Adenoiditis: Difference between revisions
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==Overview== | ==Overview== | ||
Adenoid is a lymphoid tissue that is seen as a median mass of mucousa assosiated. Together with tonsils, they are a part of Waldeyer ring. Waldeyer ring is a ring consist of lymphoid tissue situated in the posterior wall of nasopharynx. This lymphoid tissue is involved in immunoglubin production and maturation of lymphatic cells and defense against pathogens. 12117336 | |||
The adenoid usually undergoes a degree of atrophy and involution from the age of 8-10 years so it is rarely found in adults. | |||
; <nowiki>NLM ID: 101667594 [Book]</nowiki> | |||
Although close location of tonsils and adenoid gland and same tissue composition, they have different infected diseases. Adenoids can cause recurrent sinusitis and chronic persistent or recurrent otitis if remain untreated and develop to chronic adenoiditis.23641372 | |||
8343242 | 8343242 | ||
Adenoid infection is mostly due o viral infections. Some bacterial pathogens include ''H. influenzae'', group A β-hemolytic streptococcus, and ''S. aureus can cause'' the disease as well. | |||
The symptoms of adenoiditis can last for 10 or more days, and may usually present as a discharge of [[pus]] from the nose. [[Medications]] ([[antibiotics]] or [[steroids]]) or [[surgical]] approach may be required for the management of adenoiditis, depending on the causative agent. | |||
adenoid (adjacent to the choanae and the pharyngeal ostium of the eustachian tubes) | |||
Excessive infection caused by microorganisms or the allergic process can lead to hyperactivity of the tonsils and pharynx, which can increase its volume, thereby hindering the passage of air to the choanae. | |||
Some authors relate this process to changes in the production of other immunoglobulins and to infections caused by nonspecific pathogens in the lymphoid tissue or mononucleosis, cytomegalovirus (CMV), and toxoplasmosis. | |||
Another study conducted in China by Zhang and colleagues demonstrated a correlation between EBV and adenoid hypertrophy; 51.9% of the children had EBV in tissues with adenoid and tonsillar hypertrophy, although it was absent in the blood. | |||
Human adenovirus was found more frequently (47%), followed by enterovirus (40%), rhinovirus (38%), bocavirus (30%), metapneumovirus (17%), and respiratory syncytial virus (16%).12 | |||
they showed the preoperative value of IgG (''p'' = 0.002) and the significant reduction of IgA= Studies suggest that a reduction in IgA will happen postoperative of adenoidectomy. This shows a relationship between adenoiditis and allergic diseases as the measures of IgA is higher in 30% of patients during adenoiditis episodes. | |||
The etiology of tonsillar hypertrophy, as many studies have suggested, is related to the presence of infectious agents, such as viruses and bacteria that are commonly found in the microflora of the upper airway and in the humoral immune response to the body's sensitivity to one or more allergens. | |||
Sensitivity to mold allergens is an important risk factor for AH in children with AR; therefore, early prevention of exposure to molds may help reduce occurrence of AH.11686429 | |||
==Causes== | ==Causes== | ||
Revision as of 14:39, 24 May 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahshid Mir, M.D. [2]
Overview
Adenoid is a lymphoid tissue that is seen as a median mass of mucousa assosiated. Together with tonsils, they are a part of Waldeyer ring. Waldeyer ring is a ring consist of lymphoid tissue situated in the posterior wall of nasopharynx. This lymphoid tissue is involved in immunoglubin production and maturation of lymphatic cells and defense against pathogens. 12117336
The adenoid usually undergoes a degree of atrophy and involution from the age of 8-10 years so it is rarely found in adults.
- NLM ID: 101667594 [Book]
Although close location of tonsils and adenoid gland and same tissue composition, they have different infected diseases. Adenoids can cause recurrent sinusitis and chronic persistent or recurrent otitis if remain untreated and develop to chronic adenoiditis.23641372
8343242
Adenoid infection is mostly due o viral infections. Some bacterial pathogens include H. influenzae, group A β-hemolytic streptococcus, and S. aureus can cause the disease as well.
