• Clinical science

Adenoid hypertrophy (Adenoid vegetations…)

Abstract

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.

Epidemiology

  • Common in children
  • Very rare in adults

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

Epidemiological data refers to the US, unless otherwise specified.

Etiology

  • Physiological
  • Adenoidal inflammation due to
    • Viral or bacterial infections
    • Allergens

Clinical features

Mechanical congestion of the choanae

Mechanical congestion of the eustachian tubes

  1. Recurrent chronic otitis media
  2. Tympanic effusion
  3. Conductive hearing loss → can lead to 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!

Diagnostics

  • Flexible nasopharyngoscopy showing hyperplasia of the adenoids

Treatment

last updated 11/17/2017
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