腺样体的前世今生

what are adenoids

咽扁桃体俗称腺样体，位于鼻咽的顶壁和后壁

Adenoid tissue is present at birth shows physiological enlargement up to the age of six yearsandthen tends to atrophy at puberty and almost completely disappears by the age of 20

出生时存在的腺样体在六岁时显示出生理上的增大，青春期开始萎缩，20岁时几乎完全消失

why and when do they cause trouble

腺样体在什么时候会带来困扰？为什么？

adenoids are subject to physiological enlargement and childhood

在儿童期，腺样体容易发生生理性增生

certain children have a tendency to generalize the lymphoid hyperplasia in which adenoids also take part

某些儿童有广泛的淋巴结增生，其中腺样体也同时肿大

recurring attacks of rhinitis sinusitis or chronic tonsillitis may causechronic adenoidal infection and hyperplasia

鼻炎、鼻窦炎或慢性扁桃体炎的反复发作可引起慢性腺样体炎和增生

allergy of the upper respiratory tract may also contribute to the enlargement of adenoids

上呼吸道过敏也可能导致腺样体肿大

clinical features symptoms and signs depend not merely on the absolute size of the adenoid mass but a relative to the available space in the nasopharynx

临床特征、症状和体征不仅取决于腺样体的绝对大小，而且与其相对于鼻咽部的可用空间有关

enlarged and infected adenoids may cause nasal oral ear or general symptoms

肿大和感染的腺样体可引起鼻、口、耳或一般症状

A nasal symptoms

1 nasal obstruction is thecommonest symptomthis leads to mouth breathing

A鼻腔症状：

1鼻塞是一种常见症状，这导致口呼吸

nasal obstruction also interferes with feeding or sucklinga child as respiration and feeding cannot take place simultaneously

鼻塞也干扰喂养或哺乳，因为儿童不能同时进行呼吸和进食

a child with adenoids and large men fails to thrive

腺样体增值影响儿童发育

2 nasal dischargeit is partly due to choanal struction as the normal nasal secretions cannot drain into nasal pharynx and partly due to Associated chronic rhinitis

2鼻涕：部分原因是由于后鼻孔的结构，正常的鼻分泌物不能流进鼻咽，部分原因是由于相关的慢性鼻炎

the child often has a wet bubbly nose

儿童经常有鼻涕气泡

3 sinusitis chronic maxillary sinusitis is commonly associated with adenoids

3鼻窦炎慢性上颌窦炎通常与腺样体相关

it is due to persistence ofnasal dischargeand infection

这是由于持续的鼻腔分泌物和感染

reverse is also true that a primary maxillary sinusitis may lead to infected and enlarged adenoids

相反，原发性上颌窦炎可能导致腺样体的感染和肿大

4epistaxiswhen adenoids are acutely inflamed a piece taxi can occur with nose blowing

4鼻出血：腺样体急性感染时可以伴有鼻出血

5 voice change which is toneless and loses nasal quality due to nasal obstruction

5.声音变化因为鼻塞导致鼻音加重

B oral symptoms

B：耳部症状

1 tubal obstruction：adenoid mass blocks the eustachian tube leading to retracted tympanic membrane and conductive hearing loss

1.咽鼓管阻塞：由于腺样体阻塞咽鼓管导致鼓膜内陷和传导性耳聋

2recurrent attacks of acute otitis media or infection of middle earmay occur due to spread of infection via the eustachian tube because the eustachian tube is blocked due to adenoids hypertrophy

2.由于咽鼓管因腺样体肥大而阻塞，经咽鼓管传播的感染可导致急性中耳炎复发或中耳感染

3chronic suppurative otitis media or long-standing infection of middle ear occursif the otitis media fails to resolve in the presence of infected adenoids

3.如果有受感染的腺样体存在时，中耳炎不能消退会发生慢性化脓性中耳炎或中耳长期感染

C general symptoms

C：一般症状

1. adenoid faces：chronic nasal obstruction and mouth breathing lead to characteristic facial appearance called adenoid face

1.腺样体面容 慢性鼻塞和口呼吸导致的特征面部外观称为腺样体面容

the child has an elongated face with dull expression prominent open mouth for breathing and crowded upper teeth and hitched up upper lip

这些孩子有一张拉长的脸，表情呆滞，突出的张着呼吸的嘴，上面有密集的牙齿，上唇上翘

nose gives a pinched in appearance due to disuse atrophy of a lane easy

鼻子因废用而萎缩，容易使外观变皱

hard palate in these cases is highly arched as the molding action of the tongue on palate is lost because the child has to always keep the mouth open for breathing

硬腭在这种情况下是高度拱形的，因为舌头在上颚上的塑造作用消失了，因为孩子必须一直保持嘴巴张开来呼吸

2 pulmonary hypertensionin long standing nasal obstruction due to adenoid hypertrophythe oxygen reaching lungs is decreased so the blood pressure in pulmonary artery increases to carry the oxygen needed for tissues of body which can cause pulmonary hypertension and corpulmonale

2肺动脉高压 由于腺样体肥大引起的长时间鼻塞使到达肺部的氧气减少，从而使肺动脉内的血压升高以携带机体组织所需的氧气，从而引起肺动脉高压和肺心病

diagnosis

诊断

examination of post nasal space is possible in some young children and an adenoid mask can be seen with a mirror

在一些儿童中是可以借助鼻咽镜检查后鼻孔的腺样体的

soft tissue lateral radiograph of nasal pharynx will reveal the size of adenoids and also the extent to which nasal pharyngeal airspace has been compromised

鼻咽X线侧位片将显示腺样体的大小以及鼻咽部残余的空间

detailed nasal examination should always be conducted to exclude other causes of nasal obstruction

应始终进行详细的鼻腔检查，以排除引起鼻阻塞的其他原因