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Hypertrophy of the tubal tonsil: causes, symptoms, diagnosis, treatment
Last reviewed: 07.07.2025
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In the membranous-cartilaginous part of the auditory tube there are clusters of lymphadenoid tissue, first described by the German anatomist Gerlach. This tissue is more developed in the area 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 tonsil. These lymphadenoid formations are closely related both morphogenetically and functionally to the lymphadenoid ring of the pharynx. The specified lymphadenoid tissue is especially developed (hypertrophied) in children, in adults it undergoes reverse development. In rare cases, posterior rhinoscopy reveals clusters of kidney-shaped elongated formations covering the nasopharyngeal opening of the auditory tube in the form of a fringe. These formations, located in the area of the cartilaginous socket of the auditory tube, cause a violation of its ventilation and evacuation function, which invariably affects hearing acuity. Inflammation of the pharyngeal tonsils usually spreads to the tubal tonsils, causing their hypertrophy and corresponding hearing impairment. The spread of lymphoid tissue hypertrophy along the mucous membrane of the membranous-cartilaginous part of the auditory tube, especially in the isthmus area, causes persistent conductive hearing loss, which is difficult to treat due to the obstruction of the auditory tube.
Treatment primarily involves drug sanitation of the nasopharynx and, if indicated, removal of adenoids and curettage of the tubal tonsils. Sanitation of the tubal tonsil (intra-tubal lymphadenoid tissue) is performed during attempts to catheterize the auditory tube and introduce vasoconstrictor, antiseptic, corticosteroid and astringent drugs into it. In the absence of a positive result, radiation therapy is prescribed, which in the overwhelming majority of cases gives positive results.
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