How to check for adenoid hypertrophy?

Written by Yao Jun
Otolaryngology - Head and Neck Surgery
Updated on August 31, 2024
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Adenoid hypertrophy is mainly seen in infants and young children. Children with adenoid hypertrophy often also have enlarged tonsils. Therefore, it is important to ask if the patient breathes with their mouth open, snores, or has episodes of breath-holding. In older children, a nasal endoscopy can be performed to find that the adenoids block two-thirds or even up to three-quarters of the posterior nasal aperture. For smaller children who may not cooperate, imaging studies such as nasopharyngeal CT, X-rays, and lateral films can be used to detect adenoids. In the nasopharynx, the imaging will show the presence of soft tissue with clear boundaries from the surrounding areas.

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Written by Xu Qing Tian
Otolaryngology
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Does adenoid hypertrophy have a strange smell?

Adenoid hypertrophy is a common ENT disease, mostly seen in infants and young children aged 5 to 7 years. Before surgery for adenoid hypertrophy, the blockage of the posterior nasal aperture can cause edema, inflammation, and purulent secretions in the sinus and nasal mucosa, leading to an unpleasant odor in the nasal cavity. Patients with adenoid hypertrophy usually need to undergo adenoidectomy using a plasma knife. After the surgery, local burns can cause necrosis of the mucosa, resulting in bad odors in both the nasal and oral cavities. Therefore, for patients with adenoid hypertrophy, the main approach is to maintain oral hygiene, which can help reduce the unpleasant nasal odors.

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Written by Xu Qing Tian
Otolaryngology
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Can adenoid hypertrophy be seen with the naked eye?

Adenoid hypertrophy is a common disease in otolaryngology, and it is not visible to the naked eye. The diagnosis of excessive growth and hypertrophy of adenoid tissue is mainly made through electronic nasopharyngoscopy and lateral nasopharyngeal radiograph examinations. Typically, if the adenoid tissue occupies more than 2/3 of the posterior nasal aperture, it can be diagnosed as adenoid hypertrophy. Patients mainly show symptoms such as snoring, breath-holding, and hypoxia during sleep at night, as well as daytime sleepiness and reduced memory. Patients with adenoid hypertrophy require surgical ablation of the hypertrophied adenoid tissue to improve their sleep conditions at night and achieve cure.

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Written by Li Mao Cai
Otolaryngology
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Can adenoid hypertrophy cause otitis media?

Adenoid hypertrophy is commonly seen in children. The adenoids are located at the back of the nasal cavity, more precisely, at the nasopharyngeal region of the posterior nasal cavity. The nasal cavity is connected to the ears via the Eustachian tube, whose internal opening is situated in the nasopharynx. If the adenoids are enlarged, they can block the internal opening of the Eustachian tube. Therefore, adenoid hypertrophy can cause secretory otitis media. The common symptoms of secretory otitis media in children include a decrease in hearing, turning up the volume of the TV intentionally, and a sluggish response when called. This explains the mechanism and clinical presentation of how adenoid hypertrophy can lead to otitis media.

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Written by Deng Bang Yu
Otolaryngology
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The difference between adenoid hypertrophy and tonsil hypertrophy.

There is a fundamental difference between adenoid hypertrophy and tonsil hypertrophy, yet there are certain connections between them. The adenoids are located in the nasopharynx and are also a lymphoepithelial organ. The nature of adenoid hypertrophy leads to an increase in size, causing obstruction of the posterior nasal apertures and the Eustachian tubes, resulting in symptoms such as snoring and otitis media. Tonsils, on the other hand, are located in the oropharynx and their enlargement can block the oropharynx, leading to rapid breathing and obstructed breathing. It is common for tonsil hypertrophy to occur physiologically in children; clinically, it is often observed that children with tonsil hypertrophy also have adenoid hypertrophy. Both generally occur together because they are part of the internal ring of the pharyngeal lymphatic ring, which establishes a link between them. In summary, while adenoid hypertrophy and tonsil hypertrophy differ fundamentally in location and the manner of pathological changes, they are connected in certain ways.

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Written by Zhang Jun
Otolaryngology
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Does adenoid hypertrophy require nasal irrigation?

Enlarged adenoids require nasal cleansing, which can be done using saline solution for nasal irrigation. During irrigation, the inflammatory secretions on the surfaces of the nasal cavity and the pharyngeal adenoids can be washed off, thereby alleviating the symptoms of enlarged adenoids. This can relieve the patient's nasal congestion and snoring during sleep. This is a conservative treatment method for enlarged adenoids. Additionally, during the acute phase of enlarged adenoids, symptomatic anti-inflammatory treatment is also necessary, using antibiotics such as penicillins or cephalosporins, which are effective. Administration of budesonide via nebulization can also be combined to reduce congestion and edema of the mucous membrane on the surface of the adenoids, relieving symptoms. If the adenoids remain enlarged for an extended period, and conservative treatments are ineffective, and if the patient has severe snoring symptoms, then adenoidectomy might be necessary to completely cure the condition. (Medications should be used under the guidance of a doctor.)