What is adenoid hypertrophy in children?

Written by Yan Xin Liang
Pediatrics
Updated on September 04, 2024
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The adenoid, also known as the pharyngeal tonsil or lymphoid tissue, is located at the top of the nasopharynx and the posterior pharyngeal wall. It looks like an orange segment and is most active in growth from ages 2 to 6 in children, gradually atrophying after age 10. Due to repetitive inflammation, the adenoid can undergo pathological hyperplasia, known as adenoid hypertrophy, which can cause clinical symptoms such as nasal congestion and mouth breathing. The main cause of adenoid hypertrophy is inflammation in the nasopharyngeal region or the adenoid itself. Repeated stimulation leads to pathological hyperplasia. Common causes include recurrent acute and chronic nasopharyngitis, various acute infectious diseases in childhood, which exacerbate nasal congestion symptoms, obstruct nasal drainage, and nasal and sinus secretions further stimulate the adenoid, causing it to continue to grow and creating a vicious cycle.

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Written by Li Mao Cai
Otolaryngology
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Does adenoid hypertrophy cause a runny nose?

Adenoid hypertrophy can cause a runny nose, which is a very common symptom of adenoid hypertrophy. Since the adenoids are located at the back of the nasal cavity, specifically in the nasopharynx, the mucus secreted by the nasal cavity normally flows backward, precisely to the back of the nasal cavity, passing over the adenoids. When the adenoids are enlarged, they block the drainage pathway of the mucus, causing most of it to flow out from the front of the nasal cavity. Therefore, adenoid hypertrophy can lead to a runny nose, which is one of its symptoms, and can also cause related symptoms of rhinitis such as nasal congestion. After nasal congestion, it may lead to various other manifestations, including snoring.

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Written by Zhang Jun
Otolaryngology
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Is nasal discharge a sign of improvement in adenoid hypertrophy?

Enlargement of the adenoids accompanied by a runny nose is not a sign of improvement but a symptom of worsening. Enlargement of the adenoids is primarily due to symptoms caused by acute viral or bacterial infections following a decrease in the body’s immunity and resistance. This can lead to diffuse congestion and edema of the glands, causing the patient to experience persistent nasal congestion and discharge of yellow nasal mucus. In severe cases, it can cause nocturnal suffocation. Initially, a detailed examination at the hospital is necessary. Diagnosis can be confirmed with an electronic nasopharyngoscope and a nasopharyngeal CT. During the examination, granular masses can be found on the posterior wall of the nasopharynx; these are soft in texture and not painful. In terms of treatment, during the acute phase of adenoid hypertrophy, symptomatic anti-inflammatory treatment is required, including the use of antibiotics and concurrent nebulizer inhalation to reduce congestion and edema of the adenoids. If the enlargement persists and conservative treatment is ineffective, adenoidectomy may be necessary to achieve a complete cure.

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Written by Zhang Jun
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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 Rui
Otolaryngology
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What anti-inflammatory drugs should be taken for adenoid hypertrophy?

Most glandular hypertrophy does not require antibiotics or anti-inflammatory drugs, as it is a common condition or physiological manifestation in children. Glandular hypertrophy is the proliferation of lymphoid tissue in the nasopharyngeal area, causing partial obstruction of the posterior nasal aperture. Initially, clinical symptoms should be assessed. If there is only simple hypertrophy without any discomfort, it can be observed without treatment. However, if glandular hypertrophy is accompanied by clinical symptoms such as nasal congestion, runny nose, snoring during sleep, and mouth breathing, the use of oral medications and nasal sprays should be considered, but generally, anti-inflammatory drugs are not needed. If there is an acute inflammatory response in the glands, the use of antibiotics along with regular follow-ups and nasal cavity cleaning should be considered. (Note: This answer is for reference only. Medication should only be taken under the guidance of a professional medical doctor, and blind medication should be avoided.)

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How to perform pediatric massage for adenoid hypertrophy

Children's adenoid hypertrophy does not respond to massage therapy. It is typically caused by an acute inflammatory response, leading to sudden congestion, edema, proliferation, and exudation of the glands. Symptoms include fever, nasal congestion, sneezing, and snoring during sleep; severe cases can also lead to a decrease in hearing, tinnitus, and a feeling of fullness in the ears. In treating acute adenoid hypertrophy, symptomatic anti-inflammatory treatment is required first. This includes oral or intravenous antibiotics, which are usually effective due to bacterial infections, with penicillin antibiotics often having good outcomes. Local treatments such as nebulization can also help to reduce gland congestion and swelling. A light diet, drinking more water, and resting can generally lead to improvement. However, if the condition recurs frequently, local surgical treatment may be necessary. (Medication should be used under the guidance of a doctor.)