Sluggish expression

Introduction A dull expression is one of the symptoms of adenoid hypertrophy, adenoidal hypertrophy is a hyperplasia of the pharyngeal tonsils. The inflammation of the nasopharynx and its adjacent parts or the adenoid itself is repeatedly stimulated, causing pathological hyperplasia of the adenoid. Childhood is prone to acute rhinitis, acute tonsillitis and influenza, etc., if repeated episodes, adenoids can rapidly proliferate and hypertrophy, resulting in increased nasal obstruction, obstructing nasal drainage, and rhinitis and sinusitis secretions stimulate the adenoid to continue Hyperplasia, forming a vicious circle of mutual causality. More common in children, often combined with chronic tonsillitis.

Cause

Childhood is prone to acute rhinitis, acute tonsillitis and influenza, etc., if repeated episodes, adenoids can rapidly proliferate and hypertrophy, resulting in increased nasal obstruction, obstructing nasal drainage, and rhinitis and sinusitis secretions stimulate the adenoid to continue Hyperplasia, forming a vicious circle of mutual causality. More common in children, often combined with chronic tonsillitis.

an examination

Related inspection

Anterior nasal examination neurological examination

Clinical manifestations:

1, local symptoms: children with adenoid hypertrophy after occlusion of the nostrils and eustachian tube throat, can occur otolaryngeal and other symptoms. It is characterized by mouth breathing when sleeping, often snoring after the tongue root falls, no rest in the night, more nasal secretion, occlusive nasal sound when speaking, and vague voice. Due to long-term mouth breathing, the facial bone development disorder, the maxilla bone lengthened, the hard palate is high arch, the dentition is not complete, the upper incisor is exposed, the lip is thick, the face lacks expression, and the dementia manifests, forming an "adenoplasty face". Mutual discomfort between swallowing and breathing, often coughing. The secretions irritate the respiratory mucosa and are prone to bronchitis. Because of the obstruction of the eustachian tube, it is easy to cause suction in the non-suppurative otitis media, and the tympanic membrane is invaginated.

2, systemic symptoms: often have systemic nutrition and developmental disorders, mainly manifested as chronic poisoning reflex neurological symptoms, such as slow expression, chest tightness, poor lung expansion, long-term chicken chest or flat chest. A small number of chronic heart failure, long-term hypoxia and pulmonary heart disease, and even acute heart failure. Check the adenoid face, the hard palate is high and narrow, the posterior nasal examination shows that the nasopharynx has a pink, lobulated lymphoid tissue block, the nasopharyngeal palpation can touch the soft mass, if necessary, can be used as X-ray nasopharynx A slice that helps diagnose.

Diagnostic check:

1. The child has a mouthful of breathing, sometimes showing an "adenoid face".

2, oropharyngeal examination: hard sputum is high and narrow, often accompanied by sputum tonsil hypertrophy.

3, anterior nasal examination: full contraction of the nasal mucosa after examination, may see a red block bulge in the nasopharynx.

4, fiber nasopharyngoscopy: visible on the top and posterior wall of the nasopharynx on the surface of the longitudinal fissure of the lobulated lymphoid tissue, like a half peeled small orange.

5, palpation: use your fingers for nasopharyngeal palpation, in the nasopharynx and posterior wall can be soft and soft.

6, X-ray nasopharynx lateral film, which is helpful for diagnosis.

Differential diagnosis

Chronic face: The face is gray or pale, the face is stunned, and the eyes are dim. Common in chronic wasting diseases, such as cirrhosis, malignant tumors, severe tuberculosis.

Anemia face: pale and dull, pale eyes, pale lips, tired expression.

Dementia face: head and neck short, small eye cracks, wide nose, flat nose, hypertrophy of the nose, thick tongue and often stick out of the mouth, common in patients with small illness.

Typhoid face: apathy, unresponsiveness, and a state of no desire. Mostly, the face of patients with high fever and fever, such as typhoid fever, encephalitis, and meningitis.

Indifferent expression: refers to the mental behavior of the patient who lacks feeling, emotion, interest or concern for everything around him.

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