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Adenoids
腺样体
What are Adenoids?
什么是腺样体？
The nasopharyngeal tonsils, commonly called adenoids, is situated at the junction of the roof and posterior wall of the nasopharynx.
鼻咽扁桃体，俗称腺样体，位于鼻咽顶部和后壁的交界处。
Adenoid tissue is present at birth, shows physiological enlargement up to the age of six years, and then tends to atrophy at puberty and almost completely disappears by the age of 20.
人出生时就有腺样体组织，在六岁前表现出生理上的增大，然后在青春期逐渐萎缩，到20岁时几乎完全消失。
Why and When do they cause trouble?
腺样体在什么时候以及为什么会制造麻烦呢？
Adenoids are subject to physiological enlargement in childhood.
腺样体在儿童时期易出现生理性肥大。
Certain children have a tendency to generalised lymphoid hyperplasia in which adenoids also take part.
某些儿童有全身性淋巴增生的倾向，腺样体也参与其中。
Recurrent attacks of rhinitis, sinusitis or chronic tonsillitis may cause chronic adenoid infection and hyperplasia.
反复发作的鼻炎、鼻窦炎或慢性扁桃体炎可能会导致慢性腺样体感染和增生。
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 are 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肿块的大小，还与鼻咽部的可用空间相关。
Enlarged and infected adenoids may cause nasal, aural (ear) or general symptoms.
肿大和感染的腺样体可能会引起鼻、耳或一些全身症状。
a).Nasal Symptoms
鼻部症状
1.Nasal obstruction is the commonest symptom.
1.鼻塞是最常见的症状。
This leads to mouth breathing.
鼻塞会导致口呼吸。
Nasal obstruction also interferes with feeding or suckling a child.
鼻塞也会影响孩子的喂养或哺乳。
As respiration and feeding cannot take place simultaneously, a child with adenoid enlargement fails to thrive.
由于呼吸和喂养不能同时进行，患有腺样体肥大的儿童无法茁壮成长。
2.Nasal discharge
2.流鼻涕
It is partly due to choanal obstruction, as the normal nasal secretions cannot drain into nasopharynx and partly due to associated chronic rhinitis.
流鼻涕部分原因是后鼻孔阻塞，因为正常的鼻腔分泌物不能流入鼻咽，部分原因是相关的慢性鼻炎。
The child often has a wet bubbly nose.
孩子的鼻子经常湿漉漉的。
3.Sinusitis
3.鼻窦炎
Chronic maxillary sinusitis is commonly associated with adenoids.
慢性上颌窦炎通常与腺样体相关。
It is due to persistence of nasal discharge and infection.
这是由于长期流鼻涕和感染所致。
Reverse is also true that a primary maxillary sinusitis may lead to infected and enlarged adenoids.
反过来，原发性上颌窦炎也可能导致腺样体感染和肿大。
4.Epistaxis
4.流鼻血
When adenoids are acutely inflamed, epistaxis can occur with nose blowing.
当腺样体急性发炎时，可能伴有鼻出血。
5.Voice change, which is toneless and loses nasal quality due to nasal obstruction.
5.变声，说话时带有闭塞性鼻音。
b).Aural Symptoms
听觉症状
1.Tubal obstruction: Adenoid mass blocks the eustachian tube leading to retracted tympanic membrane and conductive hearing loss.
1.咽鼓管堵塞：腺样体阻塞咽鼓管，导致鼓膜收缩和传导性听力损失。
2.Recurrent attacks of acute otitis media or infection of middle ear may occur due to spread of infection via the eustachian tube because the eustachian tube is blocked due to adenoids hypertrophy.
2.由于腺样体肥大导致咽鼓管阻塞，感染经咽鼓管扩散，急性中耳炎或中耳感染反复发作。
3.Chronic suppurative otitis media or long standing infection of middle ear occurs if the otitis media fails to resolve in the presence of infected adenoids.
3.如果腺样体感染时发生中耳炎，会导致慢性化脓性中耳炎或中耳长期感染。
c).General Symptoms
全身症状
1.Adenoid facies: Chronic nasal obstruction and mouth breathing lead to characteristic facial appearance called adenoid facies.
1.腺样体面容：慢性鼻塞和口呼吸导致特征性的面部外观，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.
孩子有一张拉长的脸，表情呆滞，张嘴呼吸，上牙拥挤，上嘴唇向上翘起。
Nose gives a pinched-in appearance due to disuse atrophy of alae nasi.
由于鼻翼废用萎缩，鼻子呈现凹陷的外观。
Hard palate in these cases is highly arched as the moulding action of the tongue on palate is lost because the child has to always keep the mouth open for breathing.
在这种情况下，硬腭呈高度拱形的，因为失去了舌头对上腭的塑造作用，孩子必须始终张开嘴呼吸。
2.Pulmonary hypertension: In long-standing nasal obstruction due to adenoid hypertrophy, the 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 cor-pulmonale.
2.肺动脉高血压：由于腺样体肥大导致长期鼻塞，到达肺的氧气减少，为身体各组织输送氧气使肺动脉血压升高，从而引起肺动脉高血压和肺心病。
Diagnosis: Examination of postnasal space is possible in some young children and an adenoid mass can be seen with a mirror.
诊断：一些年幼的儿童可以进行鼻腔后间隙检查，用镜子可以看到腺样体肿块。
Soft tissue lateral radiograph of nasopharynx will reveal the size of adenoid and also the extent to which nasopharyngeal air space has been compromised.
鼻咽软组织侧位片可以显示腺样体的大小以及鼻咽空间受损的程度。
Detailed nasal examination should always be conducted to exclude other causes of nasal obstruction.
应进行详细的鼻部检查，以排除其他鼻塞原因。
Treatment: When symptoms are not marked, breathing exercises, decongestant nasal drops and antihistamines for any coexistent nasal allergy can cure the condition without need of the surgery.
治疗：没有明显症状时，可进行呼吸练习、使用减充血滴鼻剂和抗组胺药物治愈任何共存的鼻炎症状，不需要手术。
When symptoms are marked, adenoidectomy is done for complete removal of adenoids.
有明显症状时，可以进行腺样体切除术，彻底切除腺样体。
