrophy may cause pharyngeal tonsil hypertrophy and chronic lymphadenitis.

Symptom

Proliferative hypertrophy symptoms Common symptoms Lymph node enlargement Nasal turbinate or middle turbinate hypertrophy tonsil hypertrophy Hearing loss Mental retardation Mental retardation

1, children with nasal congestion, irritating cough, mouth breathing, sleep snoring, sleepless night, mental wilting, mental retardation, hearing loss.

2, proliferating body face: upper lip short thick upturn, mandibular drooping, nasolabial fold disappeared, hard sputum high arch, dentition, stagnation.

3, often accompanied by tonsil hypertrophy and inflammation, turbinate hypertrophy, nasal secretions or purulent secretions from the nasopharynx under the pharyngeal wall.

4, tympanic membrane invagination, adhesion or tympanic effusion. The submandibular and mandibular angles are swollen.

5, refers to the diagnosis of the child's nasopharyngeal top touch soft orange mass lump.

Examine

Proliferation hypertrophy

1. The posterior wall of the nasopharynx has a swollen proliferative body. Using a finger to probe the nasopharyngeal area of the child can touch a soft orange-shaped mass.

2, often accompanied by tonsil hypertrophy and chronic inflammation, nasal swelling, nasal secretions.

3, the maxilla is long and narrow, the hard sac is high arch, the dentition is not aligned, and the mandible is drooping, which is called the proliferative appearance.

4, submandibular lymph nodes or cervical lymph nodes.

5, often accompanied by secretory otitis media, pay attention to the tympana with or without effusion, can do pure tone audiometry and acoustic impedance test.

6, if necessary, for fiber nasopharyngoscopy and nasopharynx X-ray.

7, pay attention to the exception of nasopharyngeal tumors.

Diagnosis

Diagnosis and differentiation of proliferative hypertrophy

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 thickened adenoid hypertrophy in the posterior pharyngeal wall. The asymmetry of the left and right sides is asymmetrical, and the asymmetry of the pharyngeal recess disappears. The side gap is blurred, narrowed or even occluded, and there may be bone destruction of the skull base.

2, posterior pharyngeal wall abscess: more than a history of pharyngeal foreign body stab wound, local thickening soft tissue shadow is more extensive, can be seen in the nasopharynx, oropharynx, throat and anterior vertebral body, density is uneven, visible low-density pus Air shadow can be seen in the abscess, and the enhanced examination can show a more uniform enhancement of the abscess wall.

3, pharyngeal cyst: located in the left and right sides of the long muscles, a circular gas or liquid low-density stove, the edge is clear.

Generally, when the adenoid is hypertrophied, the CT axial image shows that the nasopharyngeal air cavity is deformed narrowly, the posterior wall soft tissue is thickened, the density is uniform, and the head long muscle is similar, the left and right sides are symmetrical, and the leading edge is smooth or wavy, protruding into the air cavity. The pharyngeal crypt and the eustachian tube are faintly visible or unclear. After different degrees of obstruction, the nostril gap is clear and the adjacent bone is not damaged.

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