How to check for adenoid hypertrophy?

Written by Yao Jun
Otolaryngology - Head and Neck Surgery
Updated on August 31, 2024
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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.

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Written by Li Rui
Otolaryngology
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Is adenoid hypertrophy massage effective?

Adenoid hypertrophy generally does not respond well to massage therapy, as the affected area is in the nasopharyngeal region and primarily occurs in children. Typically, children reach the peak of adenoid growth around six or seven years of age, and then the adenoids usually begin to shrink after the age of eight. If the adenoid hypertrophy is severe and blocks the posterior nasal passages, it can lead to nasal congestion, snoring, and mouth breathing while sleeping. If severe and left untreated for a long period, it can result in a condition known as "adenoid facies," which causes abnormal development or deformities of the jaw and facial bones. Treatment generally focuses on medication. If medication is ineffective, surgery may be considered. Massage therapy does not have a direct effect on adenoid hypertrophy.

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Written by Yan Xin Liang
Pediatrics
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What is adenoid hypertrophy in children?

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 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 Zhang Jun
Otolaryngology
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Can adenoid hypertrophy be felt by touch?

Adenoid hypertrophy is palpable, as the adenoids are a cluster of lymphoid tissue located at the top of the nasopharynx. If there is localized hypertrophy, it can be directly felt through the mouth. Adenoid hypertrophy most commonly occurs in children, especially those between the ages of three and six, and often follows acute colds, rhinitis, and adenoid hypertrophy, eventually leading to persistent bilateral nasal obstruction. Additionally, it may be accompanied by symptoms such as snoring during sleep, decreased hearing, tinnitus, and a feeling of ear fullness. In severe cases, it may lead to a facial appearance characteristic of adenoid hypertrophy. It is necessary to first visit a hospital for a thorough examination, which can include an electronic nasopharyngoscopy, nasopharyngeal CT, and nasopharyngeal palpation to confirm the diagnosis. In terms of treatment, acute adenoid hypertrophy requires symptomatic anti-inflammatory treatment, along with nebulized inhalation. If conservative treatment is ineffective, adenoidectomy may be necessary for cure.

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Treatment methods for adenoid hypertrophy

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.)