Tag Archive for: pharynx

The tonsils and adenoids are part of a “ring” which is located at the back of the neck (waldeyers ring). The adenoids are located behind the nose and the palate and are not seen by mouth. They can only be seen using special tools. It is located at the entrance of the airways at that point from where they enter the body by various infections. Their role is to identify the various bacteria and viruses and produce antibodies against them activating defenses organisms. The function of adenoids and tonsils occurs early in life and as the years go their function fades. In fact their role stops after the age of three (3) years. The methods used to evaluate the adenoids and the tonsils are:

  • Medical history
  • Physical exam
  • Radiography
  • Endoscopy

Clinical examination of the nose and throat may require the use of special tools like a small mirror or flexible endoscope. Examination is done when a child or adult suffers from frequent tonsillitis, pharyngitis, feverish conditions, breath odor, nasal obstruction and shortness of breath, recurrent ear infections, mouth breathing, snoring and sleep disorders and swallowing problems. All infections of the tonsils and adenoids are treated first with antibiotics. Sometimes they may require removal. The main indications for tonsillectomy and / adenoidectomy is:

  1. Repeated infections despite antibiotic treatment.
  2. Difficulty breathing due to swelling of the adenoids and the tonsils.

It is commonly known that obstruction of the airway causes snoring and sleep disorders resulting in daytime sleepiness in adults and behavioral problems in children. Moreover chronic inflammation can lead to problems of the ears as well as a large bulge that can cause orthodontic problems, especially in children.

JUST SNORING OR SOMETHING MORE?

The disturbance of breathing during sleep can range from minor problems to the health of patients (snoring) to heavy sleep apneas (breathing interruption during sleep) which may be for peripheral reasons (obstructive sleep apnea) or on the rare occasions the central reasons which potentially without treatment may lead to serious cardiovascular problems (pulmonary hypertension, right heart failure, etc.).

The syndrome causes the obstructing of breathing and affects the daily activity of patients including drowsiness, weakness, lack of concentration, irritability, increased risk of accidents, etc.
 
Patients are usually unaware of the risks of these daily difficulties and come to the doctor because of established pressure from their social environment that does not tolerate snoring.
 
Snoring is more common in men and the overweight. 45% of adults snore occasionally, while 25% snore on an everyday basis. Alcohol, smoking, over eating especially during the evening as well as some medications can aggravate the problem.
 
The risks that snoring causes include reduced muscle tone in the tongue & neck, enlarged muscle mass tissue in the nasopharynx e.g. adenoids in the nose, elongated soft palate, or uvula, deviated septum, polyps in nose etc.
 
As for the cause of obstructive sleep apnea, it’s usually a blockage caused by movement of the tongue at the rear of the throat during sleep. This can be seen e.g. in retrognathism (small jaw).
 
There are many patients who may experience 30-300 episodes of apnea at night resulting in the reduction of oxygen in the blood and therefore may require an intensive heart operation.
 
The treatment of snoring and obstructive sleep apnea depends on accurate diagnosis. The patient must undergo a complete and thorough examination. Apart from routine examination, a sleep-recording test should always be done. This examination is necessary before any treatment because it is the only one that can capture the scale of the problem ( apnea, hypopneas,how it gets oxygen during sleep, etc.).
 
After this examination and according to the results of the test, the doctor will decide a more therapeutic sleep pattern to follow. This can be simply lowering body weight, stopping smoking, a surgical therapy. If  still high level of sleep-apnea syndrome may be necessary to implement continuous positive pressure using nasal masks (CPAP).