Hyperplasia of the tonsils

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

Tonsils are a combination of lymphatic tissue, thanks to which the immune defense of the body is carried out. There are several types of glands, depending on their location. Some of them stop performing their function and are practically atrophied.

Under the influence of negative factors, tonsils can lose the ability to protect the body and become the focus of infection. When the lymphatic tissue grows, the size of the glands increases, which can impede the normal breathing process. Complication of this is the increasing hypoxia, affecting the first thing on the brain, as well as a violation in the development of the baby and frequent viral and bacterial infections.

The increase in the size of the tonsils may be due to swelling due to an inflammatory response to an allergic agent or infection and true hyperplasia. The main causes of tissue proliferation can become a viral pathogen, physiological processes from 3 to 6 years, as well as chlamydia and mycoplasma infection.

Therapeutic tactics in hyperplasia involve the use of medicines primarily. To reduce swelling and inflammation it is recommended to use anti-inflammatory drugs, and for the death of infection - antibiotics.

If the increase in glands is due to inflammatory edema without true hyperplasia, you can use the hormone "Nazonex."

In the absence of the effect of drug therapy, the next step is surgical intervention in the form of adenotomy, after which it is necessary to use local immunostimulating agents, for example, IRS-19, with a preventive purpose. Operative treatment is used only in cases of hypertrophic tonsils of degree 2 or 3.

[1], [2], [3], [4], [5], [6],

Causes of hyperplasia of tonsils

The enlargement of tonsils is mainly observed in childhood, but cases of their hypertrophy in the older are not ruled out. The causes of tonsil hyperplasia include a damaging factor, for example, a breach of integrity resulting from a burn or injury. Of course, an isolated lesion of glands is unlikely in such cases, so in combination with them the pharynx or oral cavity suffers.

The burn can be observed when swallowed boiling water (thermal exposure) or acid, alkali (chemical). Such cases must be treated exclusively in the hospital.

The next provoking factor may be a foreign body, which is more often a bone of the fish, which during the food intake damages the lymphatic tissue, which is manifested by thrusting sensations when swallowing.

Do not forget about the developmental anomalies and tumorous neoplasms. The main causes of tonsill hyperplasia are the immune response of the body to the effects of environmental factors.

This can be a long-term effect of low temperatures on the glands in mouth breathing, infected mucus secreted by the recurrence of adenoiditis, frequent inflammatory diseases of the ENT organs, as well as childhood diseases.

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

Not the least role in hypertrophy of the tonsils is played by lymphatic-hypoplastic constitutional anomaly, imbalance of hormones, hypovitaminosis and prolonged exposure to small radiation doses. The basis for the development of hyperplasia is the activation of production of lymphoid cells, namely, increased proliferation of T-lymphocytes (immature).

[7], [8], [9], [10]

Symptoms of hyperplasia of tonsils

In view of the fact that the proliferation of lymphatic tissue is most often noted in children, the main task of parents is to find out the pathological focus in time and consult a doctor. Early diagnosis will stop further growth of glands and avoid the development of complications.

A common case is hypertrophy of not one species, but several, for example, palatal hyperplasia is often observed with an increase in the pharyngeal tonsil. Thus, the symptoms of tonsillar hyperplasia have more manifestations than single growth.

Glands in palpation can have a tight-elastic or soft consistency, and the color varies from pale yellow to bright red.

The expressed degree of hypertrophy becomes an obstacle to the normal process of breathing and swallowing. As a result, dysphonia, dysphagia and noisy breathing are noted. The baby with hyperplasia of the tonsils is difficult to form a speech, there is a nasal voice, illegible pronunciation of words and incorrect pronunciation of individual letters.

Incomplete breathing contributes to an insufficient supply of oxygen to the brain, which is manifested by hypoxia. In addition, the baby can snore in sleep and often cough. Apnea due to obstruction occurs due to relaxation of pharyngeal muscles.

In the pathological process, ears can be involved with the formation of exudative otitis media as a result of hearing impairment due to tubal dysfunction.

In addition to the main manifestations of tonsillar hypertrophy, it is possible to develop complications in the form of frequent colds, which is due to the inhalation of the baby by cold air as a result of breathing through the mouth. Average otitis in turn can lead to persistent hearing loss.

Hyperplasia of tonsils in children

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

Children very often suffer from attacks of infectious agents, for example, influenza, scarlet fever, measles or whooping cough, so hypertrophy is a compensatory process in the body. In most cases, hyperplasia of the tonsils in children is noted up to 10 years.

It is worth highlighting that hyperplasia has no signs of inflammation, so there is no puffiness or hyperemia in this case, on the contrary, a gland of pale yellow color.

Depending on the degree of growth of lymphatic tissue, it is customary to distinguish several degrees of hypertrophy. Sometimes tonsils are enlarged slightly, which clinically does not manifest any symptoms. However, with intensive growth, the baby can change his voice, acquiring nasal hue, speech, breathing and even sleep.

