Can adenoid hypertrophy recur after removal?

Written by Deng Bang Yu
Otolaryngology
Updated on September 27, 2024
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The adenoid is located in the lymphatic epithelial tissue of the nasopharyngeal area. Enlargement of the adenoid can block breathing and obstruct the pharyngeal opening of the Eustachian tube, leading to secretory otitis media, and may result in secondary infections of the sinuses. Therefore, for symptoms such as snoring and hearing loss that occur simultaneously after adenoid enlargement, surgical removal is performed. The adenoid does not have a complete capsule, so it is only possible to remove the adenoid tissue as much as possible, and it cannot guarantee the complete removal of all adenoid tissue. Therefore, there is a small rate of recurrence after adenoid removal, with a recurrence rate of about 0.5%, meaning that the recurrence leading to the reappearance of symptoms is around 0.5%. Whether further treatment is needed after recurrence requires an in-person assessment at a hospital.

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Can adenoid hypertrophy be treated conservatively?

Adenoid hypertrophy is a common condition in children, primarily caused by excessive growth of the adenoid tissue on the posterior wall of the nasopharynx. This can lead to sleep apnea, snoring, and nocturnal hypoxia in patients, subsequently causing a decline in memory, lack of concentration, fatigue, and other symptoms. In mild cases of adenoid hypertrophy, where there are no significant symptoms of breath-holding or hypoxia, conservative treatment can be applied. This includes the use of steroid nasal sprays and oral administration of nasal decongestant granules, which can alleviate snoring and excessive nasal secretions. However, if a patient exhibits clear symptoms of breath-holding or hypoxia, and adenoid hypertrophy is confirmed through sleep monitoring, surgery is then necessary to treat the condition.

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Adenoid hypertrophy is what?

The adenoid is a lymphoepithelial tissue located in our nasopharynx, and it has certain immune functions. Under the stimulation of various factors such as infectious or immune factors, the immune tissue and glands of the adenoid hypertrophy, leading to enlarged adenoids. Once the adenoids are enlarged, they can block our posterior nasal apertures and the pharyngeal opening of the Eustachian tube. This, in turn, can cause us to snore, breathe through the mouth, and lead to secretory otitis media. The progression of the condition can affect our hearing, impact physical development, affect the development of the facial and jaw regions, and result in an adenoid facies. Therefore, when clinical symptoms of adenoid enlargement appear, active management is generally required, mainly surgical treatment.

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Which department should I visit for adenoid hypertrophy?

Enlarged adenoids should be examined by an otolaryngologist. Enlarged adenoids are a relatively common condition, usually seen in children, though a small portion of adults may experience it as well. The main symptoms of enlarged adenoids include nasal congestion and snoring during sleep. In severe cases, it can lead to mouth breathing or a distinctive "adenoid facies". These symptoms are usually more apparent in children around the ages of 5 to 6, and the adenoids generally begin to shrink after the age of 8. However, if the symptoms are pronounced during childhood, timely treatment is necessary. Prolonged lack of treatment or ineffective medication can potentially lead to abnormal development of the facial bones. Therefore, timely medical treatment is crucial, and in severe cases, surgery might be required.

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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.

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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.