Conservative treatment methods for adenoid hypertrophy

Written by Deng Bang Yu
Otolaryngology
Updated on September 01, 2024
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Adenoid hypertrophy refers to the enlargement of glandular tissue located in the nasopharynx, which blocks the nasal cavity or obstructs the pharyngeal opening of the Eustachian tube, leading to otitis media. Patients may experience symptoms such as snoring during sleep. Conservative treatment for adenoid hypertrophy mainly refers to medication therapy for enlarged glands. Medications such as mometasone furoate and montelukast sodium can be used, as well as inhalation therapy with medicated mists. Inhalation therapy primarily involves nasal cavity inhalation, such as using sprays. Overall, the efficacy of conservative treatment for adenoid hypertrophy is relatively poor. Therefore, it is necessary to assess the condition comprehensively and consider timely surgical treatment if necessary.

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Written by Zhang Jun
Otolaryngology
1min 10sec home-news-image

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 Mao Cai
Otolaryngology
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What tests are needed for adenoid hypertrophy?

The adenoids are located at the back end of the nasal cavity in the nasopharyngeal area, so the examination needed for adenoid hypertrophy is generally the electronic nasopharyngoscopy. Electronic nasopharyngoscopy is a minimally invasive procedure that allows direct visual observation of the enlarged adenoids and the blockage of the posterior nasal apertures. Modern electronic nasopharyngoscopes are very thin; they can be inserted through the nostrils directly into the nasopharynx, providing a clear view of the adenoids with minimal discomfort and no radiation exposure, making it the preferred method. Another test that can be performed is a lateral X-ray of the nasopharynx. This examination has been a classic approach and is available in many township and county hospitals. It can accurately display the condition of adenoid hypertrophy and any airway obstruction. However, the only drawback is that it involves some level of radiation exposure.

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Written by Li Mao Cai
Otolaryngology
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Is adenoid hypertrophy related to rhinitis?

The adenoids are located at the rear end of the nasal cavity, specifically in the nasopharynx. When the adenoids become enlarged, they can affect the ventilation and drainage functions of the nasal cavity. Therefore, enlarged adenoids can cause rhinitis, leading to symptoms such as nasal congestion, runny nose, reduced sense of smell, and snoring during sleep; these impact the nasal ventilation, which are the most common symptoms. The rationale is that when the adenoids are enlarged, the nasal mucus cannot be normally drained through the nasal cavity's drainage function. As a result, children may exhibit symptoms of excessive nasal discharge and nasal congestion, and difficulty breathing through the nose. Additionally, the rhinitis caused by the enlarged adenoids leads to nasal congestion, which then manifests as the child snoring and breathing through the mouth during sleep. Over time, this can lead to a condition known as "adenoid facies."

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Written by Li Rui
Otolaryngology
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Adenoid hypertrophy conservative treatment

Adenoid hypertrophy is a relatively common disease, mainly seen in children, with only a small portion of adults possibly experiencing adenoid hypertrophy. In terms of treatment, the first consideration is conservative medical treatment, which currently commonly involves oral medications and nasal sprays. Additionally, rinsing the nasal cavity with saline solution and adopting a side-sleeping position during sleep can be considered. Most patients see a significant improvement in symptoms after standardized medication treatment, and with increasing age, many adenoids may gradually atrophy. However, there is a small group of patients for whom medication does not work well and symptoms are more apparent; in these cases, adenoidectomy might be considered. After the surgery, regular follow-ups are necessary to monitor the relief of symptoms and to check for any recurrence. (The use of medications should be carried out under the guidance of a doctor.)

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How should adenoid hypertrophy be treated?

The main factors to consider are the extent of the enlargement and the associated clinical manifestations. If the enlargement is mild and does not cause significant nasal congestion, snoring, sleep apnea, or waking up due to breath-holding, conservative treatment can be used. The common medications for conservative treatment include nasal sprays and nasal steroids. If the adenoid enlargement affects breathing function, leading to poor sleep, snoring, breath-holding, or even waking up due to breath-holding, aggressive surgical treatment is required. Surgical treatment involves removing the enlarged adenoids to ensure a clear nasopharynx and bilateral posterior nasal openings, thereby ensuring proper breathing function and alleviating related secondary diseases.