Role of Homoeopathy in Adenoid Hypertrophy

Dr Geethanjali M

INTRODUCTION:
Adenoid also known as pharyngeal tonsil/ nasopharyngeal tonsil , is the superior most of the tonsils. It is a mass of lymphatic tissue located behind nasal cavity, in the roof of the nasopharynx, where nose blends in to throat.

DEVELOPMENT:
They develop from a subepithelial infiltration of lymphocytes after the 16^th week of embryonic life.
After birth, enlargement begins and continues until 5-7 years of age.

FUNCTION:
Adenoid is a part of immune system, they produce T cells and B cells.
Adenoids are part of Waldeyer ring of lymphoid tissue which also includes the palatine tonsils, the lingual tonsils and tubal tonsils.

ADENOID HYPERTROPHY:
Adenoid hypertrophy is an obstructive condition due to enlarged adenoids.
It is more common in children than in adults.
They naturally atrophy and regress during adolescence.

ETIOLOGY:

Infectious cause:

• Viral – Adenovirus, Coronavirus, CMV, EBV, Rhinovirus
• Bacterial – streptococcus species, H. influenzae, Staphylococcus aureus, Neisseria gonorrhea

Non- infectious cause:

• Gastroesophageal reflex
• Allergies
• Exposure to cigarette smoke
• In adults, adenoid hypertrophy can also be a sign of more serious condition such as HIV infection, lymphoma, or sino -nasal malignancy.

CLINICAL FEATURES:

• Due to nasal obstruction- mouth breathing, nasal discharge and voice becomes nasal.
• Due to eustachian tube blockage- earache, deafness, secretory otitis media, and later chronic suppurative otitis media.
• Due to mouth breathing- dribbling of saliva, noisy breathing at night, high arched palate and chronic pharyngitis.
• General- mental backwardness and lethargy.

DIAGNOSIS:

Adenoid facies develop due to chronic infection of the adenoids, i.e,

• Open mouth
• Pinched nostrils
• Nasal discharge
• Narrow maxillary arch
• Crowded protruding teeth
• Vacant facial expression

X-ray lateral skull reveals the adenoids.

Nasal endoscopy to visualize the adenoids.

DIFFERENTIAL DIAGNOSIS:

• Choanal atresia
• Allergic rhinitis
• Acute/ chronic sinusitis
• Nasal polyposis
• Acute Otitis Media
• Cholesteatoma
• Nasopharyngeal malignancy
• HIV

PROGNOSIS:
Even though it is a self- limiting condition which resolves as the adenoids atrophy and regress by adolescence, it can cause serious complication and impact on patients quality of life.

COMPLICATIONS:
Persistent middle ear effusion / disordered breathing.

Children with adenoid hypertrophy are at risk for developing speech, language and or learning disabilities as a result of conductive hearing loss which can occur with persistent secondary middle ear effusion.

Patents are also at risk for sleep- disordered breathing and sleep apnea which in children can lead to behavioural problems, bedwetting, pulmonary hypertension and has been associated with psychiatric disorders such as depression and ADHD

There is risk of adenoid re-growth especially in patients who undergo adenoidectomy at a young age.

HOMOEOPATHIC APPROACH:
Homoeopathy has a great scope in the treatment of Paediatric cases. Homoeopathic medicines not only remove the disease from its root but also increase the quality of life of the patient. It also enhances the immunity of the patient. Adenoid hypertrophy is one of commonest presentation in paediatric age groups. Homeopathy can do wonders in the treatment of adenoid hypertrophy.

Homoeopathic remedies:

Bar-c, bar-m, calc, carc, thuj, tub, agraphis nutans, iod,

• Agraphis nutans- catarrhal conditions, obstruction of nostrils. Adenoids, throat deafness. Enlarged tonsils. Mucous diarrhea from cold. Chill from cold winds.
• Baryta carb- Takes cold easily, and then always have swollen tonsils. Submaxillary glands and tonsils swollen. Quinsy. Suppurative tonsils from every cold. stinging pain in tonsils, pharynx or larynx.
• Baryta-mur- Difficult swallowing. Tonsils enlarged.  Offensive ottorhea, inflates middle ear on blowing nose.
• Calcarea carb- Takes cold at every change of weather. swelling of tonsils and submaxillary gland, stitches on swallowing .Difficulty in swallowing. Offensive odor in nose. Polypi.
• Iodum- acute exacerbation of chronic inflammation. Adenoid vegetations. Pain at root of the nose and frontal sinus. Nose stopped up. Loss of smell. Acute nasal engorgement associated with high blood pressure.
• Thuja- Polypi, chronic catarrah, thick green mucous, ulceration within the nostrils. Dryness of nasal cavities. Painful pressure at root.
• Tuberculinum- Cold is taken from slightest exposure. Persistent , offensive ottorhea. Perforation in membrana tympani, with ragged edges. Crops of small boils, intensely painful, successively appear in the nose; green fetid pus.

REFERENCES:

1. The Merck manual of diagnosis and therapy- 19^th
2. Harrison’s principles of internal medicine, 18^th international edition, McGraw-Hill, Anthony S. Fauci, 2011
3. Geiger Z. Adenoid hypertrophy. U.S. National library of medicine;2023 https://www.ncbi.nlm.nih.g
4. Boericke’s New Manual of Homoeopathic Materia Medica with Repertory, B.Jain publisher, 9^th edition ,2012

Dr Geethanjali M
PG Scholar
Department Of Paediatrics
Government Homoeopathic Medical College & Hospital, Bengaluru