First-grade enlargement of tonsils

Most people may have experienced the problem of swollen tonsils, and swollen tonsils will cause coughing and sore throat, so swollen tonsils have a great impact on a person's body. When you go to the hospital to treat your swollen tonsils, the doctor will determine the severity of the swollen tonsils based on the patient's condition. So what happens if the tonsils are enlarged?

Grading

Clinically, tonsil enlargement is divided into three degrees:

Grade I: Tonsillar enlargement does not extend beyond the palatine arch

II degree: beyond the pharyngeal palatine arch

Grade III: Swelling reaches the midline of the posterior pharyngeal wall.

1. Ear symptoms: Due to the hypertrophy of tonsils and the accumulation of inflammatory secretions in the nasopharynx, the pharyngeal opening of the Eustachian tube is blocked, which may be complicated by non-suppurative or suppurative otitis media, leading to hearing loss, tinnitus, and ear stuffiness.

2. Nasal symptoms: Enlarged tonsils are often complicated by rhinitis and sinusitis. The children have symptoms such as nasal congestion, runny nose, mouth breathing, drooling, occlusive nasal sounds when speaking, and snoring during sleep.

3. Symptoms of respiratory tract infection: Due to the inflammation, secretions irritate the respiratory mucosa, often causing inflammation of the throat, trachea and bronchitis. Therefore, patients may experience symptoms such as throat discomfort, voice changes, coughing and spitting, asthma, low fever, etc.

4. "Adenoid facies": Due to long-term mouth breathing, the development of the child's facial bones is affected, the maxilla becomes long and narrow, and the hard palate becomes high and narrow. Protruding teeth, irregular dentition, poor bite, drooping mandible, thick lips, upturned upper lip, hanging lower lip, drooping outer canthus, and shallow nasolabial groove. If there is mental depression and dull and stupid facial expressions, it becomes the so-called "adenoid facies". Symptoms of swollen tonsils: Sometimes the lymphatic tissue will enlarge (due to chronic inflammation or allergic reactions), and then swollen tonsils will appear. When tonsils are swollen, they will block the respiratory tract, causing sinusitis, otitis media, or causing stubborn coughs. People with swollen tonsils often have to breathe only through their mouths.

The onset of tonsillitis is very direct and can be confirmed by visual inspection of the condition of the tonsils. Ask the child to open his mouth wide and observe the changes in the tonsils and oropharynx to determine whether he has tonsillitis. However, in addition to diagnosing whether it is tonsillitis, another important task for doctors is to distinguish whether it is a bacterial infection or a viral infection, whether there is a systemic infection, and whether there will be other complications. Usually bacterial diseases may require antibiotics for treatment, while viral diseases do not require antibiotics. If necessary, blood tests can be done to help with diagnosis. Tonsillectomy may be necessary if there are frequent episodes of tonsillitis, or if the tonsil disease affects the child's overall health or causes the child to interrupt his or her education, or affects hearing or breathing. However, sometimes tonsillectomy is unnecessary and other problems should be considered if the diagnosis is in doubt.

Indications for tonsillectomy include: tonsillitis occurs four or more times a year; tonsillitis occurs three or more times a year within two years; upper airway obstruction caused by swollen tonsils, resulting in severe snoring, difficulty swallowing, unclear pronunciation, etc.; one or more tonsillar abscesses; tonsils cause systemic diseases and become focal tonsils; repeated inflammation of the tonsils causes repeated attacks of rhinitis, otitis media, tracheitis, etc. or long-term treatment is unrecoverable. Some parents ask doctors to remove their children's tonsils surgically because their children often suffer from tonsillitis, but doctors generally consider this carefully. Why can't tonsils be removed casually?

Tonsils are the largest lymphoid tissue in the pharynx. During childhood, it is an active immune organ that contains lymphocytes at various stages of development, such as T cells, B cells, macrophages, etc. Therefore, it not only has humoral immunity, producing various immunoglobulins, but also has certain cellular immunity. The immunoglobulin IgA produced by tonsils has strong immunity, which can inhibit the adhesion of bacteria to the respiratory mucosa, inhibit the growth and spread of bacteria, and also has a neutralizing and inhibitory effect on viruses. IgA can also enhance the function of phagocytes through complement activation. These are most active between the ages of two and five.

From an immune point of view, tonsils should not be removed casually due to their immune effects on the body. Enlarged tonsils in children are a normal physiological phenomenon. If the enlargement does not affect breathing and swallowing and does not cause serious clinical manifestations, they should not be removed. Because resection may affect the local immune response and reduce the body's ability to fight infection. If tonsillitis recurs, interferes with breathing and swallowing, and causes diseases such as rheumatism and nephritis, it should be removed promptly. Generally, tonsillectomy for children should be performed after the age of four, and it is more appropriate to wait two to three weeks after the inflammation subsides. However, if the attacks are too frequent and you cannot wait too long, you may consider having surgery a few days after the attacks subside.