Accoucheur's hand


The adenoid is a group of lymphoid tissue at the roof of the pharynx .Present at birth it hypertrophies between the ages 4 and 14 and atrophies at puberty. In young children overgrowth of this lymphoid tissue in the nasopharynx with or without enlargement of the tonsils may obstruct the respiratory passage. Obstruction to the respiration through the nose makes mouth breathing more or less obligatory .In order to breathe as the child has to keep its mouth open the hard palate and alveolar arch remain habitually out of contact with dorsm of the tongue . Lacking pressure from the tongue the children develop with an abnormally high arch palate .The hardpalate becomes narrowed laterally .The projecting alveolar process cannot afford sufficient room for the permanent teeth .They are therefore crowded ; irregularly set and overhang those in the lower jaw . The protruding upper incisors compel the child to keep the mouth open .As a result the child's saliva dribbles from the open mouth during sleep .The facial surfaces of the maxillae become pinched together .Therefore the nasal cavities and the maxillary air sinuses become narrowed resulting in altered voice and accents with or without nasal twang .The upper lip is drawn up still further exposing the front upper teeth resulting in dryness of the upper lip and collection of tartar on the upper teeth .By drooping of the lower jaw the face is lengthened .The whole expression of the child is highly characteristic suggesting vacuity and inattention .This is due to the deafness so often associated with the obstruction of the nose and of the Eustachian tubes .The deafness and inattentiveness interferes with the learning .Hence the child grows with lowered intelligence and understanding .These children may lag behind their contemporaries in the school and may even fail in the school examinations .  

2005-2006© Dr.Hemant Vinze.