The symptoms of adenoiditis can last for 10 or more days, and may usually present as a discharge of pus from the nose. Medications (antibiotics or steroids) or surgical approach may be required for the management of adenoiditis, depending on the causative agent.
adenoid (adjacent to the choanae and the pharyngeal ostium of the eustachian tubes)
Excessive infection caused by microorganisms or the allergic process can lead to hyperactivity of the tonsils and pharynx, which can increase its volume, thereby hindering the passage of air to the choanae.
Some authors relate this process to changes in the production of other immunoglobulins and to infections caused by nonspecific pathogens in the lymphoid tissue or mononucleosis, cytomegalovirus (CMV), and toxoplasmosis.
Another study conducted in China by Zhang and colleagues demonstrated a correlation between EBV and adenoid hypertrophy; 51.9% of the children had EBV in tissues with adenoid and tonsillar hypertrophy, although it was absent in the blood.
Human adenovirus was found more frequently (47%), followed by enterovirus (40%), rhinovirus (38%), bocavirus (30%), metapneumovirus (17%), and respiratory syncytial virus (16%).12
they showed the preoperative value of IgG (p = 0.002) and the significant reduction of IgA= Studies suggest that a reduction in IgA will happen postoperative of adenoidectomy. This shows a relationship between adenoiditis and allergic diseases as the measures of IgA is higher in 30% of patients during adenoiditis episodes.
The etiology of tonsillar hypertrophy, as many studies have suggested, is related to the presence of infectious agents, such as viruses and bacteria that are commonly found in the microflora of the upper airway and in the humoral immune response to the body's sensitivity to one or more allergens.
Sensitivity to mold allergens is an important risk factor for AH in children with AR; therefore, early prevention of exposure to molds may help reduce occurrence of AH.11686429
Causes
Bacterial Causes
Bacterial causes include
- Streptococcus pyogenes
- Streptococcus pneumoniae
- Moraxella catarrhalis
- Various species of Staphylococcus including Staphylococcus aureus
Viral Causes
Viruses that may cause adenoiditis include the
Epidemiology and Demographics
Age
Adenoiditis occurs mainly in childhood, often associated with acute tonsillitis. Incidence decreases with age, with adenoiditis being rare in children over 15 years due to physiological atrophy of the adenoid tissue.
Natural History, Complications and Prognosis
Complications
Complications of acute adenoiditis can occur due to extension of inflammation to the neighboring organs.
History and Symptoms
Symptoms
Acute adenoiditis is characterized by:
- Fever
- Nasal airway obstruction resulting in predominantly oral breathing
- Snoring and sleep apnea
- Runny nose with serous secretion in viral forms and mucous-purulent secretion in bacterial forms.
In cases due to viral infection symptoms usually recede spontaneously after 48 hours, symptoms of bacterial adenoiditis typically persist up to a week. Adenoiditis is sometimes accompanied by tonsillitis. Repeated adenoiditis may lead to enlarged adenoids.
Other Imaging Findings
Optical fiber endoscopy can confirm the diagnosis of adenoiditis in cases of doubt by directly visualizing the inflamed adenoid tissue.
Medical Therapy
Pharmacotherapy
Antibiotics for bacterial. A steroidal nasal spray may also be prescribed in order to reduce nasal congestion. Severe or recurring adenoiditis may require surgical removal of the adenoids.
In cases of viral adenoiditis, treatment with analgesics or antipyretics is often sufficient. Bacterial adenoiditis may be treated with antibiotics, such as amoxicillin - clavulanic acid or a cephalosporin. In case of adenoid hypertrophy, adenoidectomy may be performed to remove the adenoid.
Related Chapters
References
adenoids can contribute to recurrent sinusitis and chronic persistent or recurrent ear disease because they can harbor a chronic infection.adenoids can contribute to recurrent sinusitis and chronic persistent or recurrent ear disease because they can harbor a chronic infection.