Adenoids. (Pharyngeal Tonsil, Lursehkas Tonsil, Adenoid Vegetation, Post-nasal Growth.)—­Adenoids are overgrowths or thickenings of the glandular tissue in the vault (top) of the pharynx.  They are on the upper posterior wall of the pharynx, often filling the whole space, especially the part behind the ear-tube—­eustachian tube.

They are a soft pliable mass, well supplied with blood vessels, especially in children.  Some are firmer and these are the kind seen in adults.  The color varies from pale pink to dark red.  The structure is similar to enlarged tonsils.

[Respiratory diseases 9]

[Illustration:  Adenoids]

Symptoms.—­Children breathe chiefly or wholly through the mouth.  They are apt to breathe noisily, especially when they eat and drink.  They sleep with their mouth open, breathe hard and snore.  They have attacks of slight suffocation sometimes, especially seen in young children.  There may be difficulty in nursing in infants; they sleep poorly, toss about in bed, moan, talk, and night terrors are common.  They may also sweat very much during sleep.  A constant hacking or barking cough is a common symptom and this cough is often troublesome for some hours before going to bed.  Troubles with the larynx and pharynx are common and spasmodic laryngitis appears to be often dependent upon adenoids.  Bronchial asthma and sneezing in paroxysms are sometimes connected with them.  The chest becomes deformed.  The prolonged mouth-breathing imparts to adenoid patients a characteristic look in the face.  The lower jaw is dropped and the lips are kept constantly apart.  In many cases the upper lip is short, showing some part of the upper teeth.  The dropping of the jaw draws upon the soft parts and tends to obliterate the natural folds of the face about the nose, lips, and cheeks.  The face has an elongated appearance and the expression is vacant, listless, or even stupid.  The nose is narrow and pinched, from long continued inaction of the wings of the nose (alae nasi).  The root of the nose may be flat and broad.  When the disease sets in during early childhood, the palate may become high arched.  If the disease continues beyond second teething, the arch of the palate becomes higher and the top of the arch more pointed.  The upper jaw elongates and this often causes the front teeth to project far beyond the corresponding teeth in the lower jaw.  The high arched palate is often observed to be associated with a deflected partition (septum) in the nose.

The speech is affected in a characteristic way; it acquires a dead character.  There is inability to pronounce the nasal consonant sounds; m, n, and ng and the l, r, and th sounds are changed.  Some backwardness in learning to articulate is often noticed.

Deafness is frequently present, varying in degree, transient and persistent.  Attacks of earache are common and also running of the ears.  The ear troubles often arise from the extension of catarrh from the nose-pharynx through the eustachian tubes to the middle ear.  Sometimes the adenoids block the entrance to the tubes.  The ventilation of the middle ear may be impeded.  Dr. Ball, of London, England, says:  “Ear troubles in children are undoubtedly, in the vast majority of cases, dependent upon the presence of adenoid vegetation” (growths).