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Adenoid disease — the chronic inflammation of the lacunary device and an adenoid tissue of palatine tonsils which is usually shown repeated aggravations (quinsies) and leading to development of general infectious and allergic and autoimmune diseases in other bodies.
Chronic adenoiditis — the inflammatory process in a pharyngeal almond which is usually followed by aggravations, a hyperplasia of an adenoid tissue of an almond and difficulty of nasal breath.
The adenoid disease is diagnosed for 20% of adults and for 12 — 15% of children. The chronic adenoiditis is observed generally at children, occurs at adults seldom. Exacerbations of a disease arise during the autumn and winter period more often, and also at SARS epidemics. Risk factors at an adenoid disease are repeated overcoolings, upper respiratory tract infections, defective food, continuous overfatigue.
Russia applies two main classifications of an adenoid disease:
1. Classification of an adenoid disease by B. S. Preobrazhensky (1964)
• Simple form.
• Toksiko-allergichesky form:
— The I degrees (with easier manifestations);
— The II degrees (with the expressed manifestations).
2. Classification of an adenoid disease by I.B. Soldatov (1975)
• Nonspecific form:
• Specific forms (infectious granulomas)
Depending on the sizes of hypermarket at a back rinoskopiya allocate three degrees of its hypertrophy:
I. The hypermarket reaches an average third of a share;
II. The hypermarket reaches the lower third of a share;
III. The hypermarket reaches bottom edge of a share, closing all postnaris.
Etiology and pathogeny
The standard theory of a pathogeny of an adenoid disease and chronic adenoiditis does not exist. Major importance has existence of pathogenic microflora in lacunas of palatine tonsils (Streptococcus pyogenes of group A, Haemophilus influenzae, Streptococcus pneumonia and adenoviruses). Features of a structure of the palatine tonsils having the deep gyrose lacunas getting into thickness of a parenchyma create conditions for long contact of fabric of almonds with foreign proteins and toxins of pathogenic microorganisms. After the postponed quinsies there are commissures and unions which block a gleam of lacunas and interfere with removal of their contents — the remains of food, a desquamated epithelium and microorganisms. Against changes of immune responsiveness of an organism it leads to permanent inflammatory reaction in palatine tonsils, chronic intoxication and a sensitization (an allergy to antigens S. pyogenes of group A comes to light at 83% of patients with an adenoid disease), causing development of general infectious and allergic diseases with damage of heart, vessels, joints, kidneys, etc.
Clinical picture of chronic diseases of almonds
I. The main sign of an adenoid disease are repeated aggravations (quinsies) though also the asymptomatic current of an adenoid disease, in particular, a bezanginny form is possible. Frequent recurrence of quinsies, repeated peritonsillites and paratonsillar abscesses, intoxication, long subfebrile condition and existence of general infectious and allergic diseases to which they carry are characteristic of a dekompensirovanny form of an adenoid disease:
• glomerulonephritis, focal nephrite;
• infectious and allergic arthritis;
• pustular psoriasis;
• chronic small tortoiseshell;
• endo-, mio-and pericardis;
• polyneuritis, iridocyclitis;
• diseases of vessels (recurrent thromboangitis, nodular periarteritis).
II. The chronic adenoiditis is characterized by frequent repeated upper respiratory tract infections, a constant congestion of a nose and running off mucopurulent separated from a nasopharynx on a back wall of a throat that at children often leads to developing of persistent cough. The hypermarket at a back rinoskopiya looks edematous, increased, with pathological exudate in smoothed lacunas. The mucous membrane of a nose at a front rinoskopiya is stagnation hyperemic, cyanotic.