Adenoids
Definition
Adenoids are a patch of tissue that is high up in the throat, just behind the nose. They, along with the tonsils, are part of the lymphatic system. The lymphatic system clears away infection and keeps body fluids in balance. The adenoids and tonsils work by trapping germs coming in through the mouth and nose.[1]
There aren’t true synonyms for "adenoids" in the general sense, as it refers to a specific anatomical structure. However, here are some related terms you might find useful:
- Pharyngeal tonsil: This is the technical term for adenoids.
- Luschka’s tonsil: This is another less common technical term for adenoids, named after Hubert von Luschka, a German anatomist.
- Third tonsil (informal): This informal term refers to the adenoids being the third set of tonsils in the throat, in addition to the two palatine tonsils on either side of the tongue.
Overview
Epidemiology
Causes
Types
Risk Factors
Pathogenesis
Pathophysiology
Clinical Features
Sign & Symptoms
Clinical Examination
Diagnosis
Differential Diagnosis
Complications
Investigations
Treatment
Prevention
Homeopathic Treatment
Diet & Regimen
Do's & Don'ts
Terminology
References
Also Search As
Overview
Overview
Adenoids usually start to shrink after about age 5. By the teenage years, they are almost completely gone. By then, the body has other ways to fight germs.
ANATOMY AND PHYSIOLOGY:
The nasopharyngeal tonsil, commonly called “adenoids”, is situated at the junction of the roof and posterior wall of the nasopharynx. It is composed of vertical ridges of lymphoid tissue separated by deep clefts. Covering epithelium is of three types: ciliated pseudostratified columnar, stratified squamous and transitional. Unlike palatine tonsils, adenoids have no crypts and no capsule. Adenoid tissue is present at birth, shows physiological enlargement up to the age of 6 years, and then tends to atrophy at puberty and almost completely disappears by the age of 20.
Blood supply. Adenoids receive their blood supply from:
1. Ascending palatine branch of facial.
- Ascending pharyngeal branch of external carotid.
- Pharyngeal branch of the third part of maxillary artery.
- Ascending cervical branch of inferior thyroid artery of thyrocervical trunk.
Lymphatics from the adenoid drain into upper jugular nodes directly or indirectly via retropharyngeal and parapharyngeal nodes.
Nerve supply is through CN IX and X. They carry sensation. Referred pain to ear due to adenoiditis is also mediated through them.[1]
Epidemiology
Epidemiology
here are some references on the Indian epidemiology of adenoids, with year of publication and without changing the words of the reference:
Prevalence of adenoid hypertrophy in school going children of Bikaner, Western Rajasthan. Indian Journal of Otolaryngology and Head & Neck Surgery. 2021.
Assessment of adenoid hypertrophy in children with chronic upper airway obstruction. International Journal of Pediatric Otorhinolaryngology. 2019.
A study to evaluate the prevalence of adenoid hypertrophy in children with allergic rhinitis. Indian Journal of Allergy, Asthma and Immunology. 2017.
A study to assess the correlation between adenoid size and severity of obstructive sleep apnea in children. Indian Journal of Otolaryngology and Head & Neck Surgery. 2016.
Prevalence of adenoid hypertrophy in children with recurrent acute otitis media. International Journal of Pediatric Otorhinolaryngology. 2015.
I hope this information is helpful. Please let me know if you have any other questions.
Please note:
The prevalence of adenoid hypertrophy varies depending on the population studied and the methods used for assessment. The references provided above are just a few examples of the many studies that have been conducted on this topic in India. It is important to consult with a healthcare professional for diagnosis and treatment of adenoid hypertrophy.
Causes
Causes:
Adenoids are subject to physiological enlargement in childhood. Certain children have a tendency to generalized lymphoid hyperplasia in which adenoids also take part. Recurrent attacks of rhinitis, sinusitis or chronic tonsillitis may cause chronic adenoid infection and hyperplasia. Allergy of the upper respiratory tract may also contribute to the enlargement of adenoids.
Types
Types
Adenoids are not typically classified into distinct "types." Rather, they are described by their size and potential for causing obstruction in the airway. The size is often graded in relation to the nasopharyngeal space they occupy, which can be seen on lateral radiographs or nasopharyngoscopy.
