Adenoid Hypertrophy
What is Adenoid?
The adenoid forms part of lymphoid tissue at the portal of the upper respiratory tract. It lies within the mucous membrane of the roof and posterior wall of the nasopharynx. Regression of the adenoid occurs rapidly after 15 years of age in most children.
What is the function of Adenoid?
The function of the Adenoid is to produce antibodies. The adenoid produces B-cells, giving rise to IgG and IgA plasma cells. In children aged 4–10 years, adenotonsillectomy does not appear to cause significant immune deficiency.
What happens when the Adenoid gets hypertrophy?
- Otitis media with effusion, the benefit of adenoidectomy in the management of otitis media with effusion (OME) has been ascribed to the relief of anatomical obstruction of the Eustachian tube
- Upper airway obstruction and sleep-disordered breathing
- Rhinosinusitis acts as a reservoir for pathogenic bacteria
- Problems of olfaction: Adenoidal hyperplasia may reduce olfactory sensitivity and in particular retro-nasal smell and taste, which improves the following adenoidectomy
How is Adenoid hypertrophy being diagnosed?
- Assessment of the nasal airway may be made with Nasendoscopy using a flexible paediatric endoscope
- When endoscopy is not tolerated, assessment of adenoid size with a lateral soft-tissue radiograph of the nasopharynx is helpful and correlates well with endoscopic assessment of adenoid size
What is the treatment of Adenoid hypertrophy?
The main curative treatment for adenoid hypertrophy is surgery. Medical treatment with topical nasal steroid spray can be used, but it is not curative and takes a long time.
What is Adenoidectomy?
It is the operation of Adenoid removal. It can be done by several surgical methods which include:
- Curettage adenoidectomy
- Suction Coagulation
- Coblation
- KTP Laser
- Microdebrider
What are the expected Complications of Adenoidectomy?
Although the complications of Adenoidectomy are rare, they may involve the following:
- Bleeding: The reactionary bleeding following adenoidectomy, within 6–20 hours of operation is reported as less than 7%. Secondary haemorrhage after adenoidectomy is rare.
- Dental trauma
- Infection
- Non-traumatic atlantoaxial subluxation is rare, but it is recognized as a risk associated with adenoidectomy and tonsillectomy.
- Severe velopharyngeal incompetence is rare following adenoidectomy, estimated to occur in between 1: 1500 and 1: 10 000 procedures
- Regrowth of the adenoid
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