Tonsils and Adenoids
Tonsils and Adenoids
Definition of Tonsils and Adenoids
Tonsils and adenoids are the elements of Waldeyer's lymphatic ring which settled in oral and nasopharyngeal region. Both are play role in immunity against airborne microorganisms which inhaled through the mouth and nose.
The tonsils are located on both sides of the back of the throat. The other names of adenoid are pharyngeal tonsil and nasopharyngeal tonsil. This lymphatic tissue is situated posterior of the nasal cavity, the roof of the nasopharyngeal area.
The eustachian tubes is opened to the nasal cavity in this region.
Why Tonsils and Adenoid Enlarged?
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| Why Tonsils and Adenoid Enlarged? |
Tonsils and adenoid can grow depending on the recurrent infections and genetic causes. Living in crowded environments (such as kindergarten), exposure to cigarette smoke, atopy can be facilitated to lymphatic tissue growth. Although extremely rare, cancer sometimes causes enlarged tonsils or adenoids.
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| Kissing Tonsils |
In the above photo, in a patient with enlarged tonsils, it is seen that the tonsils are in contact with each other (kissing tonsils) and there is little airway gap between the tonsils.
Symptoms of Enlarged Tonsils and Adenoid
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| Symptoms of Enlarged Tonsils and Adenoid |
The tonsils and adenoid are settled on the airways. Most enlarged tonsils and adenoids cause no symptoms. However, when they grow up in addition to breathing problems, ear and sinus related problems also can be seen.
Enlarged tonsils and adenoids may cause the following problems:
- Chronic ear infections and hearing loss: These problems result from blockage of the eustachian tube and fluid accumulation in the middle ear.
- Recurrent sinus infections
- Obstructive sleep apnea
- Discomfort when talking and breathing
- Difficulty swallowing
- Severe respiratory distress (in young infants)
- Bad breath
- Sleeping with your mouth open
- Sweating during sleep
- Daytime sleepiness / Decrease in sleep quality
- Decrease in school performance (for children)
- Increased risk of traffic accidents (for adults)
- Swollen lymph nodes (glands) in the neck
- Nose sounds "blocked" when the person speaks
- Noisy breathing during the day
- Decreased sense of smell or taste
In adults, enlargement of the tonsils and adenoid can cause to adverse effects on the cardiovascular system in long time (Source: Cor Pulmonale: A Disorder Stemming From Pulmonary Hypertension).
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| In the photo above, a child with a newly recovered tonsillitis infection belongs to the patient. It is observed that the tonsils are hypertophic and there are still white areas on both tonsils. |
Negative Effects of Adenotonsillar Hypertrophy on Child Personality and Behavior
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| Negative Effects of Adenotonsillar Hypertrophy on Child Personality and Behavior |
Adenotonsillar hypertrophy have been thought to significantly relate with children's growth and learning capability.
This happens in children with tonsil and adenoid hypertrophy mainly in two ways:
First, adenotonsillar hypertrophy can lead to obstructive sleep apne syndrome (OSA) in children and OSA can lead to behavioral disturbances and learning deficits in children by different mechanisms.
Second, adenoid hypertrophy can cause to serous otitis media and hearing loss in children. Therefore, a decrease in school performance, perception difficulties and irritability can occur in these children.
Tonsillar Asymmetry
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| Tonsillar Asymmetry |
Symptoms of tonsil cancer are very similar to symptoms of strep throat. indication for tonsillectomy will be emerged if the increase in the unilateral tonsillar size detected. In this case the patient should contact to an ear, nose and throat specialist. Parotid tumors rarely can also cause medial displacement of the tonsil thus tonsillar asymmetry.
Adenotonsillar Hypertrophy and Sleep Apnea Video
In the video above, a baby with adenotonsillar hypertrophy has difficulty in breathing, forced position change, snoring and fluttering movements while lying on his back. In this way, as a result of the narrowing of the airways during sleep, a decrease in the oxygen level, the secretion of stress hormone, an increase in blood pressure during sleep and an increase in the heart rate occur in the patients. If hypertrophy of adenoids and tonsils is not treated, an increased risk of cardiovascular disease may occur in the long term. The collapse of the respiratory tract here causes the onset of oxidative stress. Recurrent episodes of split or intermittent sleep and wakefulness occur, such as transitioning to deep sleep and transitioning from deep sleep to superficial sleep, or waking up, changing body position during sleep. Babies with narrow airways may also have symptoms such as sweating under the neck and chin, sweating from the mouth, salivation, and reflux-related odor in the mouth, which mothers notice. Unlike patients with adult sleep apnea syndrome, daytime sleepiness may not be very evident in infants with sleep apnea syndrome.
Source Links :
Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul
Private Office:
Address: İncirli Cad. No:41, Kat:4 (Dilek Patisserie Building), Postal code: 34147, Bakırköy - İstanbul
Appointment Phone: +90 212 561 00 52
Appointment Phone: +90 212 561 00 52
Fax: +90 212 542 74 47
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