The lymphatic system of the pharynx, the so-called Waldeyer's ring, is formed by: palatine tonsils, lingual tonsil, pharyngeal tonsil, tonsillar tonsils, lymph nodules of the posterior pharyngeal wall and lateral bands.
In certain situations, under the influence of harmful factors, coexistence of bacterial or viral infections, allergies, with insufficient individual defence capabilities, hypertrophy of the tonsils can occur.
When can tonsillar hypertrophy occur?
Hypertrophy of the pharyngeal tonsil is most common in children aged 1-8 and 8-9 years. It then blocks the posterior nostrils causing difficult breathing, and is also often the cause of chronic sinusitis and conductive hearing loss (usually due to recurrent middle ear infections). Nasal speech is also characteristic due to posterior nostril blockage.
On physical examination, the so-called adenoid face with a constantly open mouth is typical. Sometimes these children have impaired intellectual and physical development. Hypertrophy of the pharyngeal tonsil is often accompanied by enlargement of the palatine tonsils, usually after inflammatory mononucleosis or in the course of inflammatory processes. Hypertrophied palatine tonsils can cause throat dysfunction during breathing, which manifests itself as snoring. As far as surgical removal of the tonsil is concerned, it is carried out when it is the cause of swallowing disorders and obstructed breathing. Indications also include recurrent respiratory infections, sinusitis and middle ear infections. An oversized pharyngeal tonsil is often removed when it is the cause of sleep apnoea.
photo: panthermedia
Removal of the tonsil as a last resort!
Since the palatine tonsils are an important part of the body's lymphatic (i.e. defence) system, surgical removal is performed when there is a peri-tonsillar abscess, tuberculosis of this area or when a neoplastic process of the tonsil is suspected, as well as with recurrent haemorrhagic tonsillitis. Relative indications for tonsillectomy are recurrent tonsillitis (5-7 incidents per year), chronic tonsillitis lasting longer than 3-6 months, lymphadenitis in the neck associated with chronic tonsillitis, swallowing disorders due to tonsillar hypertrophy and general complications in the course of chronic tonsillitis.
