Tonsils and AdenoidsPalatine tonsils are two masses of tissues which are like lymph nodes in their structure. They are situated on the sides of the throat near the posterior end of the tongue on either side of the uvula which is a piece of tissue hanging down in the midline from the back of the soft palate. The structures are roughly oval in shape and appear pink in color and can be seen if the mouth is widely opened. The surfaces of these structures has depressions called crypts. Adenoids are also made up of lymphoid tissue and are situated on the posterior wall and the roof of the pharynx behind the nose. Adenoids form a single mass of tissue. They are also referred to as pharyngeal tonsils. The adenoids cannot be seen through the mouth. Special instrument is needed to visualize this structure.
Some lymphoid tissues are found on the upper surface of the tongue near the base of the tongue. There is a collection of lymphoid tissue near the pharyngeal end of the Eustachian tube on either side. These are referred to as lingual and tubal tonsil respectively. All these four structures collectively form what is known as the Waldeyer's ring. These structures filter micro organisms entering the body through the nose and mouth and are part of the immune system helping the body to fight infections. As frequent infections are common in infants and children these structures are usually larger in children than in adults. Inflammation of these structures-tonsillitis and adenoiditis is a common problem in children. Tonsillitis is a common cause of sore throat in children. With frequent infections and inflammation these structures can become quite big and cause problems. Enlarged adenoids can cause difficulty in breathing through the nose and lead to mouth breathing. Mouth breathing is not good for health as it causes dryness of mouth and also predisposes to infection of lungs as the air is not filtered in the nose. Enlargement of adenoids can also cause constant running nose and blockage of the Eustachian tubes leading to recurrent ear infections and even hearing loss. Snoring is another problem due to obstruction to flow of air. Chronic adenoid enlargement leads to certain facial changes like pinched nose, high arched palate, abnormality in position of teeth and open mouth. The term adenoid faces is used for this condition. Difficulty in swallowing is another problem when the enlargement is considerable. In some children the enlargement can cause a serious problem called obstructive sleep apnea. Apnea means cessation of breathing for a brief period. This may decrease oxygen supply to the brain and children may not be fully active during day. Very rarely this can lead to increased blood pressure inside the lungs a condition known as pulmonary hypertension which can cause extra stress to the heart. Surgical removal- tonsillectomy or adenoidectomy or both is sometimes advised when these structures are causing problems. This is somewhat controversial and many people think that surgery is often done unnecessarily. It is very important to remember that no surgery is without complications and the possible benefits should always be weighed against the possible complications. Even deaths have been reported following tonsillectomy or adenoidectomy. Hence surgery should only be considered if all other measures fail.
Page last reviewed on 13th January 2010
|
