Adenoid hypertrophy

Adenoid hypertrophy

Definition:

Adenoid hypertrophy is an enlargement of the adenoids (lymphatic tissue in the back of the nose). The adenoids, along with the tonsils, comprise the Waldeyer ring.

Alternative Names:

Enlarged adenoids

Causes, incidence, and risk factors:

Hypertrophy (enlargement) of the adenoids may occur naturally (beginning during fetal development), or it may be caused by chronic inflammation. This enlargement can cause breathing difficulties ranging from mouth breathing, snoring, bad breath, and chronic runny nose, to health threatening conditions such as intermittent sleep apnea, pulmonary hypertension, and right-sided heart failure (cor pulmonale).

Symptoms:

Mouth breathing (mostly at night)
- Dry mouth
- Cracked lips
Mouth open during day (more severe obstruction)
Bad breath
Persistent runny nose or nasal congestion
Frequent ear infections (otitis media)
Snoring
Restlessness while sleeping
Intermittent sleep apnea

Signs and tests:

Physical examination of the throat confirms that the tonsillar tissue is enlarged. The adenoids cannot be visualized by looking in the mouth directly, but it can be seen with a special mirror looking into the nasopharynx or using a flexible endoscope through the nose.

X-ray, side view of the throat demonstrates hypertrophy of the adenoids.
Sleep apnea studies (severe cases only)

Treatment:

Adenoidectomy (surgical removal of the adenoids) will prevent complications, and will cure complications if they already exist from adenoid hypertrophy. Antibiotics may be used to treat tonsil, adenoid, and sinus infections when they occur.

Expectations (prognosis):

Full recovery is expected. Right-sided heart failure (cor pulmonale) is reversible on correction of the sleep apnea and airway obstruction.

Complications:

Calling your health care provider:

Call your health care provider if your child has symptoms of airway obstruction that interferes with normal nasal breathing, or if the child has other symptoms discussed above.

Prevention:

Early treatment of throat infections may reduce hypertrophy associated with chronic infection and inflammation. Adenoidectomy prevents the complications associated with chronic airway obstruction related to hypertrophy.

Review Date: 10/31/2001
Reviewed By: Ashutosh Kacker, Department of Otolaryngology, New York Presbyterian Hospital, New York, NY. Review provided by VeriMed Healthcare Network.

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