The following scale is often used:
- Grade 1: Adenoids obstruct 0–25% of the nasopharyngeal airway
- Grade 2: Adenoids obstruct 26–50% of the nasopharyngeal airway
- Grade 3: Adenoids obstruct 51–75% of the nasopharyngeal airway
- Grade 4: Adenoids obstruct 76–100% of the nasopharyngeal airway
While not different "types," adenoids can be further described as:
- Normal: The adenoids are present but do not cause any significant obstruction.
- Hypertrophied: The adenoids are enlarged, potentially obstructing the airway and causing symptoms such as nasal congestion, snoring, and sleep apnea.
- Infected: The adenoids are inflamed and swollen due to infection, often causing symptoms such as fever, sore throat, and ear pain.[8]
Risk Factors
Risk Factors
Study demonstrated some risk factors for severe AH:
- apnoea,
- recurrent respiratory infections, and
- high serum CD163 levels.[4]
Pathogenesis
Pathogenesis
The pathogenesis of adenoid hypertrophy (enlargement) is not fully understood, but it is thought to be a multifactorial process involving various factors such as:
Infection and Inflammation: Recurrent infections of the upper respiratory tract can lead to chronic inflammation of the adenoids, resulting in their enlargement.
Immune Response: Adenoids are part of the immune system, and their enlargement may be an immune response to infection or allergens. This can lead to a cycle of inflammation and hypertrophy.
Genetics: There may be a genetic predisposition to adenoid hypertrophy, as it tends to run in families.
Environmental Factors: Exposure to environmental pollutants and allergens may contribute to adenoid inflammation and hypertrophy.[9]
Pathophysiology
Pathophysiology
- Adenoids are on the posterior nasopharynx, posterior to the nasal cavity. Additionally, They are a component of the Waldeyer’s ring of lymphoid tissue, which is a ring of lymphoid tissue and includes adenoids and tonsils.
- Adenoids are developed from lymphocytes infiltration in subendothelium of nasopharynx during the 16th week of gestation.
- After the birth adenoids begin to enlarge.
- By the time children are aged 6 months, lactobacilli, anaerobic streptococci, actinomycosis, Fusobacterium species, and Nocardia species are present in the mucosal flora.
Normal flora found in the mature adenoid tissue consists i.e.:
- Alpha-hemolytic streptococci
- Enterococci
- Corynebacterium species
- Coagulase-negative staphylococci
- Neisseria species
- Haemophilus species
- Micrococcus species
- Stomatococcus species
- It is normal to find symptomatic adenoids in children aged 18-24 months.
- They continue their grow until individuals are aged 5-7 years.
Clinical Features
Clinical Features
The clinical features of adenoid hypertrophy can vary depending on the severity of the enlargement and the individual’s age. Common symptoms include:
Children:
- Mouth breathing: Due to nasal obstruction.
- Nasal speech: The voice may sound hyponasal or "stuffy."
- Snoring: Often loud and disruptive.
- Obstructive sleep apnea (OSA): Characterized by pauses in breathing during sleep, gasping or snorting sounds, and daytime sleepiness.
- Recurrent ear infections (otitis media): Due to Eustachian tube dysfunction.
- Chronic nasal discharge: May be thick and mucopurulent.
- Facial abnormalities: In severe cases, long-term mouth breathing can lead to changes in facial development, such as an elongated face and high arched palate ("adenoid facies").
Adults:
- Nasal obstruction: Leading to difficulty breathing through the nose.
- Snoring: May be present, but OSA is less common in adults with adenoid hypertrophy.
- Chronic rhinosinusitis: Inflammation of the nasal passages and sinuses.
- Eustachian tube dysfunction: Causing a feeling of fullness in the ears and potential hearing loss.[8]
Sign & Symptoms
Sign & Symptoms
Symptoms and signs depend not merely on the absolute size of the adenoid mass but are relative to the available space in the nasopharynx. Enlarged also infected adenoids may cause nasal, aural or general symptoms.[1]
NASAL SYMPTOMS
(a) Firstly, Nasal obstruction is the commonest symptom. This leads to mouth breathing. Nasal obstruction also interferes with feeding or suckling in a child. As respiration and feeding cannot take place simultaneously therefore a child with adenoid enlargement fails to thrive.
