ADENOID HYPERTROPHY

Commonly occurs in children. It may be due to simple enlargement, to inflammation, or to both. It is the size of the mass relative to the nasopharyngeal space rather than the absolute size that is important.

Clinical Features

  • Nasal obstruction leading to mouth-breathing
  • Difficulty in breathing and eating
  • Drooling of saliva
  • Snoring, and toneless voice.
  • Adenoid facies may later develop.
  • Eustachian tube obstruction leads to deafness, inflammatory process in the nose, sinuses, and ears.
  • Persistent nasal discharge
  • Cough
  • Cervical adenitis.
  • Mental dullness and apathy may be marked due to poor breathing, bad posture, or deafness. Eustachian tube obstruction leads to
    deafness.
  • Nocturnal enuresis, habit tics, and night terrors may be aggravated.

Investigation

Lateral soft tissue x-ray of the nasopharynx – shows narrowing of the nasopharyngeal air space.

Management

Conservative treatment – for patients with mild symptoms:

  • Chlorpheniramine 0.4mg/kg/day (or other antihistamine)
  • Antibiotics in presence of infection as for acute tonsillitis.

Refer to ENT if

  • Failure to improve
  • Refractory cases
  • Features of chronic upper airway obstruction