Hyperplasia of the tonsils

Hyperplasia of the tonsils is most often observed in childhood. In the folds of the mucous glands, accumulation of purulent masses is possible, which cause the development of kidney and heart pathology.

The tonsils are a collection of lymphatic tissue that provides immune protection to the body. There are several types of tonsils, depending on their location. Some of them stop performing their function and practically atrophy.

When exposed to negative factors, the tonsils may lose their ability to protect the body and become a source of infection. When lymphatic tissue grows, the size of the tonsils increases, which can interfere with the normal breathing process. A complication of this is increasing hypoxia, which primarily affects the brain, as well as disruption of the baby's development and frequent viral and bacterial infections.

The increase in the size of the tonsils can be caused by swelling due to an inflammatory reaction to an allergic agent or infection and true hyperplasia. The main causes of tissue growth can be a viral pathogen, physiological processes from 3 to 6 years, as well as chlamydial and mycoplasma infection.

Treatment tactics for hyperplasia primarily involve the use of medications. To reduce swelling and inflammation, it is recommended to use anti-inflammatory drugs, and to kill the infection, antibiotics.

If the enlargement of the tonsils is caused by inflammatory edema without true hyperplasia, you can use the hormonal drug "Nasonex".

If drug therapy is ineffective, the next step is surgical intervention in the form of adenotomy, after which it is necessary to use local immunostimulants, such as IRS-19, for prophylactic purposes. Surgical treatment is used only in the case of hypertrophied tonsils of grade 2 or 3.

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Causes of tonsil hyperplasia

Enlargement of the tonsils is mainly observed in childhood, but cases of their hypertrophy in older age are not excluded. The causes of hyperplasia of the tonsils include a damaging factor, for example, a violation of integrity as a result of a burn or injury. Of course, isolated damage to the tonsils in such cases is unlikely, therefore, in combination with them, the pharynx or oral cavity suffers.

A burn can be observed when swallowing boiling water (thermal effect) or acid, alkali (chemical). Such cases must be treated exclusively in a hospital.

The next provoking factor may be a foreign body, most often a fish bone, which damages the lymphatic tissue during the process of eating, which manifests itself as a stabbing sensation when swallowing.

One should not forget about developmental anomalies and tumor-like neoplasms. The main causes of tonsil hyperplasia are the body's immune response to the impact of environmental factors.

This may be the long-term effect of low temperatures on the tonsils during mouth breathing, infected mucus secreted during a relapse of adenoiditis, frequent inflammatory diseases of the ENT organs, as well as childhood illnesses.

The accompanying background for hyperplasia is poor nutrition, inadequate living conditions and other factors that contribute to a decrease in the body's protective level.

The lymphatic-hypoplastic constitutional anomaly, hormonal imbalance, hypovitaminosis and prolonged exposure to small doses of radiation play an important role in tonsil hypertrophy. The basis for the development of hyperplasia is the activation of lymphoid cell production, namely, increased proliferation of T-lymphocytes (immature).

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Symptoms of tonsil hyperplasia

Since the proliferation of lymphatic tissue is most often observed in children, the main task of parents is to promptly detect the pathological focus and consult a doctor. Early diagnosis will stop further growth of the tonsils and avoid complications.

It is not uncommon for hypertrophy to occur not in one form, but in several at once; for example, hyperplasia of the palatine tonsils is often observed with an increase in the pharyngeal tonsil. Thus, the symptoms of hyperplasia of the tonsils have more manifestations than a single growth.

When palpated, the tonsils may have a dense-elastic or soft consistency, and the color varies from pale yellow to bright red.

A pronounced degree of hypertrophy becomes an obstacle to the normal process of breathing and swallowing. As a result, dysphonia, dysphagia and noisy breathing are observed. With tonsil hyperplasia, it is difficult for a child to form speech, a nasal voice appears, words are slurred and individual letters are mispronounced.

Inadequate breathing contributes to insufficient oxygen supply to the brain, which manifests itself as hypoxia. In addition, the baby may snore in his sleep and cough frequently. Apnea due to obstruction occurs due to relaxation of the pharyngeal muscles.

The ears may be involved in the pathological process with the formation of exudative otitis media as a result of hearing impairment due to tubular dysfunction.