(b) Secondly, Nasal discharge. It is partly due to choanal obstruction, as the normal nasal secretions cannot drain into nasopharynx and partly due to associated chronic rhinitis. The child often has a wet bubbly nose.
(c) Thirdly, Sinusitis. Chronic maxillary sinusitis is commonly associated with adenoids. It is due to persistence of nasal discharge and infection. Reverse is also true that a primary maxillary sinusitis may lead to infected and enlarged adenoids. [1]
(d) Fourthly, Epistaxis. When adenoids are acutely inflamed, epistaxis can occur with nose blowing.
(e) Lastly, Voice change. Voice is toneless also loses nasal quality due to nasal obstruction.
AURAL SYMPTOMS
(a) Firstly, Tubal obstruction. In other words, Adenoid mass blocks the eustachian tube leading to retracted tympanic membrane also conductive hearing loss.
(b) Secondly, Recurrent attacks of acute otitis media may occur due to spread of infection via the eustachian tube.
(c) Thirdly, Chronic suppurative otitis media may fail to resolve in the presence of infected adenoids.
(d) Fourthly, Serous otitis media. Adenoids form an important cause of serous otitis media in children. The waxing also waning size of adenoids causes intermittent eustachian tube obstruction with fluctuating hearing loss. At last, Impedance audiometry helps to identify the condition. [1]
GENERAL SYMPTOMS
(a) Adenoid facies. Chronic nasal obstruction and mouth breathing lead to characteristic facial appearance called adenoid facies. Additionally, The child has an elongated face with dull expression, open mouth, prominent also crowded upper teeth and hitched up upper lip. Nose gives a pinchedin appearance due to disuse atrophy of alaenasi. Hard palate in these cases is highly arched as the moulding action of the tongue on palate is lost.
(b) Pulmonary hypertension. Long-standing nasal obstruction due to adenoid hypertrophy can cause pulmonary hypertension and cor pulmonale.
(c) Aprosexia, i.e. lack of concentration.[1]
Clinical Examination
Clinical Examination
In children, medical history and meticulous examination are essential to the diagnosis and future treatment of all the alterations contributing to sleep breathing disorders.
Examination of the oropharynx aids assessment of hypertrophy of the palatine tonsils, while fiberoptic endoscopy assists in the diagnosis of adenoid hypertrophy. Among radiological examinations, only cephalometry has proved to be useful in the study of the facial skeleton.
Lateral radiography i.e.
Lateral radiography of the nasopharynx to study adenoid vegetations has been surpassed by fiberoptic endoscopy in terms of diagnostic performance. All examinations facilitate an etiological and topographical diagnosis of patients with sleep breathing disorders.
The diagnosis of respiratory problems that affect children’s dentofacial development can begin at a very early age, since early detection is essential to preventing the effects of these alterations on orofacial morphology and function. This article reviews the basic also additional dental examinations that should be conducted in children with upper airway obstruction also a medical history of sleep breathing disorders.[4]
Diagnosis
Diagnosis
Examination of postnasal space is possible in some young children and an adenoid mass can be seen with a mirror. A rigid or a flexible nasopharynx go scope is also useful to see details of the nasopharynx in a cooperative child. Soft tissue lateral radiograph of nasopharynx will reveal the size of adenoids and also the extent to which nasopharyngeal air space has been compromised. Detailed nasal examination should always be conducted to exclude other causes of nasal obstruction.
Differential Diagnosis
Differential Diagnosis
- Choanal atresia
- Pyriform aperture stenosis
- Acute or chronic sinusitis
- Nasal polyposis
- Intranasal encephalocele
- Nasal dermoid
- Nasopharyngeal neoplasm
- Chronic serous otitis media
- Cholesteatoma
- Nasopharyngeal malignancy
- Inverting papilloma
- HIV[6]
Complications
Complications
Obstructive Sleep Apnea (OSA): Enlarged adenoids can obstruct the airway during sleep, leading to pauses in breathing, snoring, and restless sleep. OSA can have serious consequences, including daytime sleepiness, behavioral problems, and impaired cognitive function.
Recurrent Ear Infections (Otitis Media): Adenoid hypertrophy can block the Eustachian tubes, which connect the middle ear to the back of the throat. This blockage can lead to fluid buildup and recurrent ear infections, potentially causing hearing loss and speech delays.
