Age-specific vascular organization of pharyngeal tonsil

Abstract

Adenoid vegetations belong to the most common pathology of the upper respiratory tract in children. According to some authors, adenoids may also occur in adult population, producing a number of clinically significant symptoms. It is known that intraoperative bleeding in adenotomy in adult patients is more intense than in children. Therefore, to know the age-specific features of the vascular organization of adenoid tissue is necessary for development and improvement of sparing methods of surgical treatment of pharyngeal tonsil hypertrophy. The authors examined 96 patients (n = 96), divided into 4 groups: Group 1 included the patients aged 7 to 12 years (n = 25); Group 2 – the patients aged 12 to 15 years (n = 25); Group 3 – the patients aged 15 to 18 years (n = 25); Group 4 – the patients aged 18 to 42 years (n = 21). There were 58 (60%) male and 38 (40%) female patients. As a result of histological examination of adenoid tissue, the authors revealed characteristic changes in adenoid tissue vessels in each age group, especially pronounced between 15 and 18 years of age. Besides, the authors observed the development of sclerosis and hyalinosis of vascular walls with the formation of cavernously enlarged full-blooded veins with thickened rigid walls. The patients over 18 years of age have morphological reorganization of the connective tissue (basal) layer manifested by immersion of lymphoid tissue with a developed microcirculatory bloodstream, which accounts for the significant intraoperative bleeding in adenotomy. Therefore, the results of the histological examination can serve as one of the indications for application of electrophysical adenotomy methods in patients over 15 years of age.