Adenoids are masses of lymphoid tissue located in the nasopharynx. Adenoids are most common in children between the ages of 3 and 7 years. With age, the nasopharyngeal tonsil decreases in volume, lymphoid tissue is replaced by connective tissue and by puberty (14-15 years) in the nasopharynx there is only a small remnant of lymphoid tissue. Nevertheless, there are cases in which the palatine tonsil in adults does not decrease in volume.
Why do adenoids persist in adults?
As practice shows, this is not always the case, and there are factors that can prevent its reverse development, which leads to the preservation of adenoids and in adulthood.
These include:
- frequent and prolonged infections, allergies, exposure to polluted air – there is a compensatory enlargement of the tonsils, so it tries to cope with the high level of load on the immune system and protect the body from foreign substances;
- Hormonal disorders in the body – diseases such as diabetes mellitus, obesity, can sometimes cause disorders in the pharyngeal tonsil;
- The body’s genetics – something that unfortunately cannot be controlled, with tonsils enlarging in childhood and often remaining in adults.
There is also an opinion that the more frequent detection of adenoids in adults is now associated not with the deterioration of people’s health, but with improved methods of diagnosing the disease. It is much more difficult to detect an enlargement of the pharyngeal tonsils in an adult than in a child, due to the peculiarities of the anatomical structure of the nasopharynx.
Symptoms
The manifestations of adenoids are primarily related to the fact that an enlarged pharyngeal tonsil creates an obstacle to the normal movement of air. In adults, the symptoms are generally the same as in children.
It is worth paying attention to:
- constantly stuffy nose and difficulty breathing;
- voice changes, nasality;
- snoring in sleep, coughing;
- frequent diseases of the upper respiratory tract (abnormal pharyngeal tonsil itself becomes a source of infection);
- frequent headaches;
- ear blockage, frequent otitis media.
The combinations of symptoms can be very different. In some cases, a person will have all of the above symptoms at once, and in others – one of them at a time, sometimes the symptoms will occur around the same time, and sometimes alternately. Any of the above symptoms that persist for a long time and worsen the quality of life is a reason to see a doctor.
Diagnosis of adenoids
Recently, hypertrophy of adenoids in adults is detected more often due to the widespread introduction of endoscopic equipment into the practice of otorhinolaryngologists. Of course, it is possible to suspect the diagnosis and when conducting routine examinations:
- Pharyngoscopy – examination of the oral cavity in order to assess the state of the oropharynx, the presence of discharge on the posterior pharyngeal wall, the state of the palatine tonsils.
- Anterior rhinoscopy – examination of the nasal passages, which allows to assess the condition of the nasal passages, to determine the presence of edema, discharge in the nasal cavity.
- Posterior rhinoscopy – examination of the nasal passages by an otolaryngologist using a mirror through the oropharynx.
- X-ray examination of the nasopharynx – the possibility of a more accurate diagnosis of the presence of adenoids and determining the degree of adenoid vegetations.
The diagnosis can only be definitively confirmed by endoscopic examination of the nasopharynx or on the basis of a CT scan.
Possible Complications of Adenoids in Adults
If adenoids in an adult are left untreated and untreated for a long time, they can lead to the development of various complications:
- Chronic sinusitis and rhinitis – constant impairment of mucus flow from the sinuses contributes to inflammation and infections.
- Hearing loss – hypertrophied tonsils can block the mouth of the eustachian tube, causing hearing loss or frequent otitis media.
- Oxygen deprivation – constant mouth breathing causes the body to be deprived of oxygen, which can lead to rapid fatigue, decreased concentration and even sleep disturbances.
- Obstructive sleep apnea syndrome – enlarged adenoids can cause temporary stops in breathing during sleep, which is accompanied by snoring, restless sleep and a feeling of brokenness in the morning.
- Changes in appearance – if nasal breathing is disturbed for a long time, the so-called “adenoid face” is formed: open mouth, elongated face, smoothed nasolabial triangle (more often in children, but in neglected cases it may persist into adulthood).
Treatment
Although adenoids are most commonly associated with childhood, adults are treated with consideration of their more developed anatomy and possible comorbidities.
1. Conservative treatment
It is effective in the initial stages and includes:
- Anti-inflammatory drugs;
- Antihistamines if the cause of hypertrophy is allergy;
- Nasal rinses (saline solutions, antiseptics);
- Immunomodulators and general strengthening of the body.
However, it is important to realize: in adults, conservative treatment often only temporarily relieves symptoms and does not always eliminate the cause.
2. Surgical treatment
It is performed in case of severe hypertrophy and persistent symptoms. Modern methods make the surgery more gentle:
- Endoscopic adenotomy – with visual control, more accurate and safer than classical;
- Laser removal – minimizes blood loss and speeds up recovery;
- Radiowave surgery – virtually bloodless method, reduces the risk of complications.
Surgery is usually performed under general anesthesia and requires a short recovery period (3-7 days).
Life after removal of adenoids
Most patients significantly improve nasal breathing, snoring disappears, and performance improves.
After surgery, it is important to maintain the nasopharynx in a healthy state: regular flushing, avoiding hypothermia, avoiding smoking.
It is important to eliminate the cause of chronic inflammation (for example, treat allergies, correct the hormonal background, sanitize other foci of infection).
Conclusion
Adenoids in adults are not uncommon as commonly thought and can significantly impair quality of life, causing chronic nasal congestion, snoring, hearing loss and frequent infections. Symptoms should not be ignored, as in neglected cases serious complications can develop, including obstructive sleep apnea syndrome and chronic oxygen deprivation. Modern diagnostic methods allow timely detection of the problem, and a wide range of therapeutic approaches – effectively coping with it. With the right approach and careful attention to health, the prognosis is favorable: breathing is restored, sleep improves, headaches disappear and general well-being improves.