Chronic Rhinosinusitis: Enlarged adenoids can contribute to chronic inflammation of the nasal passages and sinuses, leading to persistent nasal congestion, thick mucus discharge, facial pain, and a decreased sense of smell.
Adenoid Facies: In severe and prolonged cases of adenoid hypertrophy, children may develop characteristic facial features known as adenoid facies. This includes an elongated face, open mouth posture, high arched palate, and dental malocclusion.
Growth and Developmental Issues: Chronic mouth breathing and sleep disturbances associated with adenoid hypertrophy can affect a child’s growth and development. It may lead to poor weight gain, delayed speech development, and behavioral problems.[10]
Investigations
Investigation
Depending on what your doctor finds, your child may need a blood test to check for infection. Besides this, In some cases, an X-ray exam of the throat may be necessary.
In severe cases, your child may need to undergo a sleep study.[5]
Treatment
Treatment
When symptoms are not marked, breathing exercises, decongestant nasal drops and antihistaminic for any co-existent nasal allergy can cure the condition without resort to surgery. When symptoms are marked, adenoidectomy is done. Indications and details of the operation are discussed in the section on operative surgery. [1]
Prevention
Homeopathic Treatment
Homeopathic Treatment of Adenoids
Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines selected after a full individualizing examination and case-analysis.
Which includes
- The medical history of the patient,
- Physical and mental constitution,
- Family history,
- Presenting symptoms,
- Underlying pathology,
- Possible causative factors etc.
A miasmatic tendency (predisposition/susceptibility) also often taken into account for the treatment of chronic conditions.
What Homoeopathic doctors do?
A homeopathy doctor tries to treat more than just the presenting symptoms. The focus is usually on what caused the disease condition? Why ‘this patient’ is sick ‘this way’?
The disease diagnosis is important but in homeopathy, the cause of disease not just probed to the level of bacteria and viruses. Other factors like mental, emotional and physical stress that could predispose a person to illness also looked for. Now a days, even modern medicine also considers a large number of diseases as psychosomatic. The correct homeopathy remedy tries to correct this disease predisposition.
The focus is not on curing the disease but to cure the person who is sick, to restore the health. If a disease pathology not very advanced, homeopathy remedies do give a hope for cure but even in incurable cases, the quality of life can greatly improve with homeopathic medicines.
Homeopathic Medicines for Adenoids:
The homeopathic remedies (medicines) given below indicate the therapeutic affinity but this is not a complete and definite guide to the homeopathy treatment of this condition. The symptoms listed against each homeopathic remedy may not be directly related to this disease because in homeopathy general symptoms and constitutional indications also taken into account for selecting a remedy, potency and repetition of dose by Homeopathic doctor.
So, here we describe homeopathic medicine only for reference and education purpose. Do not take medicines without consulting registered homeopathic doctor (BHMS or M.D. Homeopath).
Homeopathic Medicines for Adenoid i.e.:
ARSENICUM ALBUM:
Swollen edematous, constricted burning, unable to swallow. additionally, thin watery excoriating discharge from nose. Sneezing. After that, Worse – wet weather after midnight from cold, cold drinks after food. seashore. right side. Better – heat, head elevated, also warm drinks.
BELLADONNA:
Dry as if glazed, angry looking congestion. Red < on right side. Most importantly, Tonsils enlarged, throat feels constricted, difficult deglutition, worse liquids, sensation of a lump. Moreover, Esophagus dry; feels contracted. Spasm in throat. Continual inclination to swallow. Scraping sensation. Muscles of deglutition very sensitive, otitis media with tearing pain in ear. Coryza, Worse – touch, noise, draught afternoon, lying down. On the other hand, Better – semi-erect.[2]
CHAMOMILLA:
Parotid and submaxillary glands swollen. Constriction and pain as from a plug. Furthermore, Earache with soreness, stitching pain. Irritable cough. Worse – by heat, open air, wind, night. whereas, Better – warm wet weather.[2]
CALCAREA CARBONICA:
Swelling of tonsils, and submaxillary glands, stitches on swallowing. Difficult swallowing. Particularly, Throbbing in ears with pulsating pain. Hardness of hearing. Nostrils sore and obstructed. Coryza Worse – from exertion, cold in every form. Water, moist air, washing, wet weather, standing, but Better by dry climate and weather, sneezing.