In addition to the main manifestations of tonsil hypertrophy, complications may develop in the form of frequent colds, which is caused by the baby inhaling cold air as a result of breathing through the mouth. Otitis media, in turn, can lead to persistent hearing loss.

Tonsil hyperplasia in children

Hypertrophy of lymphatic tissue is based on the activation of cell proliferation processes due to the impact of an unfavorable provoking factor. Due to the increased work of the lymphatic system in childhood, an increase in tissue volume with the development of hyperplasia is observed.

Children very often suffer from attacks of infectious agents, such as flu, scarlet fever, measles or whooping cough, so hypertrophy is a compensatory process in the body. In most cases, tonsil hyperplasia in children is observed up to 10 years of age.

It is worth noting that hyperplasia does not have signs of inflammation, so swelling and hyperemia are absent in this case, on the contrary, the tonsil is pale yellow.

Depending on the degree of proliferation of lymphatic tissue, it is customary to distinguish several degrees of hypertrophy. Sometimes the tonsils are slightly enlarged, which is not clinically manifested by any symptoms. However, with intensive growth, the baby's voice may change, acquiring a nasal tone, speech, breathing and even sleep.

Thus, hyperplasia of the tonsils can push aside the soft palate and prevent their contraction, which is manifested by hearing impairment. The voice loses its timbre, becomes muffled and incomprehensible, and the breathing process is complicated by an incomplete act of inhalation. As a result, the baby snores in his sleep, and the brain suffers from hypoxia, which can later manifest itself as developmental delays.

Hyperplasia of the tonsils in children is characterized by a soft consistency and a pale, smooth surface when palpated. Numerous follicles are more fragile than usual and close the lacunae without plugs.

Hyperplasia of the palatine tonsils

Moderate enlargement of the tonsils due to the proliferation of lymphatic tissue and in the absence of an inflammatory process in them is more often observed in children. Hyperplasia of the palatine tonsils in them manifests itself as a compensatory process in response to a large number of attacks from infectious agents.

The main threat of hypertrophied tonsils is the complete blockage of the airway. To avoid this, at a certain stage it is necessary to perform surgical removal of part of the organ, which ensures adequate breathing.

Hyperplasia of the palatine tonsils is characterized by an immunoreactive process that occurs in response to the negative impact of environmental factors. In addition, the proliferation of lymphatic tissue is facilitated by breathing through the mouth in the presence of enlarged adenoids.

As a result of adenoiditis, increased secretion of infected mucus is possible, which affects the tonsils. Hypertrophy is also promoted by infectious diseases, allergies and frequent inflammatory processes in the nasal cavity and oropharynx.

Among the accompanying factors, it is worth highlighting unsuitable living conditions for the baby, poor nutrition with insufficient amounts of vitamins, hormonal imbalance due to thyroid or adrenal pathology, as well as small radiation doses that have an effect for a long time.

Enlarged tonsils are characterized by a pale pink color, smooth surface, formed lacunae and loose consistency. They protrude slightly from the anterior palatine arches. Babies experience coughing, difficulty swallowing and breathing.

Speech impairment occurs due to disturbances in the upper resonator, which manifests itself as a nasal voice. Hypoxic changes in the brain cause restless sleep, insomnia and coughing. At night, periods of no breathing (apnea) are possible due to relaxation of the pharyngeal muscles.

In addition, tubular dysfunction can cause the development of exudative otitis media with further reduction in hearing function.

Hyperplasia of the lingual tonsil

In children, the lingual tonsil is very well developed and is located in the area of the tongue root. From the age of 14-15, its reverse development is observed, as a result of which it is divided into 2 parts. However, sometimes this process does not occur, and the lymphatic tissue continues to increase.

Thus, hyperplasia of the lingual tonsil can reach such a size, occupying the space between the root and the pharynx (back wall), resulting in a sensation of a foreign body.

Hypertrophic processes can continue up to 40 years, the cause of which is most often a hereditary developmental anomaly. Symptoms of enlarged tonsils include difficulty in swallowing, a feeling of an additional formation in the oral cavity, a change in the timbre of the voice, the appearance of snoring and frequent periods of no breathing (apnea).

