Adenoids

Adenoids are a collection of lymphoid tissue in the nasopharynx that actively participates in the formation of the immune response in early childhood. They are part of the lymphoid pharyngeal ring and are the first to come into contact with viruses, bacteria, and allergens that enter through inhaled air. Physiologically, adenoids are most active in preschool age and then gradually undergo involution. However, in some children, this tissue remains enlarged and becomes a source of chronic symptoms and complications.

Adenoid hypertrophy is not a consequence of diet or lifestyle per se. It is an immunological and anatomical condition that can be influenced by frequent infections, allergic inflammation, and features of lymphatic system development.

Definition and Physiological Role

Adenoids are lymphoid tissue located in the area of the nasal isthmus on the posterior wall of the nasopharynx. Their main function is to participate in the formation of local immune responses, especially in the early years of life when the child’s immune system is actively learning to recognize pathogens.

Normally, adenoids enlarge in response to antigenic load and then gradually decrease as immunity matures. When this process is disrupted, persistent hypertrophy develops, which begins to mechanically obstruct nasal breathing and disrupt ventilation of the middle ear.

Clinical Manifestations

• difficulties in nasal breathing, especially at night;
• mouth breathing, dryness of mucous membranes, and morning discomfort;
• snoring, episodes of apnea, and fragmented sleep;
• chronic rhinitis, postnasal drip;
• frequent or prolonged otitis media, serous effusion in the middle ear;
• hearing loss, fatigue, decreased concentration.

Diagnosis

Diagnosis is conducted by an otolaryngologist. The main method is the examination of the nasopharynx using endoscopy, which allows for the assessment of the degree of hypertrophy and the condition of surrounding tissues. Additionally, the condition of hearing, tympanic membrane, and ventilation of the middle ear may be evaluated.

It is important to exclude concomitant conditions such as allergic rhinitis, chronic sinusitis, or hypertrophy of the palatine tonsils, as they can exacerbate symptoms and influence treatment tactics.

Treatment Approaches

The treatment strategy depends on the severity of symptoms and the presence of complications:

• dynamical observation in cases of minimal symptoms and preserved nasal breathing;
• conservative therapy to reduce swelling and inflammation of the mucosa;
• regular saline nasal rinses to improve mucociliary clearance;
• local anti-inflammatory medications as prescribed by a doctor;
• treatment of the allergic component if present;
• adenoidectomy in cases of persistent obstruction, sleep disturbances, hearing loss, or recurrent otitis media.

Not every enlargement of the adenoids requires active intervention.

Prognosis and Prevention

In a significant number of children, adenoids decrease as they grow older, and symptoms weaken or disappear. With timely treatment of complications such as otitis media and sleep disturbances, the risk of long-term consequences is minimal.

Prevention includes general measures:

• maintaining optimal humidity levels;
• treating allergic diseases;
• reducing the frequency of upper respiratory infections;
• early consultation with a specialist in case of breathing or hearing disturbances.

Adenoids are a physiological part of a child’s immune system that can become a source of problems under certain conditions. The key factor for successful management is timely

diagnosis and individually tailored treatment tactics, rather than attempts to correct the condition solely through diet.