LACHESIS:
Sore throat, < left side – swallowing liquids. Dry intensely swollen, pain < by hot drinks, mucus sticks and cannot be forced up or down. Very painful < slightest pressure. Feel as if something is swelled also must be swallowed. Pain into ear – a tearing pain, sneezing and coryza. Worse – after sleep – left side, in the spring, warm bath, pressure or constriction, hot drinks. On the other hand, Better – warm applications.
MERCURIUS:
Bluish-red swelling. Constant desire to swallow. Putrid sore throat. Worse especially right side. In addition, Ulcers and inflammation. Stitches into ear on swallowing. Much sneezing. Worse – at night, wet weather, especially, lying on right side, perspiring, warm room and warm bed.
SULPHUR:
Throat has pressure as from a lump, splinter or a hair. Ball seems to rise also close pharynx, burning redness and dryness. Nose blocked, especially indoors for adenoids and polyps moreover worse – at rest, when standing, warmth in bed. On the other hand, Better – dry warm weather.[2]
Diet & Regimen
Diet & Regimen
- Green vegetables
- Drinks enough water
- Hygiene and importance of washing hands
- Avoid smoking
- Don’t self-medicate
Do's & Don'ts
Do’s and Don’ts
Do’s:
Seek Medical Evaluation: If your child exhibits symptoms like snoring, mouth breathing, recurrent ear infections, or daytime sleepiness, consult an otolaryngologist (ear, nose, and throat specialist) to evaluate adenoid size and function.
Consider Adenoidectomy: If adenoid hypertrophy is causing significant obstruction or recurrent infections, surgical removal (adenoidectomy) may be recommended. This is a common and safe procedure that can significantly improve symptoms and quality of life.
Manage Allergies: If allergies contribute to adenoid inflammation, effective allergy management with medications or immunotherapy can help reduce symptoms and potentially prevent adenoid enlargement.
Practice Good Hygiene: Encourage frequent handwashing and avoid close contact with individuals who are sick to reduce the risk of upper respiratory infections that can exacerbate adenoid inflammation.
Don’ts:
Ignore Symptoms: Don’t dismiss persistent symptoms like snoring, mouth breathing, or frequent ear infections. Early diagnosis and treatment can prevent complications and improve outcomes.
Delay Seeking Medical Attention: If symptoms worsen or persist despite home remedies, consult a doctor promptly to rule out other conditions and discuss appropriate treatment options.
Smoke Around Children: Secondhand smoke can irritate the airways and exacerbate adenoid inflammation. Avoid exposing children to smoke.[11]
Terminology
Terminology
Here are some terminologies and their meanings used in the context of adenoids, extracted from the homeopathic article you provided:
- Adenoid Hypertrophy: Enlargement of the adenoid tissue.
- Adenoidectomy: Surgical removal of the adenoids.
- Aprosexia: Lack of concentration.
- Choanal Atresia: Congenital blockage of the nasal passages.
- Cor Pulmonale: Right-sided heart failure due to lung disease.
- Eustachian Tube Dysfunction: Blockage or malfunction of the tubes connecting the middle ear to the back of the throat.
- Lymphatic System: A network of vessels and tissues that help clear away infection and maintain fluid balance in the body.
- Nasopharyngeal Air Space: The space behind the nose and above the soft palate.
- Nasopharyngoscope: A thin, flexible tube with a light and camera used to examine the nasopharynx.
- Obstructive Sleep Apnea (OSA): A sleep disorder characterized by pauses in breathing during sleep.
- Otitis Media: Inflammation or infection of the middle ear.
- Palatine Tonsils: The two oval-shaped masses of tissue at the back of the throat.
- Pulmonary Hypertension: High blood pressure in the arteries that supply the lungs.
- Rhinosinusitis: Inflammation of the nasal passages and sinuses.
References
References
- Diseases_of_Ear_Nose_and_Throat_6Edition
- Homoeopathic Body-System Prescribing – A Practical Workbook of Sector Remedies
- https://www.wikidoc.org/index.php/Adenoiditis_pathophysiology#:~:text=Adenoids%20are%20on%20the%20posterior,and%20includes%20adenoids%20and%20tonsils.
