Adenoid

adenoid

Hypertrophy of the nasopharyngeal tonsil sufficient to produce symptoms .
- most commonly between 3 & 6 years.
- atrophy begins after 10 years / completes before 20 years.

Symptoms &signs

• Due to hypertrophy :
• 1. nasal obstruction causing :
• a- mouth breathing
• b- difficulty in eating
• c- noisy breathing & eating
• d- drooling
• e- snoring
• f- toneless voice
• Eustachian tube obstruction:
• a- deafness
• b- Secretory o. m.


• B. Due to inflammation:
• nasal discharge & post nasal drip
• ( egg- white plug of mucus seen behind uvula on gagging is almost diagnostic) .
• O.M.
• rhinosinusitis
• Cx. Lymphadenitis.

C. Generalized disturbances:

mental dullness
Apathy
Nocturnal enuresis .

diagnosis

Symptoms, signs & examination by postnasal mirror in quite young children .
X-ray of post nasal space .
Endoscope.


DDX. :
• Other causes of nasal obstruction
intrinsic rhinitis
F.B.
hypertrophy of posterior end of the inf. Turbinate.
Nasal septal deviation .
Congenital choanal atresia
Sinusitis
Antrochoanal polyp.

• Orthodontoic abnormalities / high arch palate.

• Thorn Waldt`s disease / cystic persistence of the median furrow of the n/ph tonsil.

treatment

A- conservative / no marked symptoms & signs
- decongestant nasal drop
- fresh air breathing & postural exercise
- nose blowing training

B- adenoidectomy

Indications of adenoidectomy
1- obstructive sleep apnea .
2- significant hearing loss.
3- repeated tonsillitis ,sinusitis or otitis media.