Enlargement/inflammation of nasopharyngeal tonsil. Common in small children.
Clinical features
May be due to enlargement, inflammation, or both
- Obstruction of the nose leading to mouth breathing, difficulty eating, snoring, jaw deformities
- Obstruction of Eustachian tube leading to hearing loss, which fluctuates due to fluid in middle ear (”Glue ear”)
- Recurrent otitis
- Discharge from the nose
- Recurrent cough
- Physical and other developmental retardation, e.g. small size for age
Investigations
- Diagnosis is usually based on history
- X-ray for neck soft tissue: lateral view shows narrowing of the post-nasal space
Differential diagnosis
- Other causes of nasal obstruction and discharge, e.g, rhinitis, FB, deviated septum, sinusitis
- Dental and jaw diseases or abnormalities
MANAGEMENT
Mild (If symptoms are not marked)
- Give conservative treatment with chlorpheniramine 1-2 mg daily (depending on
age) for 7 days - Topical nasal steroids if available
Moderate and Severe (If symptoms are marked or do not improve on treatment)
- Refer to ENT surgeon for surgery