Tonight's question: Adenoids: Where are they, and what are they good for?
I pondered this question as I listened to Bobbin snoring, and recalled the conversation with the doctor yesterday at the possibility that Bobbin may need her adenoids removed if she continues to be a virus-magnet even as cold & flu season starts to wane.
The related question I had, not having ANY kind of sense of anatomy beyond the major organs, bones, and muscle groups (the latter two I can only point to with any accuracy and not actually name with their official medical nomenclature) is whether adenoids were anything like tonsils, given their propensity to be recommended for removal upon repeated diagnoses of upper respiratory illnesses.
And so, after being forced out of bed to comfort my fussing Bobbin (who, it turns out, also has a bad case of gas which is what I think is probably the main cause of tonight's restlessness and discomfort, as opposed to the snoring, which is probably something she's become somewhat used to by now) I came out to the kitchen to find the answers.
And so also, shall I share with you, the answers that I found.
According to the ever-so-trustworthy wikipedia:
"Adenoids (or pharyngeal tonsils, or nasopharyngeal tonsils) are a mass of lymphoid tissue situated at the very back of the nose, in the roof of the nasopharynx, where the nose blends into the mouth.
Normally, in children, they make a soft mound in the roof and posterior wall of the nasopharynx, just above and behind the uvula."
In terms of what are they good for? As part of the immune system, adenoids trap infectious agents - bacteria, viruses - and produce antibodies.
The main reason one would want to remove them is if they were chronically infected and the infections did not clear up with repeated use of antibiotics.
Some articles suggest another reason for removal is if they become so enlarged that they started obstructing airflow enough so that breathing through the nose requires an uncomfortable amount of work, and inhalation occurs through the mouth instead.
Enlargement is usually caused by infection. And infection can happen when the bacteria and viruses that they are supposed to trap get lodged within it and survive.
However adenoids also enlarge with age, usually reaching their greatest size by 5 years of age and then atrophying to microscopic size by around 7 years of age. So the conclusion seems to be that snoring/breathing problems alone, unless they also interfere with one's ability to take in sufficient amounts of oxygen or unless they had a cancer or abscess or something of that nature, would not be a reason to remove enlarged adenoids in children since they are likely going to decrease in size as the child gets older.
As for whether or not there is any relation to tonsils - as apparently anyone with even remotely more anatomical sense than I have (which is probably almost everyone who attended a high school biology class, now that I've read up on this subject... and here I was thinking I was so smart for making the connection) will tell you - yes, yes in fact there is. Tonsils are also lymphoid tissue and as such also act as part of the immune system to help protect against infection. Palatine tonsils (which is what is usually being referred to when people use the generic term "tonsils", as opposed to pharyngeal tonsils, a.k.a adenoids, or lingual tonsils) are located (and yes, even I knew this) in the back of the throat.
The new question that arose as a result of this research was "If adenoids produce antibodies and serve to fight infection, what happens to one's ability to fight infection if they are removed?" The answer is that, like any good security system, our immune system contains multiple layers of defenses to protect us from infection. And the lymphatic system, which is the layer in which the adenoids and tonsils are located, is made up of multiple lymph nodes. And while I couldn't find a definitive answer to that specific question, I assume that the main reason adenoid and/or tonsil removal has little if any effect on one's ability to fight infection is because there's still lots of other stuff in the body that can continue to do the job sufficiently without these two parts. I am quite sure The Sis can provide a much more specific answer though, which I'd love to hear!
As for whether or not we'll remove them; I hope not. And it's not something we would know right now, with us still being in the midst of cold and flu season. But if she continues to contract every cold or flu that comes within a 10 mile radius of her by mid-summer it is probably something we're going to have to consider. We'll see. We're still within that "the first 2 years are the sickest one, and then it starts getting better" window and I really would prefer to avoid having to put her through this if we don't really need to.
And now armed with my new-found knowledge, I feel much more at ease and better capable of making the decision if/when it comes to that. I also have another chapter for my ever-growing mental encyclopedia of medical conditions.
Comments
Immunology was actually one of my favourite classes in school. The immune system is pretty freakin' cool.
Posted by The Sis on March 16, 2007 7:35 AM.Anyway, yes, tonsils are almost completely redundant. I say "redundant" instead of "useless" because they do serve a purpose � all lymphoid tissue does. Tonsils are part of the MALT � mucosal-associated lymphoid tissue. You find it pretty much anywhere you'd expect to find mucous... the nose, throat, and gastrointestinal tract. The mucous membranes of an average human cover a surface area of 400 metres-squared, and it is a major site of entry for many pathogens. So, MALT helps gaurd that gateway. The tonsils (all of them, not just the ones in your throat) are actually quite organised structures, containing a variety of immune cells: B cells, which produce anti-bodies; T cells, the immune system's big cheese; macrophages, big cells that "eat" other cells; and M cells, which "eat" antigens, then communicate with B cells to let them know what anti-bodies to produce.
So, if you remove a tonsil, you have some back up. Incidentally, the appendix is also part of the MALT...