Enlarged Adenoids - Symptoms, Causes, Diagnosis and Treatment

Growth (Hypertrophy) of The Adenoid

Enlarged Adenoid

Adenoid is a tissue in the lymphoid structure located at the back of the nostrils. The microbes entering through the breath from the nose adhere to the particles and allergens and they are prevented from reaching the lower airways. In general, symptoms of enlarged adenoid can be grouped into those associated with nasal obstruction and those related to the middle ear.

Adenoid hypertrophy, also known as enlarged adenoids, is a common condition that affects many children and some adults. The adenoids are lymphoid tissue located in the back of the throat, behind the nose, and above the tonsils. Their primary function is to help trap and filter out bacteria, viruses, and other harmful microorganisms that enter through the nose and mouth. However, when the adenoids become enlarged, they can cause a range of problems and symptoms.

What Causes Adenoid Hypertrophy?

The exact cause of adenoid hypertrophy is unknown, but it is believed to result from repeated infections or inflammation. Frequent respiratory tract infections, allergies, sinus infections, and chronic nasal congestion are often associated with adenoid hypertrophy. Additionally, genetic factors and exposure to environmental irritants may play a role in the development of this condition.

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Apart from genetic predisposition; it can facilitate Adenoid hypertrophy with contaminated air, high allergenicity, cigarette smoke, high microbial concentration and long periods in allergen-rich environment.

Depending on the adenoid growth, nasal obstruction, open mouth sleeping, recurrent sinus infections in children, middle ear infections and middle ear fluid may be seen.

In children with enlarged adenoids, the appearance of a mouth that appears to be open and that there is little communication around can occur. This condition is called "adenoid face".

Symptoms of Adenoid Hypertrophy

Symptoms of adenoid hypertrophy can vary depending on the severity of the enlargement. Some common symptoms include:

1. Nasal congestion and difficulty breathing: Enlarged adenoids can block the nasal passages, resulting in chronic nasal congestion. This can make it difficult to breathe through the nose, leading to mouth breathing and snoring during sleep.

2. Sleep problems: Due to difficulty breathing, individuals with adenoid hypertrophy may experience disrupted sleep patterns, including snoring, restless sleep, or even sleep apnea. This can result in daytime fatigue, irritability, and poor concentration.

3. Ear problems: Enlarged adenoids can obstruct the Eustachian tubes, which are responsible for equalizing pressure between the middle ear and the throat. This can lead to recurring ear infections, fluid buildup in the middle ear (serous otitis media), ear pain or discomfort, and temporary hearing loss.

4. Speech and language difficulties: In children, enlarged adenoids can interfere with normal speech development

Typical facial appearance and mouth-open breathing pattern in a child with adenoid hypertrophy

Children with large adenoids may experience decreased sleep quality and signs of sleep apnea. Repeated episodes of sleep apnea can be seen in children, especially those with tonsils and natriuretic growth.

Diagnosis of Adenoid Hypertrophy

Diagnosing adenoid hypertrophy typically involves a combination of medical history, physical examination, and sometimes imaging tests. Here are the common diagnostic methods used:

1. Medical History: Your healthcare provider will ask questions about your symptoms, the duration and progression of symptoms, and any other relevant medical history. They may inquire about recurring infections, sleep disturbances, snoring, or ear problems.

2. Physical Examination: During a physical examination, the healthcare provider will examine your throat, nose, and ears. They may use a small lighted instrument called an otoscope to visualize the adenoids and check for signs of enlargement, redness, or infection. They may also examine the tonsils and evaluate the overall condition of the nasal passages.

3. Nasal Endoscopy: In some cases, your healthcare provider may recommend a nasal endoscopy. This procedure involves inserting a thin, flexible tube with a tiny camera (endoscope) through the nose. The camera allows the doctor to visualize the adenoid.

4. Imaging Methods: Imaging methods are not the first choice diagnostic tools in the diagnosis of adenoid hypertrophy, but lateral cranial radiography and magnetic resonance imaging taken in soft tissue dose and with the mouth open can show the volume of the adenoid tissue and how narrow the air passage is.

Endoscopic examination is sufficient for diagnosis of enlarged adenoid. It is not always necessary to remove radiographs.

Adenoid Hypertrophy - Adenoidectomy Operation - Enlarged Adenoids - Enlarged Adenoids Causes, Diagnosis of Adenoid Hypertrophy - Treatment of Hypertrophy - Adenoidectomy in IstanbulAdenoid surgery is performed under general anesthesia. Adenoids are removed with the help of a curette, called an adenoidectomy, after the automatic puncture is placed and the palate is stretched.

Postoperative simple ocean water sprayers and pain relievers can be used. As in tonsillectomy, a special diet is not necessary. Only the first 1 or 2 days can be fed with a soft mild diet.

Adenoid hypertrophy graphy image
Above is a lateral cranial radiograph taken in soft tissue dose and with the mouth open. Adenoid tissue narrowing with air column in the nasopharynx is seen (enlarged adenoid).

Adenoid hypertrophy prevents the normal posture of the tongue in babies!

Patients with adenoid hypertrophy may experience nasal congestion since infancy, and during this period they may have to continue their daily lives with their mouth open during sleep. The tongue is a muscular organ that plays a role in shaping the jaw and facial bones of babies. A baby cannot place his tongue in the upper jaw while sleeping. The tongue, which normally pushes the upper jaw forward and to the side while pulling the lower jaw forward, cannot perform these functions. Due to chronic open-mouth breathing and the tongue remaining at the floor of the mouth, many problems such as the small mandible, the appearance of a dome palate in the upper jaw (narrow and deep upper palate), the facial bones being sunken inwards, and the teeth overlapping each other, due to the influence of the facial muscles in the front of the face. It may come out. The adverse health effects of adenoid hypertrophy in children may result in susceptibility to sleep apnea and permanent airway narrowing in adulthood. Adenoidectomy operation, which is a procedure that takes only a few minutes, can prevent these permanent negative effects (dentofacial changes) from occurring.

Treatment of Adenoid Hypertrophy

The treatment options for adenoid hypertrophy depend on the severity of the symptoms and the impact on the individual's quality of life. Here are some common treatment approaches:

1. Observation: In mild cases, where the symptoms are not significantly impacting the individual, a "watch and wait" approach may be recommended. This involves regular monitoring of symptoms and periodic check-ups to assess the progression of the condition.

2. Medications: If the symptoms are predominantly caused by allergies or nasal congestion, medications such as antihistamines, nasal decongestants, or steroid nasal sprays may be prescribed. These medications can help reduce inflammation, improve nasal airflow, and alleviate symptoms.

3. Antibiotics: If there is evidence of an active infection, such as recurrent or persistent bacterial infections, your healthcare provider may prescribe a course of antibiotics to clear the infection.

4. Surgical intervention: If conservative measures do not provide relief or the symptoms are significantly affecting the individual's quality of life, surgical removal of the adenoids may be done. You can find detailed information and videos about the adenoidectomy operation below.

The link group you can click to read the articles about adenoid hypertrophy that I have previously published on this website >> https://www.ent-istanbul.com/search?q=adenoid+hypertrophy+

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul

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