So, hyperplasia of glands can push out the soft palate and prevent their contraction, which is manifested by deterioration of hearing. The voice loses its timbre, becomes deaf and incomprehensible, and the process of breathing is complicated by an inferior act of inspiration. As a result, the baby snores in a dream, and the brain suffers from hypoxia, which may later manifest as a developmental lag.

Hyperplasia of the tonsils in children with palpation is characterized by a soft consistency and a pale smooth surface. Numerous follicles are more fragile than usual, and they cover lacunas without stoppers.

Hyperplasia of palatine tonsils

Moderate increase in glands due to proliferation of lymphatic tissue and in the absence of inflammatory process in them is more often noted in children. Hyperplasia of palatine tonsils is manifested as a compensatory process in response to a large number of attacks from infectious agents.

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

Hyperplasia of palatine tonsils is characterized by an immunoreactive process that occurs in response to the negative effects of environmental factors. In addition, the proliferation of lymphatic tissue contributes to 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 palatine glands. Hypertrophies are also facilitated by infectious diseases, allergies and frequent inflammatory processes in the nasal cavity and oropharynx.

Of the attendant factors, it is worth highlighting the unsuitable conditions for the baby, poor nutrition with insufficient vitamins, hormonal imbalance due to the pathology of the thyroid gland or adrenal glands, as well as small radiation doses that have an impact for a long time.

The enlarged palatine tonsils are characterized by a pale pink tint, a smooth surface, formed lacunae and loose consistency. They protrude a little from behind the front palatine arch. Babies experience coughing, difficulty in swallowing and breathing.

Violation of speech occurs due to violations in the upper resonator, which is manifested by the nasal voice. Hypoxic changes in the brain cause restless sleep, the appearance of insomnia and cough. At night, periods of lack of breathing (apnea) are possible due to relaxation of the pharyngeal muscles.

In addition, tubal dysfunction can lead to the development of exudative otitis media with a further decrease in auditory function.

Hyperplasia of lingual tonsil

In children, the lingual tonsil is developed very well and is located in the root of the tongue. Since 14-15 years, its reverse development has been noted, 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 pharynx (posterior wall), as a result of which the sensation of a foreign body is noted.

Hypertrophic processes can last up to 40 years, the cause of which is often the hereditary anomaly of development. Symptoms of enlarged glands include difficulty in swallowing, a feeling of additional education in the oral cavity, a change in the voice timbre, the appearance of snoring and frequent periods of lack of breathing (apnea).

Hyperplasia of the lingual tonsil with physical activity is manifested by noisy bubbling breath. Cough that occurs without cause, dry, sonorous and often leads to laryngospasm. Drug therapy does not improve, so the cough worries for years.

In some cases, bleeding due to coughing is observed due to the pressure of the enlarged gland on the epiglottis and irritation of the nerve endings.

Hyperplasia of the nasopharyngeal tonsil

It is generally believed that nasopharyngeal glands are involved in the immune defense of the body mainly up to 3 years. The proliferation of lymphatic tissue is provoked by frequent childhood illnesses, for example, measles, colds, viral diseases, 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 those who receive malnutrition. As a result, the body loses its defenses and is exposed to the aggression of infectious agents, which leads to inflammatory processes in the respiratory system.

Depending on the size of the tonsils, 3 degrees of growth are distinguished. When the adenoids close the top of the plate (vomer), which forms the nasal septum, it is worth talking about the first degree. If the opener is closed by 65% - this is the second, and 90% or more - the third degree of increase in the glands.

Hyperplasia of the nasopharyngeal tonsil is manifested in the baby with almost constant nasal congestion with strong secretions covering the nasal passages. As a result, there is a violation of the local circulation in the nasal cavity, nasopharynx with the further development of the inflammatory process.

Large adenoids lead to a violation of the voice, when it loses its sonority and becomes deaf. A significant decrease in the auditory function is observed when the aperture of the auditory tubes is closed, especially in the rhinitis.

The baby can open his mouth, and the lower jaw hangs, and the nasolabial folds are smoothed. In the future this can cause deformation of the face.

Hyperplasia of pharyngeal tonsils

In relation to the remaining glands of the pharyngeal ring, the pharyngeal develops faster than all. The increase in it in size often occurs before the age of 14, especially in infancy.

Hyperplasia of the pharyngeal tonsil refers to the signs of lymphatic diathesis. In addition, hereditary predisposition to its hypertrophy is possible, but do not underestimate the wrong food, frequent hypothermia and the effects of viral pathogens.

In some cases, chronic inflammation of the glands is a starting point to their hyperplasia, as the lack of full-fledged treatment leads to an increase in the cells of the lymphatic tissue for the exercise of the protective function of the body.

Hyperplasia of the pharyngeal tonsil is characterized by obstructed nasal breathing, which promotes the constant opening of the mouth to perform the act of breathing. Because of this, sometimes even a facial expression can be suspected of the necessary diagnosis, because in addition to the open mouth, the raised upper lip is marked, the face is slightly elongated and swollen, and visually it seems that the child with a decreased intellectual level.

