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Adenoid hypertrophy
Is adenoid hypertrophy more severe in winter?
Adenoid hypertrophy tends to be more severe in the winter due to the weather changes which can lead to significant adenoid hyperplasia. Adenoid hypertrophy is generally more common in children aged three to eight. It is caused by repeated stimulation from acute inflammation, leading to congestion, edema, and growth of the adenoids. This condition can cause patients to experience persistent bilateral nasal congestion, snoring during sleep, and episodes of breath-holding. Additionally, patients may also experience tinnitus, hearing loss, and other related symptoms. Diagnosis can be confirmed through an electronic nasopharyngoscope and adenoid CT scans. For treatment, patients can initially opt for conservative treatments such as oral antibiotics. Additionally, localized nebulizer inhalation can be used to reduce congestion and swelling of the adenoids. If conservative treatments are ineffective, adenoidectomy may be necessary for recovery. (Medication should be taken under the guidance of a doctor.)
Does adenoid hypertrophy require surgery?
The adenoids are tissue organs located in our nasopharynx. Whether we need surgery after adenoid hypertrophy depends on two circumstances. The first is the degree of hypertrophy; if the adenoids are significantly enlarged, we might consider surgery. However, merely having enlarged adenoids is not enough; we need to see if the hypertrophy blocks the nasal cavity, obstructs our Eustachian tube, leads to adenoid facies, etc. If there are symptoms and secondary diseases, such hypertrophied adenoids, also known as adenoid hypertrophy, will necessitate surgery. If the adenoid hypertrophy is mild and presents no symptoms, we can temporarily observe without needing surgical intervention.
Can adenoid hypertrophy recur after removal?
The adenoid is located in the lymphatic epithelial tissue of the nasopharyngeal area. Enlargement of the adenoid can block breathing and obstruct the pharyngeal opening of the Eustachian tube, leading to secretory otitis media, and may result in secondary infections of the sinuses. Therefore, for symptoms such as snoring and hearing loss that occur simultaneously after adenoid enlargement, surgical removal is performed. The adenoid does not have a complete capsule, so it is only possible to remove the adenoid tissue as much as possible, and it cannot guarantee the complete removal of all adenoid tissue. Therefore, there is a small rate of recurrence after adenoid removal, with a recurrence rate of about 0.5%, meaning that the recurrence leading to the reappearance of symptoms is around 0.5%. Whether further treatment is needed after recurrence requires an in-person assessment at a hospital.
The difference between adenoid hypertrophy and rhinitis.
Adenoid hypertrophy and rhinitis certainly have their differences. The adenoid is a lymphoepithelial tissue located in the nasopharynx, and its enlargement can block the posterior nasal aperture, leading to nasal congestion. Rhinitis refers to the inflammation of the nasal mucosa, where the mucosa becomes congested and swollen, leading to narrowing and obstruction of the nasal cavity. There are fundamental differences between them. The clinical treatment for rhinitis primarily involves medication, while the treatment for adenoid hypertrophy mainly involves surgical removal. In the early stages of adenoid hypertrophy, some medications can be used, but the effectiveness of medical treatment is often relatively poor and rarely controls the progression of the condition, so surgery is primarily used. Clinically, it is often seen that rhinitis and adenoid hypertrophy coexist, which requires doctors to differentiate and determine whether the nasal congestion is caused by adenoid hypertrophy or rhinitis.
Is adenoid hypertrophy related to rhinitis?
The adenoids are located at the rear end of the nasal cavity, specifically in the nasopharynx. When the adenoids become enlarged, they can affect the ventilation and drainage functions of the nasal cavity. Therefore, enlarged adenoids can cause rhinitis, leading to symptoms such as nasal congestion, runny nose, reduced sense of smell, and snoring during sleep; these impact the nasal ventilation, which are the most common symptoms. The rationale is that when the adenoids are enlarged, the nasal mucus cannot be normally drained through the nasal cavity's drainage function. As a result, children may exhibit symptoms of excessive nasal discharge and nasal congestion, and difficulty breathing through the nose. Additionally, the rhinitis caused by the enlarged adenoids leads to nasal congestion, which then manifests as the child snoring and breathing through the mouth during sleep. Over time, this can lead to a condition known as "adenoid facies."
