Adenoids

• Synonym: Nasopharyngeal tonsil

• Adenoids is the hypertrophied mass of lymphoid

tissue situated at the junction of roof & post. wall
of nasopharynx.

• The mass of lymphoid tissue is termed as

Adenoids only when it is hypertrophied.

• It usually undergoes atrophy by puberty (13-14

yrs)
 FEATURES :
• Pink, globular mass

• Vertical ridges on its surface

• No crypts

• Lined by ciliated columnar epithelium

• No capsule
 SYMPTOMS :
LOCAL GENERAL
• B/L nasal obstruction • Anorexia
• Snoring
• Lethargy
• Mouth breathing
• Rhinolalia clausa • Poor physical & mental
• Frequent rhinorrhoea development
• Epistaxis • Bed-wetting
• Feeding problems in children • Pigeon chest
• Conductive deafness due to ET • Protuberent abdomen
block
• Cervical lymphadenopathy
• Otitis media
• Adenoids facies
• Bronchitis
 Adenoids Facies
• Sunken eyes
• Narrow pinched nostrils
• Open mouth
• High-arched palate
• Crowded teeth
• Dull mask-like face
• Protruding teeth
• Drooling saliva
• Everted upper lip
• Rhinorrhoea
• Loss of nasolabial fold
Aural manifestations in Adenoids
• Otalgia

• Secretory otitis media

• Acute otitis media

• Atelectasis of TM

• ET block

• Chonic otitis media

JUVENILE NASOPHARYNGEAL ANGIOFIBROMA

• Commonest of all benign tumours of nasopharynx.

• Locally invasive, but histologically benign vascular
tumour.
• Seen in young adolescent males . It regresses after
adolescense.
 Tonsillitis
Inflammation 0f tonsils due to
bacterial or viral infection causing
a sore throat , fever, and difficulty
in swallowing is called tonsillitis.

There are 3 types of it

1.Acute tonsillitis
2. chronic tonsillitis
3. Compensated
tonsillitis
Bacteria cause 15-30% of cases of pharyngotonsillitis.
Anaerobic bacteria play an important role in tonsillar
disease.
Most cases of bacterial tonsillitis are caused by group
A beta-hemolytic Streptococcus pyogenes (GABHS).
S pyogenes adheres to adhesin receptors that are
located on the tonsillar epithelium.
Immunoglobulin coating of pathogens may be
important in the initial induction of bacterial tonsillitis.
Symptoms: Signs:
• Sore throat • Swollen congested
• Difficulty in tonsils with
exudates
swallowing
• Enlarged tender
• Generalised body Jugulo-diagastric
ache lymph nodes
• Fever • Coasted tongue
• Earache and • Foetid breath
Thick speech • Hyperaemia of
pillars soft palate &
uvula.
• Recurrent streptococcal tonsillitis is diagnosed when an
individual has
– 7 culture-proven episodes in 1 year,
– 5 infections in 2 consecutive years, or
– 3 infections each year for 3 years consecutively.
• Individuals with chronic tonsillitis may present with chronic
sore throat, halitosis, tonsillitis, and persistent tender cervical
nodes.
• Children are most susceptible to infection by those in the
carrier state.

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 TREATMENT
• Bed rest
• Plenty of oral fluids
• Analgesics
• Antimicrobial therapy penicillin
• In case of penicillin sensitivity erythromycin
are given.
• Antibiotics should be continued for 7_10 days
 COMPLICATIONS
• chronic tonsillitis
• peritonsillar abscess
• parapharyngeal abscess
• cervical abscess
• acute otitis media
• rheumatic fever
• acute glomerulo nephritis
• sub acute bacterial endocarditis
Peritonsilar abscess

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