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Adenoids hypertrophy (adenoid vegetations)

Adenoids hypertrophy (adenoid vegetations)

The term "adenoidal vegetations" was first proposed by a Danish doctor Meyer in 1873. He published a monograph "About adenoidal vegetations in the nasopharynx", in which he gave a detailed description of the anatomy and histological structure, clinical symptoms of adenoidal hypertrophy, highlighted their leading role in the development of the pathological process, especially in children. This was the beginning of work on this issue.

Adenoids hypertrophy (adenoid vegetations) — is abnormal proliferation of lymphoid tissue, normally always present in the nasopharynx, located in its vault or on the transition arch in the rear wall and constituting (in addition to the two palatinal tonsils) third (pharyngeal) tonsil (tonsilla pharyngea). However, in rare cases of adenoidal hypertrophy may be located on the rear wall of the nasopharynx. Adenoids is a common disease among children from one year to fifteen years. In order to examine the nasopharyngeal tonsil, the ENT requires special tools and video installation. Currently, there is a tendency to identify adenoids in children at an earlier age.

Adenoids location in the nasopharynx (in children).

In modern medical practice, widespread methods of surgery for adenoidal hypertrophy and adenoiditis — removal of the adenoid tissue (adenoidectomy) using surgical instruments.

The implementation of this surgical intervention provided by different designs adenotome, the most widespread of which got more than 100 years ago Beckman's adenotome.

However, the implementation of adenotomy (inflammated adenoids removal surgery) using Beckman's adenotome often leads to aspiration of incised lymphadenoid tissue pieces and blood by patient (due to overshoot them through the adenotomes window) that can cause serious complications, including asphyxia, followed by tracheostomy.

In addition, with the introduction of the working part of the body with a curved fenestrated knife into the nasopharynx (during the adenoids removal operation) possible injury of the soft tissues (palatine tonsils, back arches, uvula, soft palate).

The need for additional introduction of a Kocher clamp to remove the incised tissue lengthens surgery time, creates additional complexity and inconvenience to the ENT doctor and the conditions for the occurrence of unwanted gag reflex in patients.

Complications caused by adenoidal hypertrophy in a child

Complications caused by adenoid hypertrophy in a child include:

  1. Frequent colds. The presence of adenoids impedes nasal breathing and creates favorable conditions for the development of infection and occurrence of inflammation and infection.
  2. Violation of the middle ear physiology. The human ear communicates with the nasopharynx through the Eustachian tube. The entrance to the auditory tube is located in the vicinity of the location of the adenoids. If the child has enlarged adenoids, they close the entrance of the auditory tube. As a result, the child often suffers from ear infections and hearing loss.
  3. Chronic foci of infection. Enlarged nasopharyngeal tonsil (adenoids) is usually in a state of chronic inflammation and is the background for the development of infectious-inflammatory and allergic diseases.
  4. Violation of the facial skeleton. Prolonged violation of nasal breathing in the presence of adenoids in a child impaired teeth and facial skeleton growth.
  5. Violation of the vocal apparatus - twang (rhinolalia).
  6. Reducing working capacity. When the nose breathing is difficult, there is a constant lack of oxygen. Therefore, children with adenoids, less attentive and badly learn.
  7. Frequent respiratory tract inflammatory diseases. The growth of adenoid tissue leads to chronic inflammation with a constant release of mucus and pus, that drips through the nasopharynx and into the trachea, which causes a throat disease – pharyngitis, tracheitis, bronchitis and asthma. Typically, after removal of the adenoids asthma attacks diminish or disappear altogether.

 

Adenoidal hypertrophy treatment in children and adults

Adenoidal hypertrophy treatment in children and adults in the case of adenoiditis (inflammation of the adenoid tissue) may be conservative and surgical.

 

Non-surgical treatment of adenoidal hypertrophy

The first step is conservative (non-surgical) treatment of adenoids. Only when тon-surgical treatment inefficiency is held adenoids vacuum removal or laser photodestruction.

Non-surgical treatment of adenoidal hypertrophy is carried out using antiseptic, homeopathic solutions with an admixture of silver solutions by vacuum aspiration sanitation. These methods of treatment of adenoids are efficient, pain-free and have no contraindications.

 

Endoscopic adenoidectomy using vacuum suction

The most effective method of treatment of adenoids — surgery. The quality of the operation (adenoids removal) depends on the skill of the surgeon (ENT doctor).

In our clinic vacuum adenoidectomy carry out with endoscopic control. This allows completely remove the adenoid tissue. It is advisable to adenotomy (adenoids removal surgery) in children after four years, but when indicated - at any age.

Anesthesia for surgery to remove the adenoids: local anesthesia or general anesthesia. The most effective method of anesthesia — narcosis. Vacuum adenotomy has a number of advantages over the conventional adenotomies method. When vacuum adenotomy none of those complications, which happen in the normal adenotomy (excision with fenestrated knife).

Tool for adenoidectomy with endoscopic control in children.