swollen and infected adenoids can trap BACTERIAin
the EUSTACHIAN TUBE and middle EAR. Adenoid
hypertrophy is a leading cause of OTITISmedia (mid-
dle ear INFECTION) in children.
Symptoms of adenoid hypertrophy include
- frequent ear infections
- MOUTHbreathing
- snoring, and, when hypertrophy is severe,
OBSTRUCTIVE SLEEP APNEA - POSTNASAL DRIP
- bad breath (HALITOSIS)
Because the adenoids atrophy with physical
maturation, doctors prefer to treat occasional
infections with appropriate ANTIBIOTIC MEDICATIONS.
ALLERGIC RHINITIScan also cause adenoid hypertro-
phy. When adenoid infections become chronic or
when the swelling does not retreat, doctors may
recommend adenoidectomy (surgery to remove
the adenoids). Once the adenoids are removed,
any related health problems go away.
See also SURGERY BENEFIT AND RISK ASSESSMENT;
TONSILLITIS.
aging, otolaryngologic changes that occur with
The natural changes that take place in the struc-
tures and functions of the EAR, NOSE, THROAT, and
MOUTH as a person grows older. Age-related
changes manifest in late childhood, as facial struc-
tures elongate, and again in the sixth decade and
beyond, as some diminishment of function, partic-
ularly sensory perception, develops.
Otolaryngologic Changes in Late Childhood
Though the senses of hearing, taste, and smell are
fully developed by about one month of age,
changes in facial structure later in childhood alter
some aspects of function. The rounded facial
structures of the young child begin to change
around age five or six and continue into early
ADOLESCENCE. The head elongates, expanding the
nasal and oral passages. The eustachian tubes
lengthen and angle downward, improving their
ability to remain patent (open and clear of conges-
tion). The arch of the palate (roof of the mouth)
flattens, and the permanent TEETHcome in. Con-
trol of the tongue, lips, and other muscular struc-
tures of the face and neck improves. These
changes facilitate the ability to form words. By late
childhood, many difficulties with speech begin to
resolve. Continued development of the brain’s
temporal lobe, which processes hearing and lan-
guage as well as taste and smell, expands and
refines speech capabilities and sensory inter-
pretations. Whereas a child may perceive a flavor
as “chocolate,” an adult will discern that same fla-
vor in terms of multiple descriptors.Otolaryngologic Changes in Late Life
In healthy adults, sensory perceptions, balance,
and language capacity remain intact well into the
sixth or seventh decade. Beyond this point, many
people experience alterations in taste and smell,
and particularly hearing. Health conditions that
become more prevalent with age, such as STROKE
and PARKINSON’S DISEASE, also affect sensory func-
tions as well as swallowing and speech.
Taste cells, located within taste buds, are the
only sensory cells that regenerate, and they do so
regularly throughout life. By midlife the rate of
regeneration slows, and a person at age 60 has
about half as many taste cells as at age 30. The
more significant influence on the perception of
taste, however, is the loss of olfactory receptors in
the nose. The body does not replenish these spe-
cialized sensory cells, which detect thousands of
odors in comparison to the four basic qualities the
sense of taste detects. By age 70 there are about a
third as many olfactory receptors as at age 30.
These changes influence a person’s interest in food
and desire to eat, which commonly becomes a
reason for inadequate nutrition and diet in the
elderly. As well, the loss of teeth due to DENTAL
CARIES (cavities) and gum diseases such as PERI-
ODONTAL DISEASE, and decreased saliva production,
diminish the ability to chew, further restricting
food choices.
The clinical term for age-related HEARING LOSSis
PRESBYCUSIS. The HAIR cells within the COCHLEA,
which respond to the frequencies of the vibrations
that pass into the inner EAR, are extraordinarily
sensitive. By the sixth or seventh decade of life,
the fibers of the hair cells, particularly those sensi-
tive to high frequency vibrations, break and expe-
rience other damage. This causes loss of the ability
to register sounds in those frequencies, which
manifests as hearing loss. As these are the fre-8 The Ear, Nose, Mouth and Throat