Treatment methods for adenoid hypertrophy

Written by Deng Bang Yu
Otolaryngology
Updated on October 31, 2024
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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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Written by Deng Bang Yu
Otolaryngology
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How is adenoid hypertrophy surgery performed?

The adenoid is a lymphoepithelial tissue located in the nasopharyngeal region. Enlargement of the adenoid can block the nasal passages, leading to snoring and sleep apnea, often requiring surgical removal of the adenoid. The surgery is performed under general anesthesia. Firstly, we use a catheter to suspend the soft palate to expose the adenoid tissue. Then, using a nasal endoscope, with the right hand holding a plasma knife, the enlarged adenoid is ablated. The surgery involves inserting the nasal endoscope and adenoid knife through the mouth. The procedure is relatively short, lasting about five to ten minutes. There is very little bleeding after the surgery, making it truly a minimally invasive procedure.

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Written by Li Mao Cai
Otolaryngology
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Adenoid hypertrophy is caused by what?

Adenoid hypertrophy can be divided into physiological and pathological hypertrophy. Physiological hypertrophy is a normal part of everyone's development. It begins at the age of three, peaks at about seven, and gradually shrinks around the age of ten. Pathological hypertrophy, on the other hand, often occurs on the basis of physiological hypertrophy, followed by inflammatory stimuli. Factors such as viral infections, colds, and allergic reactions are the main causes of pathological adenoid hypertrophy. This type of hypertrophy can lead to poor respiratory function, symptoms such as snoring during sleep, nasal congestion, and a runny nose. If the enlarged adenoids block the Eustachian tube, it can also lead to secretory otitis media.

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Written by Zhang Jun
Otolaryngology
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Can you get vaccinated if you have enlarged adenoids?

Adenoid hypertrophy needs to be distinguished first between acute and chronic hypertrophy. If it is acute adenoid hypertrophy, vaccination should not be administered. Acute adenoid hypertrophy is most often caused by an acute inflammatory infection, usually secondary to acute rhinitis or sinusitis. When the inflammation affects the adenoids, it leads to congestion, edema, enlargement, and hyperplasia, resulting in clinical symptoms such as nasal congestion, ear stuffiness, and ear pain. The treatment primarily involves symptomatic anti-inflammatory treatment, along with nebulized inhalation to alleviate local congestion and edema, which can lead to gradual improvement. Vaccination can be administered once the inflammation has subsided. However, if it is chronic hypertrophy, patients can be vaccinated. Chronic hypertrophy is mostly due to continuous slow enlargement and hyperplasia of the adenoids caused by chronic inflammatory stimulation, leading to symptoms like snoring during sleep and mouth breathing. In such cases, adenoidectomy can be curative.

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Written by Li Mao Cai
Otolaryngology
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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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Written by Deng Bang Yu
Otolaryngology
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Can adenoid hypertrophy heal itself?

The adenoids are normal lymphoepithelial tissue located in our nasopharynx. In young children, especially around the ages of 5-6, the adenoids become enlarged or hyperplastic. This can then easily lead to the obstruction of surrounding structures causing issues such as snoring, sinusitis, and otitis media. Generally, adenoid hypertrophy is self-resolving because, after the age of around ten, the adenoids gradually atrophy. However, there are a minority of patients in whom the adenoids do not atrophy. Although the adenoids of the vast majority of patients will atrophy around the age of ten, it is important to recognize that from hypertrophy to atrophy, there is a long duration during which if deformities or conditions that affect body development occur, they cannot be reversed to normal. Therefore, it is essential to treat and intervene timely in patients with adenoid hypertrophy.