How should adenoid hypertrophy be treated?

Written by Li Mao Cai
Otolaryngology
Updated on April 08, 2025
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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.

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Written by Yan Xin Liang
Pediatrics
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What should be done about children's adenoid hypertrophy?

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 Xu Qing Tian
Otolaryngology
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Can adenoid hypertrophy be seen with the naked eye?

Adenoid hypertrophy is a common disease in otolaryngology, and it is not visible to the naked eye. The diagnosis of excessive growth and hypertrophy of adenoid tissue is mainly made through electronic nasopharyngoscopy and lateral nasopharyngeal radiograph examinations. Typically, if the adenoid tissue occupies more than 2/3 of the posterior nasal aperture, it can be diagnosed as adenoid hypertrophy. Patients mainly show symptoms such as snoring, breath-holding, and hypoxia during sleep at night, as well as daytime sleepiness and reduced memory. Patients with adenoid hypertrophy require surgical ablation of the hypertrophied adenoid tissue to improve their sleep conditions at night and achieve cure.

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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 Li Rui
Otolaryngology
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Does adenoid hypertrophy require medication?

Adenoid hypertrophy does not necessarily require medication because it is relatively common clinically. Some cases may need medication, while others can be observed. This mainly depends on the severity of the adenoid hypertrophy and the specific clinical symptoms. If the enlargement is not severe and there are no clinical symptoms, it is possible to consider observation without drug treatment, as the adenoids can gradually shrink as age increases. If the adenoids are significantly enlarged and may be accompanied by clinical symptoms such as nasal congestion, snoring, and mouth breathing, it is necessary to consider timely drug treatment. If drug treatment is ineffective, some cases may need to consider adenoidectomy surgery.

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Written by Deng Bang Yu
Otolaryngology
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Can adenoid hypertrophy recur after removal?

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.