What should be done about children's adenoid hypertrophy?

Written by Yan Xin Liang
Pediatrics
Updated on September 02, 2024
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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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Written by Dong Xian Yan
Pediatrics
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Does a baby snoring mean that the adenoids are enlarged?

Baby snoring cannot necessarily be attributed to enlarged adenoids; it might also be due to a cold, nasal congestion, enlarged tonsils, or the position of the tongue falling back while sleeping. Therefore, the specific cause of a baby's snoring needs to be determined by a professional physician's examination, and appropriate treatment should be given based on the specific cause. If the snoring is due to enlarged adenoids or tonsils, a professional evaluation may be required to decide whether surgery is necessary to alleviate the symptoms of snoring. If the cause is nasal congestion, oral antihistamines or local nasal sprays can be used to relieve the symptoms of snoring. (If medication is required, please proceed under the guidance of a doctor.)

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Written by Zhang Peng
General Surgery
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Does adenoid hypertrophy always require surgery?

Is surgery necessary for adenoid hypertrophy? The answer is not necessarily. Adenoid hypertrophy is generally caused by acute rhinitis, tonsillitis, or acute epidemic influenza, among other factors. These factors can lead to the rapid proliferation and enlargement of the adenoids, which may compress the tissues of the nasal cavity, causing nasal obstruction or sinusitis. In such cases, it depends on the symptoms triggered and how significant the impact is on the patient. If the symptoms are not particularly severe, some non-surgical treatments can be adopted, such as enhancing the body's own disease resistance. Oral medications for clearing heat and detoxifying, and if necessary, traditional Chinese medicine for promoting blood circulation and removing blood stasis can be used to adjust the condition. If the enlargement of the adenoids is significantly alleviated with these medicinal treatments, surgery may not be necessary. However, if the disease is not well-controlled and severely affects breathing or swallowing, surgical treatment may be considered.

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Written by Deng Bang Yu
Otolaryngology
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Will adenoid hypertrophy recur after surgery?

The adenoid is a normal lymphoid organ in the nasopharyngeal area of the human body. Enlargement of the adenoids can block the nasal cavity, leading to otitis media, snoring during sleep, and other symptoms. The main treatment for enlarged adenoids is surgery. Since the adenoids do not have a complete capsule, there is a certain chance of recurrence after surgery. There are two scenarios for recurrence: one is a mild, localized proliferation that does not cause symptoms such as snoring or otitis media again; the other is a severe enlargement of the adenoids, leading to the reoccurrence of spontaneous conditions like snoring and otitis media. This latter situation accounts for about 0.5% of cases. Therefore, while there is a certain rate of recurrence after adenoidectomy, the rate of recurrence is relatively low.

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Written by Deng Bang Yu
Otolaryngology
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What medicine is good for adenoid hypertrophy?

The adenoids are lymphatic tissue located in the nasopharynx, and adenoid hypertrophy can be treated with some medications. Adenoid hypertrophy is often related to allergic factors or stimulation from bacterial infections. Therefore, for the treatment of adenoid hypertrophy, some medications can be used for nasal administration, such as mometasone furoate nasal spray, as well as anti-allergy medications like montelukast sodium. Additionally, some traditional Chinese medicines with aromatic properties, such as Bi Yuan Tong Qiao granules, can be used as adjunct therapy. In summary, the pharmaceutical treatment for adenoid hypertrophy is not directly targeted, and the effectiveness of medication is relatively poor, so a comprehensive evaluation of the condition should be considered when contemplating medication treatment.

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Written by Yao Jun
Otolaryngology - Head and Neck Surgery
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How to check for adenoid hypertrophy?

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.