Tubal tonsil hypertrophy: causes, symptoms, diagnosis, treatment
Last reviewed: 23.04.2024
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In the membranous-cartilaginous part of the auditory tube there are clusters of lymphadenic tissue, first described by the German anatomist Gerlach. This tissue is more developed in the region of the isthmus of the auditory tube and is especially abundant in the area of the socket of the nasopharyngeal opening, where it forms the tubal amygdala. These lymphadenoidal formations are closely connected both morphogenetically and functionally with the lymphadenoid ring of the pharynx. This lymphadenoid tissue is especially developed (hypertrophied) in children, in adults it undergoes reverse development. In rare cases, with posterior rinoscopy, clusters of kidney-shaped elongated formations are found covering the nasopharyngeal opening of the auditory tube in the form of a fringe. These formations, being in the area of the cartilaginous socket of the auditory tube, cause a violation of its ventilation and evacuation function, which invariably affects the acuity of hearing. Inflammation of the pharyngeal tonsils spread, as a rule, to the tubal tonsils, causing their hypertrophy and corresponding hearing impairment. The spread of hypertrophy of the lymphoid tissue along the mucous membrane of the membranous-cartilaginous part of the auditory tube, especially in the isthmus region, causes persistent hearing loss of a conductive nature that is difficult to treat due to the obstruction of the auditory tube.
Treatment involves first of all medical rehabilitation of the nasopharynx and in the presence of indications removal of adenoids and curettage of tubal tonsils. Sanitation of the tubal tonsil (intrabular lymphadenoid tissue) is performed with attempts to catheterize the auditory tube and introduce vasoconstrictive, antiseptic, corticosteroid and astringent drugs. In the absence of a positive result, radiotherapy is prescribed, which in the overwhelming majority of cases gives positive results.
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