Pharyngeal tonsil – what are the symptoms of hypertrophy and what is the surgical treatment?

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The pharyngeal tonsil, also known as the third, together with the palatine tonsils forms the pharyngeal lymphatic ring, i.e. a barrier that protects the body against microbes. It plays an important role in the immune function of a young child – it produces antibodies, and in its environment, lymphocytes mature, which instead of inflammation are provided nearby. In later years, his role loses its importance, and in adolescence it eventually disappears. Very often the tonsils become infected themselves, and in the case of the hypertrophy of the third tonsil, the most common solution is adenoidectomy, i.e. surgical removal under general anesthesia.

The causes and symptoms of adenoid hypertrophy

This condition most often affects children from 3 to 6 years of age. In adults, it is diagnosed relatively rarely. Among the causes of hypertrophy of the third tonsil lie chronic and recurrent inflammation of the mouth and upper respiratory tract. Apart from that, genetic predisposition, going through some infectious diseases and allergies are mentioned.

Symptoms include, in particular, problems with nasal breathing that make the baby breathe by mouth, slurred speech, snoring while sleeping, chronic runny nose, recurrent infections, difficulty eating and sleep apnea. In addition, the overgrown tonsil impairs the patency of the sinuses and compresses the Eustachian tube, leading to the accumulation of secretions in the tympanic cavities. This can lead to deterioration of hearing as well as wet ear infection.

If diagnosed too late, it can cause malocclusion in an older child, jaw retraction, oblong face syndrome (adenoid face), gothic palate, overshot bite, lower tongue position or shortening of the upper lip.

Treatment of a hypertrophied third tonsil

If the tonsil is not very enlarged, it is usually started with conservative treatment with nasal glucocorticosteroids. In the event that it hinders the functioning, it applies adenoidectomy, which is the surgical removal of an overgrown tonsil. However, not every child can be subjected to it. Contraindications include: cleft palate, neurological disorders, acute phase of infection.

It is usually performed under general anesthesia in order to minimize the discomfort of the operated patient. The patient should be observed for at least a day. Food that is hot, spicy, acidic or hard should be avoided during the first few days so as not to irritate the wound. An easily digestible diet and plenty of cold fluids are recommended.

The most common complications after surgery to remove the third tonsil they relate to recurrent bleeding from a wound or damage to structures that lie in its vicinity. The removed tonsil may regrow if there is even a small amount of lymphoid tissue left after the procedure, but this happens relatively rarely. The operation should then be repeated.

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