Adenoids
Adenoids, or nasopharyngeal tonsils, are masses of soft tissue located in the upper throat behind the nose and are part of the lymphatic system, which plays a crucial role in the body's immune response. They help defend against infections, especially in children aged three to four, when they are at their largest and most active. As children grow, adenoids typically shrink and may even disappear. However, they can become enlarged, a condition known as adenoid hypertrophy, which can lead to breathing difficulties, sleep disturbances, and changes in facial structure due to excessive mouth breathing. Infections can also occur, causing conditions like adenoiditis, which may result in recurrent sinusitis and ear infections. Treatment options include antibiotics for infections or surgical removal (adenoidectomy) in more severe cases. While adenoidectomies were once common, they are now generally reserved for serious instances due to concerns about potential impacts on a child's immune development. Nonetheless, the procedure remains a recommendation for children suffering from chronic infections and associated complications.
Adenoids
Also known as: Pharyngeal tonsils, nasopharyngeal tonsils
Anatomy or system affected: Ears, immune system, lymphatic system, mouth, nose, throat
Definition: A type of tonsil, part of the lymphatic system.
Structure and Functions
The nasopharyngeal tonsils, usually referred to as adenoids when swollen, are a mass of soft tissue in the nose-mouth area. Along with the palatine tonsil and the lingual tonsil, they belong to the lymphatic system, part of the body’s immune system. Adenoids lie in the back of the nasal passage and above the pharynx, which is the uppermost part of the throat.
Much like lymph nodes, the lymphoid tissue of the adenoids wards off infection and are part of the body’s first line of defense against bacteria that enter through the mouth and nose. They are largest in children, particularly those of three to four years of age, which is the period when humans are most susceptible to respiratory infection. Afterward, the adenoids slowly shrink and may even disappear.
Disorders and Diseases
In the process of fighting infection, the adenoids can become enlarged, sometimes with a diameter of greater than forty millimeters (one and a half inches). This condition is called adenoid hypertrophy. In such cases, the mass may prevent breathing through the nose, obstruct the eustachian tube, and cause snoring, soreness, change in the voice, and sleep apnea. Excessive mouth breathing, in turn, can lead to changes in the facial structure of children (called adenoid facies), such as an elongated face and pinched nostrils. The enlarged adenoids may also harbor chronic infection, or adenoiditis, that fosters recurrent sinusitis and ear infections. In rare cases, cancer may cause the adenoids to swell.
Physicians may treat infected adenoids with a penicillin-derived drug. In the case of penicillin allergy or intractable infection, the adenoids can be removed surgically in an adenoidectomy, which is usually concurrent with the removal of the other tonsils in a tonsillectomy. Lasting about thirty minutes, it is usually an outpatient procedure and leaves patients with a sore throat for about a week.
Perspective and Prospects
Adenoidectomies were once routine, but that began to change in the 1980s. Pediatricians worried that removal of the adenoids could retard development of a child’s immune system, and so the procedure came to be reserved for severe cases of adenoiditis. Still, in the 2020s, when a child sufferers from chronic ear infections, sinus infections, and sleep problems, the procedure is recommended.
Bibliography
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