Hyperplasia of the lingual tonsil during physical exertion manifests itself as noisy gurgling breathing. The cough, which occurs without reason, is dry, sonorous and often leads to laryngospasm. Drug therapy does not bring improvement, so the cough bothers for years.

In some cases, bleeding occurs due to a hacking cough caused by the pressure of the enlarged tonsil on the epiglottis and irritation of the nerve endings.

Hyperplasia of the nasopharyngeal tonsil

It is generally accepted that the nasopharyngeal tonsils participate in the immune defense of the body mainly up to 3 years. The proliferation of lymphatic tissue is provoked by frequent childhood illnesses, such as measles, viral colds or scarlet fever.

Hyperplasia of the nasopharyngeal tonsil is also observed in children living in houses with poor living conditions (high humidity, insufficient heating) and receiving inadequate nutrition. As a result, the body loses its protective abilities and is exposed to the aggression of infectious agents, which leads to inflammatory processes in the respiratory organs.

Depending on the size of the tonsils, there are 3 degrees of enlargement. When the adenoids cover the top of the plate (vomer) that forms the nasal septum, it is worth talking about the first degree. If the vomer is closed by 65% - this is the second, and by 90% or more - the third degree of enlargement of the tonsils.

Hyperplasia of the nasopharyngeal tonsil manifests itself in a child by almost constant nasal congestion with strong discharge that closes the nasal passages. As a result, there is a violation of local blood circulation in the nasal cavity, nasopharynx with further development of the inflammatory process.

Large adenoids lead to voice impairment, when it loses sonority and becomes muffled. A significant decrease in hearing function is observed when the opening of the auditory tubes is closed, especially with a runny nose.

The baby's mouth may be open, with the lower jaw hanging down and the nasolabial folds smoothed out. This may later cause facial deformation.

Hyperplasia of the pharyngeal tonsil

In relation to the other tonsils of the pharyngeal ring, it is the pharyngeal that develops the fastest. Its increase in size most often occurs before the age of 14, especially in infancy.

Hyperplasia of the pharyngeal tonsil is a sign of lymphatic diathesis. In addition, hereditary predisposition to its hypertrophy is possible, but one should not underestimate improper nutrition, frequent hypothermia and the impact of viral pathogens.

In some cases, chronic inflammation of the tonsils is a trigger for their hyperplasia, since the lack of adequate treatment leads to an increase in lymphatic tissue cells to carry out the body's protective function.

Hyperplasia of the pharyngeal tonsil is characterized by difficult nasal breathing, which contributes to the constant opening of the mouth to perform the act of breathing. As a result, sometimes even by the facial expression one can suspect the necessary diagnosis, because in addition to the open mouth, there is a raised upper lip, the face is slightly elongated and swollen, and visually it seems that the child has a reduced intellectual level.

Due to the lack of physiological nasal breathing, the brain suffers from a lack of oxygen in the form of hypoxia. In addition, periods of apnea at night become more frequent. The baby looks sleep-deprived in the morning, which manifests itself in whims and tearfulness during the day.

The oral mucosa is dry, and cold air, getting into the larynx and trachea, contributes to the development of a hoarse voice with the appearance of a cough. In addition, with hyperplasia, long-term rhinitis with complications - sinusitis, as well as otitis and tubotympanitis are observed.

Among the general manifestations, it is necessary to note the possibility of an increase in temperature to subfebrile numbers, decreased appetite, psychoemotional lability and cognitive impairment (deterioration of memory and attention).

Diagnosis of tonsil hyperplasia

When parents with a baby go to the doctor, the first thing that catches their eye is the child's facial expression. After a thorough survey of complaints and the course of the disease, an objective examination must be carried out. Thus, the anamnesis may highlight frequent respiratory pathologies, weak immunity and long-term nasal breathing problems.

Diagnosis of tonsil hyperplasia involves the use of laboratory research methods, such as identifying the composition of microflora with subsequent determination of the sensitivity of microorganisms to the most commonly used drugs, in other words, bacteriological culture from the pharynx.

To examine the entire body, a blood test is performed to determine the acid-base ratio and a urine test. Thus, it is necessary to check for the presence of an inflammatory component and the state of health in general.

