Adenoid hypertrophy

Notes

## Basic introduction

  • Adenoids are also known as a pharyngeal tonsils (or nasopharyngeal tonsils)
  • They are mass of lymphatic tissue in the posterior nasopharynx that are largest in children 2 - 6yrs
  • They contain cells and antibodies of the immune system that help prevent throat and lung infections, though this role is not critical

## Causes of adenoids

  • Allergy and irritants
  • Bacterial infection
  • GERD
  • Viral infection e.g. EBV

## Effects of enlarged adenoids

  • Otitis media (due to the obstruction of the eustachian tubes)
  • Sinusitis (due to the obstruction of posterior choanae)
  • Both otitis media and sinusitis
Symptoms
  • “Adenoid facies”
  • Bad posture
  • Chronic mouth breathing
  • Cough
  • Drooling of saliva
  • Epistaxis
  • Halitosis
  • Hyponasal speech
  • Mental dullness and apathy
  • Mouth-breathing
  • Nasal obstruction
  • Nasopharyngitis
  • Nocturnal enuresis
  • Otitis media with possibility of loss of hearing
  • Persistent nasal discharge
  • Sinusitis
  • Sleep disturbance
  • Snoring
Diagnosis
  • Clinical review
  • Fiberoptic nasopharyngoscopy
  • Lateral soft tissue X-ray of the nasopharynx (narrow nasopharynx air space)
Differential
  • Lymphoma
  • Angiofibroma
  • Pharyngitis
  • Strep throat
Prevention
  • None is known
Reference

a. Kenyan Ministry of Health. Clinical guidelines for management and referral of common conditions at levels 4-6. Hospitals. 2009; 3:259-261.http://apps.who.int/medicinedocs/documents/s21000en/s21000en.pdf

 

Management
  • Antibiotics
  • Intranasal corticosteroids
  • Antihistamines
  • Adenoidectomy (in cases of persistent and severe symptoms)
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