Adenoid hypertrophy

Last updated: March 23, 2021

Summarytoggle arrow icon

Adenoid hypertrophy is hyperplasia of the pharyngeal tonsils. It only becomes symptomatic if it leads to congestion of the choanae and eustachian tubes. The condition is common in children with recurrent inflammation of the upper airways. Clinical features include mouth breathing, snoring, hyponasal speech, and adenoid facies. Adenoid hypertrophy is diagnosed using flexible nasopharyngoscopy, which should show enlarged adenoid tissue. An adenotonsillectomy is indicated in patients with chronic/recurrent sinusitis, chronic/recurrent otitis media, and/or symptomatic nasal obstruction.

Epidemiologytoggle arrow icon

  • Common in children
  • Very rare in adults [1]

Adenoid hypertrophy is the most common cause of nasal obstruction in children.

Epidemiological data refers to the US, unless otherwise specified.

Etiologytoggle arrow icon

  • Physiological
  • Adenoidal inflammation due to

Clinical featurestoggle arrow icon

Mechanical congestion of the choanae

Mechanical congestion of the eustachian tubes

  1. Recurrent chronic otitis media
  2. Tympanic effusion
  3. Conductive hearing loss → developmental disorders (e.g., language development disorder)

Hyperplasia of the pharyngeal tonsil does not itself cause symptoms. The patient only becomes symptomatic after congestion of the choanae and auditory tubes.

Diagnosticstoggle arrow icon

Treatmenttoggle arrow icon

  • Asymptomatic adenoid vegetations do not require treatment.
  • Adenotonsillectomy, or surgical excision of adenoids, is indicated for:
  • Treat the underlying cause of inflammation (e.g., intranasal corticosteroids for allergies or antibiotics for infection)

Referencestoggle arrow icon

  1. Rout MR, Mohanty D, Vijaylaxmi Y, Bobba K, Metta C. Adenoid Hypertrophy in Adults: A case Series.. Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India. 2013; 65 (3): p.269-74.doi: 10.1007/s12070-012-0549-y . | Open in Read by QxMD
  2. Dinc ME, Altundag A, Dizdar D, et al. An objective assessment of halitosis in children with adenoid vegetation during pre- and post-operative period.. Int J Pediatr Otorhinolaryngol. 2016; 88: p.47-51.doi: 10.1016/j.ijporl.2016.06.042 . | Open in Read by QxMD

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