Adenoid hypertrophy is what?

Written by Deng Bang Yu
Otolaryngology
Updated on September 16, 2024
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The adenoid is a lymphoepithelial tissue located in our nasopharynx, and it has certain immune functions. Under the stimulation of various factors such as infectious or immune factors, the immune tissue and glands of the adenoid hypertrophy, leading to enlarged adenoids. Once the adenoids are enlarged, they can block our posterior nasal apertures and the pharyngeal opening of the Eustachian tube. This, in turn, can cause us to snore, breathe through the mouth, and lead to secretory otitis media. The progression of the condition can affect our hearing, impact physical development, affect the development of the facial and jaw regions, and result in an adenoid facies. Therefore, when clinical symptoms of adenoid enlargement appear, active management is generally required, mainly surgical treatment.

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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.

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What should be done about children's adenoid hypertrophy?

In the case of adenoid hypertrophy in children, the first step is to assess the severity of the enlargement. If the adenoids are enlarged to the third degree, affecting breathing, especially with noticeable snoring after falling asleep at night, or symptoms such as frequent waking due to choking and hypoxia, surgery is generally recommended. This involves going to an otolaryngology department to surgically remove the enlarged adenoids. If the enlargement is only at the first degree or between the first and second degrees, and not very severe, local anti-inflammatory and swelling-reducing medications can be used for treatment.

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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.

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Treatment methods for adenoid hypertrophy

Adenoid hypertrophy refers to the hyperplasia and enlargement of the adenoid tissue in the nasopharynx, blocking the local upper airway passages, leading to conditions such as rhinitis, sinusitis, otitis media, and snoring during sleep. Clinically, there are two treatment methods: conservative medication and surgery. Currently, there are no specific drugs aimed at adenoid hypertrophy. Typically, treatments involve the use of nasal corticosteroids such as mometasone furoate nasal spray and anti-allergic medications like montelukast. However, the effectiveness of the treatment may vary from person to person or be unpredictable. Generally, medication is first tried for one to three months, or depending on the severity of the adenoid hypertrophy, treatment can last about two weeks to four weeks. If the medication is not effective, or shows no results, surgical intervention to remove the enlarged adenoids and facilitate airway clearance is necessary. (Please use medication under the guidance of a clinical doctor and do not self-medicate.)

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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."