ADENOIDS:

SYNONYM: Adenoid hypertrophy, chronic adenitis

DEFINITION:

Chronic inflammation or the enlargement of the adenoids causing obstruction to the naso pharyngeal air way and consequent recurrent nasosinus infections, otitis media or mal development of the face

ETIOLOGY:

– Common in children
– Physiological hypertrophy
– Recurrent respiratory tract infections
– Low socio economic status
– H -influenza infection has been commonly implicated in adenoid and tonsillar hyperplasia
– Tuberculosis can rarely affect the adenoids
– Adenoid hypertrophy is uncommon in adults should raise the suspicion of lymphoma
The best way to prevent any disease is good immunity power.

CLINICAL FEATURES:

SYMPTOMS:

Nasal symptoms: due to recurrent naso sinus infection and obstruction
Nasal obstruction associated with mouth breathing and snoring is the most common symptom

Anterior nasal discharge which is mucoid or muco purulent
Post nasal discharge is common
Obstructive sleep apnoea is common
Hypo nasal speech
Epistaxis is rae

AURAL SYMPTOMS:

Recurrent otalgia
Deafness
Ear discharge

THROAT SYMPTOMS:

Recurrent sore throat
Dysphagia
Change in the voice
Poor eaters
Mal nutrition

GENERAL SYMPTOMS:

Mental dullness
Nocturnal eneuresis
Night terrors

NECK:
Cervical lymphadenopathy is commonly present involving upper deep cervical and posterior triangle nodes

FACIAL FEATURES:
This is also known as adenoids facies
– Pinched nose
– Mouth breathing
– Dribbling of saliva
– Flat nasal arch
– Malar hypoplasia
– Elongated face
– Dull idiotic appearance
– Loss of naso labial fold
– Short protruding upper lip
– Crowding of teeth especially upper jaw
– High arched palate
– Deafness

GENERAL FEATURES:
– Growth retardation
– Recurrent lower respiratory tract infections
– Frequent diarrhea
– Low nutritional status
– Pigoen shaped chest
– Protuberent abdomen

SIGNS:
– Mucosal congestion of the pharynx
– Feature of acute otitis media
– Mucosal congestion and edema of nasal mucosa
– Granular posterior pharyngeal wall
– Post nasal drip is noted

INVESTIGATIONS:

1.Diagnostic nasal endoscopy
2.Xray nasopharynx
3.Sleep studies

MANAGEMENT:

– Control of frequent respiratory tract infections
– Improve nutritional status
– Breathing exercises

HOMOEOPATHIC APPROACH:

HYDRASTIS:

Symptoms produced by adenoid vegetations, it has the yellow mucus and general lymphoid hypertrophy
Obstructions of the nose
Redness and swelling of the nasal mucosa
Frequent sneezings with thick yellow discharges

CISTUS CANADENSIS:

In scrofulous or arthritic individuals who have adenoid vegetations
Extreme sensitiveness to the cold air
This is the characteristic feature
Sensation of heat and dryness in the throat so intense the patient must drink to relieve the complaint
Cold air inhaled causes distress in the throat
It has special affinity to the pharynx

AGRAPHIS NUTANS:

Obstruction of the nostrils from adenoids
Throat deafness
Deafness and deaf mutism , breathes with mouth wide open
Catarrhal remedy and acts especially on the glands connected with nasal cavity
Its use generally avoids adenoid surgery

CALCAREA PHOS:

Most affecatious remedy in adenoid affections
It corresponds to dyscrasia, which permits adenoid growths or tonsillar enlargement
The patient is lean and thin with delayed closure of fontanels
Rachitic baby with weak extremities
Malnutrition
Fragile bones

BARYTA CARB:

Valuable remedy in adenoid growths
Child is short and idiotic
The baby is very shy and fearsome
Mental inactivity
Scrofulous diathesis
Recurrent attacks of the colds
Frequent attacks of the acute tonsillitis

Author Bio: Dr Guptha associated with ICD10 Certification and Dr Guptha associated with ICD10 training

Category: Education
Keywords: icd10, training, certification