- Anatomy
The adenoid is a single aggregation of lymphoid tissue that occupies the space between the nasal septum and the posterior pharyngeal wall. A thin fibrous capsule separates it from the underlying structures; the adenoid does not contain the complex crypts that are found in the palatine tonsils but rather more simple crypts
Anatomy
Lymphoid tissue located between the palatoglossal fold (anterior tonsillar pillar) and the palatopharyngeal fold (posterior tonsillar pillar) forms the palatine tonsil. This lymphoid tissue is separated from the surrounding pharyngeal musculature by a thick fibrous capsule
Normal Function
Situated at the opening of the pharynx to the external environment, the tonsils and adenoid are in a position to provide primary defense against foreign matter. The immunologic role of the tonsils and adenoids is to induce secretory immunity and to regulate the production of the secretory immunoglobulins
Pathology
Most episodes of acute pharyngotonsillitis are caused by viruses
Treatment
MEDICAL SYMPTOMATIC IN VIRAL INFECTIONS
PENICILLIN FOR 10 DAYS IN STREPTOCOCCAL TONSILLITIS
TONSILLECTOMY
Potential but nonevidenced based indications include 7 or more throat infections treated with antibiotics in the preceding yr, 5 or more throat infections treated in each of the preceding 2 yr, or 3 or more throat infections treated with antibiotics in each of the preceding 3 yr. The American Academy of Otolaryngology—Head and Neck Surgery offers guidelines of 3 or more infections of tonsils and/or adenoids per yr despite adequate medical therapy; the Scottish Intercollegiate Tonsillectomy Guidelines Network recommends 5 or more episodes per yr of tonsillitis with disabling symptoms and lasting for longer than 1 yr
Treatment
Tonsillectomy has not been shown to offer clinical benefit over conservative treatment in children with mild symptoms.
Adenoidectomy Adenoidectomy alone may be indicated for the treatment of chronic nasal infection (chronic adenoiditis), chronic sinus infections that have failed medical management, and recurrent bouts of acute otitis media, including those in children with tympanostomy tubes who suffer from recurrent otorrhea. Adenoidectomy may be helpful in children with chronic or recurrent otitis media with effusion. Adenoidectomy alone may be curative in the management of patients with nasal obstruction, chronic mouth breathing, and loud snoring suggesting sleep-disordered breathing. Adenoidectomy may also be indicated for children in whom upper airway obstruction is suspected of causing craniofacial or occlusive developmental abnormalities
Dr. Jayaprakash
Superintendent, ICH.
Institute of Child Health.
Gov. Medical College Kottayam.
Kerala, India.