In the absence of physiological nasal breathing, the brain suffers from a lack of oxygen in the form of hypoxia. In addition, periods of sleep apnea are increasing during the night. Baby for the morning looks not slept, that during the day is shown by whims and tearfulness.

Mucous of the mouth is dry, and cold air, getting into the larynx and trachea, promotes the development of a hoarse voice with the appearance of a cough. In addition, with hyperplasia, there is a prolonged rhinitis with complication - sinusitis, as well as otitis and tubotimpanitis.

Of the general manifestations, it is necessary to note the possibility of raising the temperature to subfebrile digits, reduced appetite, psychoemotional lability, and cognitive impairment (memory and attention impairment).

Diagnosis of tonsillar hyperplasia

When the parents turn to the doctor with their baby, the child's face is first of all displayed. After a thorough survey of complaints and the course of the disease, it is necessary to conduct an objective examination. So, it is possible in the history will be allocated frequent respiratory pathologies, weak immunity and a prolonged disruption of nasal breathing.

Diagnosis of tonsillar hyperplasia consists in the use of laboratory methods of investigation, such as the detection of the composition of microflora with the subsequent determination of the sensitivity of microorganisms to the most frequently used drugs, in other words bacteriological culture from the throat.

For the examination of the whole body, a blood test is performed to determine the acid-base ratio and urine analysis. Thus, it is necessary to check the presence of the inflammatory component and the state of health in general.

In addition, the diagnosis of tonsillar hyperplasia should include instrumental methods, for example, pharyngoscopy, ultrasound of the pharyngeal region, rigid endoscopy and fibroendoscopy.

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

[11], [12], [13], [14], [15]

Treatment of tonsillar hyperplasia

After conducting a complete examination and setting the final diagnosis, you should determine the therapeutic tactics. Treatment of tonsillar hyperplasia can be carried out by drugs, physiotherapy procedures and surgical method.

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

It is also necessary to lubricate hypertrophy with a solution of silver nitric acid with a concentration of 2.5% and take lymphotropic drugs in the form of lymphomyositis, umcalor, tonsilotrene, or tonzigon.

From physiotherapy methods it is worth noting UHF on the site of hyperplastic glands, microwave, ozone therapy and ultrasound. Using spa treatment, climatotherapy, vacuum hydrotherapy with antiseptics and mineral water, inhalation of herbal decoctions, electrophoresis and mud phonophoresis is carried out. Endopharyngeal laser treatment is also possible.

Treatment of hyperplasia of tonsils of degree 2 and 3 is carried out by several surgical methods. The most proven and effective is tonsillotomy, when the removal of part of the tissue of the glands is carried out. 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 considered cryosurgery, when the amygdala is exposed to a low temperature for the destruction of pathological tissues. The plus of this method is the lack of blood and the absence of pain.

Cryosurgery is used when it is impossible to carry out tonsillotomy, as well as severe GB, heart disease, atherosclerosis and heart failure. In addition, it is advisable to use it in the pathology of blood, kidneys, endocrine organs, menopause and in the elderly.

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

Prophylaxis of tonsillar hyperplasia

Based on the causes of hypertrophy of the tonsils, it is possible to identify the main preventive directions that will help to avoid the disease or reduce the risk of its occurrence.

Thus, the prevention of hyperplasia of glands is to create an enabling environment for living. This includes clean room, permissible humidity and air temperature. In addition, it is necessary to monitor the diet, because insufficient intake of vitamins and minerals reduces the immune defenses of the body.

It is necessary to warmly dress in the cold season and try to breathe through the nose, since the air thus enters the respiratory tract moistened and warmed. A good effect for confronting infectious diseases and maintaining a good level of immunity is provided by hardening. In addition, spa treatment and the intake of vitamins and mineral elements are recommended.

Prevention of tonsillar hyperplasia also implies the timely treatment of respiratory and other diseases in order to avoid the chronicization of the pathological process. When the first signs of hypertrophy of the glands appear, you need to see a doctor to begin treatment and avoid surgical intervention.

Prognosis of tonsillar hyperplasia

In most cases, the prognosis of tonsillar hyperplasia is favorable, since tonsillotomy performed on time allows you to restore nasal breathing and a full protection function. The inhaled air is humidified and warmed before entering the respiratory tract, which prevents the cooling and development of inflammation.

The brain receives a sufficient amount of oxygen, the baby normally sleeps and feels well. Speech becomes legible and there is no nasal voice.

Usually, if moderate hyperplasia is observed at an early age, then after 10 years, the reverse development is possible. In the case where this does not occur, in adults, you can observe enlarged glands without inflammatory signs.

Hyperplasia of the tonsils is a physiological process, but sometimes it arises as a pathological process in response to the negative factor. The enlargement of the glands can continue until the act of breathing through the nose, swallowing and worsening of the general condition begin to break. To avoid this, it is recommended that you follow our recommendations for prevention and, in case of symptoms, contact your doctor for early diagnosis and treatment.