How to treat adenoid hypertrophy?
Adenoid hypertrophy mainly occurs in infants and children. It is a congenital disease, meaning that most children are born with varying degrees of adenoid hypertrophy. However, in many children, the adenoids begin to shrink after six months and generally do not cause symptoms. If the adenoids are enlarged, it can lead to the child breathing through their mouth, snoring, and gasping, which may cause facial changes, brain hypoxia, and delayed brain development. In such cases, adenoidectomy might be considered, generally performed under general anesthesia. However, some children with adenoid hypertrophy also have enlarged tonsils, so both surgeries are often performed together. Otherwise, if only the adenoid hypertrophy is treated without addressing enlarged tonsils, problems such as mouth breathing and snoring may not improve.
What department should I go to for adenoid hypertrophy?
Glandular hypertrophy is a common condition in the field of otolaryngology, so for glandular hypertrophy, one should consult the otolaryngology department. The glands are located at the back of the nasal cavity, specifically in the nasopharyngeal area. Thus, when the glands are enlarged, it can cause various related symptoms in the ears, nose, and throat. The most common symptoms include nasal congestion, runny nose, snoring, mouth breathing, adenoid facies, secretory otitis media, and even suppurative otitis media. Therefore, in such cases, it is essential to visit the otolaryngology department of a hospital, undergo a nasopharyngoscopy to assess the extent of glandular hypertrophy, and decide on the appropriate treatment based on the specific diagnosis.
Will adenoid hypertrophy recur after surgery?
The adenoid is a normal lymphoid organ in the nasopharyngeal area of the human body. Enlargement of the adenoids can block the nasal cavity, leading to otitis media, snoring during sleep, and other symptoms. The main treatment for enlarged adenoids is surgery. Since the adenoids do not have a complete capsule, there is a certain chance of recurrence after surgery. There are two scenarios for recurrence: one is a mild, localized proliferation that does not cause symptoms such as snoring or otitis media again; the other is a severe enlargement of the adenoids, leading to the reoccurrence of spontaneous conditions like snoring and otitis media. This latter situation accounts for about 0.5% of cases. Therefore, while there is a certain rate of recurrence after adenoidectomy, the rate of recurrence is relatively low.
What tests are needed for adenoid hypertrophy?
The adenoids are located at the back end of the nasal cavity in the nasopharyngeal area, so the examination needed for adenoid hypertrophy is generally the electronic nasopharyngoscopy. Electronic nasopharyngoscopy is a minimally invasive procedure that allows direct visual observation of the enlarged adenoids and the blockage of the posterior nasal apertures. Modern electronic nasopharyngoscopes are very thin; they can be inserted through the nostrils directly into the nasopharynx, providing a clear view of the adenoids with minimal discomfort and no radiation exposure, making it the preferred method. Another test that can be performed is a lateral X-ray of the nasopharynx. This examination has been a classic approach and is available in many township and county hospitals. It can accurately display the condition of adenoid hypertrophy and any airway obstruction. However, the only drawback is that it involves some level of radiation exposure.
Does adenoid hypertrophy always require surgery?
Is surgery necessary for adenoid hypertrophy? The answer is not necessarily. Adenoid hypertrophy is generally caused by acute rhinitis, tonsillitis, or acute epidemic influenza, among other factors. These factors can lead to the rapid proliferation and enlargement of the adenoids, which may compress the tissues of the nasal cavity, causing nasal obstruction or sinusitis. In such cases, it depends on the symptoms triggered and how significant the impact is on the patient. If the symptoms are not particularly severe, some non-surgical treatments can be adopted, such as enhancing the body's own disease resistance. Oral medications for clearing heat and detoxifying, and if necessary, traditional Chinese medicine for promoting blood circulation and removing blood stasis can be used to adjust the condition. If the enlargement of the adenoids is significantly alleviated with these medicinal treatments, surgery may not be necessary. However, if the disease is not well-controlled and severely affects breathing or swallowing, surgical treatment may be considered.