Alternative Names adenoidal enlargement, enlarged adenoids
Definition Adenoidal hypertrophy refers to the increased size of the adenoids, the 2 infection-fighting swellings at the back of the nose and above the tonsils.
What is going on in the body? The adenoids, along with the tonsils, help prevent infection-causing agents such as bacteria and viruses from entering the body. The adenoids are made up of a group of blood cells that create antibodies, which are proteins that neutralise foreign substances in the body. Unlike the tonsils that are easy to see in the mouth, the adenoids are located at the back part of the nasal cavity, behind the soft palate. 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.
What are the signs and symptoms of the condition? When the adenoids enlarge, the following can occur:
What are the causes and risks of the condition? The exact cause of enlarged adenoids is not always clear. Most studies point to chronic infection of the upper respiratory tract. The adenoids can also enlarge from chronic irritation when infected or inflamed nasal secretions are constantly swept back over it. Allergies may also cause enlargement of the adenoids. Adenoid enlargement is more common in children than adults.
What can be done to prevent the condition? There is no way to prevent this condition.
How is the condition diagnosed? In young children, the easiest way to find an enlarged adenoid is with an x-ray. In older children, diagnosis is usually made in the office by using a mirror to look behind the palate. Another procedure is to use fibreoptic instruments, which are instruments that allow structures deep inside the body to be seen through a narrow tube. The healthcare professional can use the tool to examine the back part of the nasal cavity.
What are the long-term effects of the condition? Long-term problems include ear disease, such as chronic otitis media, and breathing through the mouth. In addition, undiagnosed sleep apnoea can lead to problems such as decreased mental alertness, high blood pressure, and enlargement of the right side of the heart.
What are the risks to others? There are no risks to others.
What are the treatments for the condition? In most cases, antibiotics and oral steroids 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 medication.
What are the side effects of the treatments? With any antibiotic, there is always the possibility of allergic reactions. Short-term use of oral steroids usually has few side effects. These may include stomach upset, increased appetite, moodiness, poor sleep, or fluid retention. The main complication that can happen after surgery is excessive bleeding, which occurs in less than 1% of people.
What happens after treatment for the condition? Antibiotics and steroids usually help the adenoids return to a smaller size. However, if the adenoids get big again and symptoms return, surgery is recommended.
How is the condition monitored? The person can monitor the symptoms of nasal blockage, leakage through the nose, and ear disease.
Author: Mark Loury, MD Reviewer: eknowhow Medical Review Panel Editor: Dr John Hearne Last Updated: 25/04/2005 Contributors Potential conflict of interest information for reviewers available on request
