Adenoidal hypertrophy refers to the increased size of the adenoids. These are the two infection-fighting glands at the back of the nose and above the tonsils.
The adenoids, along with the tonsils, help prevent agents such as bacteria and viruses from entering the body. The adenoids are populated by lymphocytes, a group of immune cells also found in the blood, that create antibodies.
Antibodies are proteins that neutralize foreign substances in the body. When infection or inflammation occurs, the adenoids can enlarge. Since they are seated at the back of the nasal cavity, the swollen adenoids can block airflow through the nose.
When the adenoids enlarge, the following can occur: chronic ear infections, known as chronic otitis mediachronic or repeated tonsillitis, that is, inflammation of the tonsilschronic sinusitisdifficulty breathing through the noseexcessive snoringobstructive sleep apnea, a condition in which breathing stops episodically during sleep because the tissues at the back of the nose and throat block the upper airway
The exact cause of enlarged adenoids is not always clear. Most studies point to chronic infection of the upper respiratory tract. Allergies may also cause the adenoids to enlarge. Adenoid enlargement is more common in children than adults.
Effective treatment of allergies may prevent some cases of adenoidal hypertrophy. Many times, the condition cannot be prevented.
Diagnosis of adenoidal hypertrophy begins with a history and physical exam. In young children, the easiest way to find an enlarged adenoid is with an X-ray. In older children, the healthcare professional can use a small mirror to look behind the palate. Another procedure is to use fiberoptic instruments, which allow the examiner to see the back part of the nasal cavity.
Long-term problems include ear disease, such as chronic otitis media, and breathing through the mouth.
Adenoidal hypertrophy is not contagious, and poses no risk to others.
In most cases, antibiotics and oral corticosteroids are given and are usually successful. For long-term problems, nasal steroid sprays can be used. Surgical removal of the adenoids is sometimes needed for those who do not respond to medicine.
Antibiotics may cause stomach upset, rash, or allergic reaction. Oral corticosteroids may increase the risk of infections. Surgery can be complicated by bleeding, infection, or reactions to anesthesia.
Antibiotics and steroids usually help the adenoids return to a smaller size. However, if the adenoids enlarge again, surgery may be recommended.
Any new or worsening symptoms should be reported to the healthcare professional.