In addition, the diagnosis of tonsil hyperplasia should include instrumental methods, such as pharyngoscopy, ultrasound of the pharyngeal region, rigid endoscopy and fibroendoscopy.

To determine the leading diagnosis, it is necessary to conduct differential diagnostics taking into account the anamnestic data obtained and the conclusion of the examination. It consists of identifying possible diseases that can provoke tonsil hyperplasia. These include tuberculosis, oncological processes in the tonsils, leukemia, granulomas of the pharynx of infectious genesis, and lymphogranulomatosis.

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Treatment of tonsil hyperplasia

After a full examination and a final diagnosis, a treatment strategy should be determined. Treatment of tonsil hyperplasia can be carried out with medications, physiotherapy procedures, and surgery.

The basis for the use of medications is the first degree of hypertrophy of the tonsils. Astringent and cauterizing preparations can be used for rinsing, for example, a tannin solution diluted 1:1000 or antiseptic solutions.

It is also necessary to lubricate the hypertrophy with a 2.5% silver nitrate solution and take lymphotropic drugs in the form of lymphomyosot, umckalor, tonsilotren or tonsilgon.

Among the physiotherapeutic methods, it is worth noting UHF on the area of hyperplastic tonsils, microwave, ozone therapy and ultrasound. Using spa treatment, climatotherapy, vacuum hydrotherapy with antiseptics and mineral water, inhalations of herbal decoctions, electrophoresis and mud ultraphonophoresis are carried out. Endopharyngeal laser treatment is also possible.

Treatment of tonsil hyperplasia of grades 2 and 3 is carried out by several surgical methods. The most proven and effective is tonsillotomy, when part of the gland tissue is removed. The operation is performed up to 7 years, but provided there are no contraindications. These include blood pathology, infectious diseases, diphtheria and poliomyelitis.

The next method is cryosurgery, when the tonsil is exposed to low temperatures to destroy pathological tissues. The advantage of this method is that it is bloodless and painless.

Cryosurgery is used when it is impossible to perform tonsillotomy, as well as in severe hypertension, heart defects, atherosclerosis and heart failure. In addition, it is advisable to use it in pathologies of the blood, kidneys, endocrine organs, menopause and in the elderly.

The third method is diathermocoagulation, or "cauterization". It is almost never used anymore due to the high risk of complications and the presence of painful sensations.

Prevention of tonsil hyperplasia

Based on the causes of the development of tonsil hypertrophy, we can identify the main preventive measures that will help avoid the disease or reduce the risk of its occurrence.

Thus, prevention of tonsil hyperplasia consists of creating favorable living conditions. This includes cleanliness of the premises, acceptable humidity and air temperature. In addition, it is necessary to monitor nutrition, because insufficient intake of vitamins and minerals reduces the body's immune defense.

It is necessary to dress warmly in the cold season and try to breathe through the nose, as the air thus enters the respiratory tract moistened and warmed. Hardening has a good effect on resisting infectious diseases and maintaining a good level of immunity. In addition, sanatorium and resort treatment and taking vitamins and minerals are recommended.

Prevention of tonsil hyperplasia also involves timely treatment of respiratory and other diseases to avoid chronicity of the pathological process. When the first signs of tonsil hypertrophy appear, you should consult a doctor to begin treatment and avoid surgical intervention.

Prognosis of tonsil hyperplasia

In most cases, the prognosis for tonsil hyperplasia is favorable, since tonsillotomy performed in time allows for the restoration of nasal breathing and full protective function. Inhaled air is moistened and warmed before entering the respiratory tract, which prevents cooling and the development of inflammation.

The brain receives enough oxygen, the baby sleeps normally and feels well. Speech becomes clear and the voice is no longer nasal.

Usually, if moderate hyperplasia is observed at an early age, then after 10 years of age, reverse development is possible. In cases where this does not happen, enlarged tonsils without inflammatory signs can be noted in adults.

Hyperplasia of the tonsils is a physiological process, but sometimes it occurs as a pathological process in response to the impact of a negative factor. The enlargement of the tonsils can continue until the act of breathing through the nose, swallowing begins to be disrupted and the general condition worsens. To avoid this, it is recommended to follow our recommendations for prevention and, if symptoms appear, consult a doctor for early diagnosis and treatment.