In adenoid hyperplasia – colloquially called adenoids or “adenoids” – (synonyms: Hyperplasia of the tonsil pharyngealis; adenoid hyperplasia; adenoid adenoid hyperplasia of the pharyngeal tonsil; adenoid vegetations, adenoid proliferation, or simply adenoid; ICD-10-GM J35.2: Hyperplasia of the pharyngeal tonsil) is an enlargement (hyperplasia) of the pharyngeal tonsil (tonsilla pharyngea).
The tonsilla pharyngea is located at the roof of the nasopharynx (nasopharynx), in the area behind the nose. It is not visible when the mouth is open.
It grows in infancy along with the other tonsils during the learning phase of the immune system.
Notice: When the vernacular speaks of “adenoids,” it refers to adenoids (adenoid vegetations; enlargements (hypertrophies) of the lymphoepithelial tissue, i.e., the pharyngeal tonsil). They have nothing to do with the “true” adenoids of the nasal passage, which are usually in the majority (polyposis nasi).
Sex ratio: balanced
Frequency peak: Mostly children are affected between the 2nd and 6th year of life; but also earlier or up to adolescent age.
Course and prognosis: The development of adenoid hyperplasia is accompanied by recurrent (recurring) infections. These lead to an overload of the pharyngeal tonsil function, which in turn leads to an increase in lymphoid tissue and thus to an enlargement of the pharyngeal tonsil.Pharyngeal tonsil hyperplasia leads to further problems because it (partially) displaces the opening of the nasal cavity (cavitas nasi) located towards the nasopharynx (nasopharyngeal cavity) and at the same time closes the entrance to the middle ear (Eustachi tube) located closely next to it. The resulting sequelae include rhinitis (cold), recurrent upper respiratory tract infections with cough (bronchitis), recurrent otitis media (middle ear infection), and hearing impairment.If symptoms are clear, such as chronic obstruction of nasal breathing, chronic recurrent inflammation of the adenoids, recurrent otitis media, etc., surgical removal of the enlarged adenoids (adenotomy) is indicated. If there is concomitant tympanic effusion, paracentesis (tympanic membrane incision), with insertion of a tympanic ventilation tube if necessary, can be performed during the same procedure.