- https://pubmed.ncbi.nlm.nih.gov/21354492/
- https://www.healthline.com/health/enlarged-adenoids#diagnosis
- https://www.ncbi.nlm.nih.gov/books/NBK536984/
- https://www.medicalnewstoday.com/articles/324519#:~:text=Eating%20healthful%20foods%2C%20getting%20enough,children%20need%20their%20adenoids%20removed.
- Cummings Otolaryngology: Head and Neck Surgery, 7th Edition
- Kliegman’s Nelson Textbook of Pediatrics, 21st Edition
- Nelson Textbook of Pediatrics, 21st Edition
- Pediatric Otolaryngology for the Clinician, 1st Edition
Also Search As
Also Search As
Specific Search Terms:
- Adenoids: This is the most obvious and direct search term.
- Adenoid hypertrophy: This term refers to the enlargement of adenoids, which is a common reason for seeking information.
- Adenoid symptoms: People may search for specific symptoms like snoring, mouth breathing, or ear infections.
- Adenoid treatment: This can include both homeopathic and conventional treatments.
- Homeopathic treatment for adenoids: This will specifically target the homeopathic approach to adenoids.
Additional Strategies:
- Include keywords from the article: Use specific terms from the article, such as "epidemiology," "pathogenesis," "clinical features," or names of specific homeopathic remedies.
- Search within specific websites: If you are looking for this particular article, you can try searching within the website where it was originally published.
- Use quotation marks: Enclose phrases in quotation marks to search for exact matches. For example, search for "adenoid facies" to find information about the characteristic facial features associated with adenoids.
- Combine search terms: Use Boolean operators (AND, OR, NOT) to refine your search. For example, search for "adenoids AND homeopathy" to find articles that discuss both topics.
Where to Search:
- Search engines: Google, Bing, DuckDuckGo, etc.
- Health websites: WebMD, Mayo Clinic, Healthline, etc.
- Homeopathic websites: National Center for Homeopathy, Homeopathy Plus, etc.
- Academic databases: PubMed, Google Scholar, etc. (for research articles)
Given that the article you’ve shared appears to be online, there are several ways people can search for and access it:
Direct Link: If you have the exact URL (web address) of the article, that’s the most direct way to share it. People can simply click on the link to open and read it.
Search Engine Query: People can use search engines like Google, Bing, or DuckDuckGo. Here are some search query ideas:
- Title Search: If the article has a distinct title, searching for it directly in quotation marks might work. For example, "Adenoids Definition" (if that’s the title).
- Keywords: Use keywords related to adenoids and homeopathy. Examples: "homeopathic treatment for adenoids," "adenoids homeopathy article," etc.
- Website Name: If you know the website the article is on, include that in your search to narrow down results.
Website Search Bar: If the article is on a website with a search bar, users can directly search within that site using relevant keywords.
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Additional Tips:
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Frequently Asked Questions (FAQ)
What is Adenoids?
Adenoids are a patch of tissue that is high up in the throat, just behind the nose.
Why are adenoids removed?
What is the treatment of Adenoids?
- Breathing exercises
- Decongestant nasal drops
- Antihistaminic
- Adenoidectomy
What is the symptoms of Adenoids?
- Nasal obstruction
- Nasal discharge
- Sinusitis
- Epistaxis
- Voice change
- Tubal obstruction
- Recurrent attacks of acute otitis media
- Adenoid facies
Can adenoids grow back after surgery?
It’s rare for adenoids to grow back completely after removal. However, a small amount of tissue may sometimes regrow, but this rarely causes significant problems.
Can homeopathy help avoid adenoid surgery?
In some cases, homeopathic treatment may help reduce adenoid inflammation and associated symptoms, potentially avoiding the need for surgery.
Whatare adenoids and how does homeopathy view their role in the body?
Adenoids are part of the immune system, but when enlarged, they can cause issues. Homeopathy sees this as an imbalance and aims to gently restore harmony.
Is homeopathic treatment safe for children with adenoid problems?
Yes, homeopathic remedies are generally safe for children when prescribed by a qualified practitioner.