The disease affects males and females to the same extent and is rarely encountered after the age of 15 years because adenoid tissue undergoes a normal process of involution beyond this age [1] [2]. Patients usually present between the ages of 3 and 5 because adenoid growth causes nasopharyngeal airway narrowing [3]. Children from high socioeconomic classes are infrequently affected.

In incipient stages, adenoid hypertrophy is asymptomatic. As the disease progresses, patients manifest with chronic mouth breathing, sleep disturbances, nasal obstruction, rhinorrhea, swallowing difficulties, snoring, cough, epistaxis, and halitosis. Hearing loss develops gradually as a consequence of persistent or recurring middle ear infections. If left untreated for a long period of time, the patient presents with hyponasal voice and a typical facies, characterized by elongated middle facial area and narrow palate [4].

When obstructive sleep apnea develops as a consequence of adenoid hypertrophy, it can cause more severe, long-term morbidity such as failure to thrive, learning difficulties, delayed speech [5], decreased intelligence quotient, and hyperactivity. Possible cardiovascular impairment consists of elevated diastolic blood pressure, left ventricular hypertrophy, and decreased right ventricular ejection fraction [1] [6].

Clinical examination may reveal signs consistent with atopy such as a cough, expiratory wheezing and rhonchi, and prolonged expiratory time.

• Recurrent Otitis Media

  An adenotonsillectomy is indicated in patients with chronic/recurrent sinusitis, chronic/recurrent otitis media, and/or symptomatic nasal obstruction. Epidemiology Adenoid hypertrophy is the most common cause of nasal obstruction in children. [amboss.com]

  This investigation is indicated when the manifestations presented above are present or when the patient presents with recurrent sinusitis, otitis media, or persistent ear effusions. [symptoma.com]

  […] or persistent otitis media in children aged 3 to 4 or older; it should be taken into account that treating otitis media resolves the resultant hearing impairment as well recurrent or chronic sinusitis Promoted articles (advertising) [radiopaedia.org]

  PICTURE SHOWING ADENOID FACIES INDICATION FOR SURGICAL TREATMENT Chronic nasal infections- chronic adenoiditis Chronic sinus infections with failure to medical treatment Recurrent otitis media including those with tympanostomy tube with recurrent otorrhoea [drdkjha.com]

• Poor Growth

  “Large VSDs with excessive pulmonary blood flow and pulmonary hypertension are responsible for dyspnea, feeding difficulties, poor growth, profuse perspiration, recurrent pulmonary infections, and cardiac failure in early infancy.” [slideplayer.com]

• Snoring

  The primary outcomes were improvement in symptoms of nasal obstruction, mouth breathing, rhinorrhea, snoring, cough, and total nasal symptoms. [ncbi.nlm.nih.gov]

  From Wikidata Jump to navigation Jump to search upper respiratory tract disease characterized by the unusual growth of the adenoid tonsil; has symptom snoring, has symptom hyponasality, has symptom otitis media with effusion, has symptom mouth breathing [wikidata.org]

  Out of 13, 5 patients complained of nasal obstruction and snoring, 3 complained of snoring and mouth breathing, rest of the 5 patients complained of fullness in ears, diminished hearing and nasal obstruction. [webmedcentral.com]

  Discussion The adenoids may cause nasal obstruction, hyponasal speech, snoring, mouth breathing, and nasal discharge. Adenoidectomy is helpful in relieving all these symptoms [ 3 ]. [alliedacademies.org]

  Snoring was the most frequent symptom which had a linear relation with the size of the adenoid. Conclusion: There was good agreement between symptom and the X-ray findings. [jfmpc.com]

• Rhinitis

  Comparison of the groups for AR duration demonstrated significantly higher frequency of persistent rhinitis in patients with AH (p 0.05). [ncbi.nlm.nih.gov]

  Adenoid hypertrophy and adenoiditis are accompanied by chronic rhinitis with or without otitis media. It is very common phenomena at ages 2-6 years and those children are symptomatic with snoring, rhinitis, nasal obstruction. [clinicaltrials.gov]

• Nasal Congestion

  […] significantly improve nasal congestion 14, 15. [nature.com]

  AH should be considered and investigated particularly in non-asthmatic children with pronounced nasal congestion and A. alternata sensitivity. [ncbi.nlm.nih.gov]

  Severity of Nasal Congestion at Baseline and Week 12 [ Time Frame: Baseline and Week 12 ] Nasal congestion is a symptom of allergic rhinitis. [clinicaltrials.gov]

  Example sentences with "adenoid hypertrophy", translation memory add example en Adenoidal hypertrophy, nasal turbinate hypertrophy*, dyspnoea*, nasal mucosal disorder*, obstructive airway disorder*, abnormal respiration*, nasal congestion, mouth breathing [glosbe.com]

• Rhinorrhea

  There was tendency of improvement in rhinorrhea, and cough with mometasone. [ncbi.nlm.nih.gov]

  Number of Participants Referred to Surgery (Adenoidectomy) Within 12 Weeks of Start of Therapy [ Time Frame: Baseline to 12 weeks ] Secondary Outcome Measures : Severity of Rhinorrhea at Baseline and Week 12 [ Time Frame: Baseline and Week 12 ] Rhinorrhea [clinicaltrials.gov]

  As the disease progresses, patients manifest with chronic mouth breathing, sleep disturbances, nasal obstruction, rhinorrhea, swallowing difficulties, snoring, cough, epistaxis, and halitosis. [symptoma.com]

  […] pathological, please see the separate article, adenoidal hypertrophy (adults). nasal congestion: adenoid facies chronic or recurrent otitis media due to their proximity to the Eustachian tubes swallowing difficulties speech anomalies (hyponasal speech) rhinorrhea [radiopaedia.org]

• Tonsillar Hypertrophy

  There was also a significant difference between rates of tonsillar hypertrophy and nasopharynx obstruction in the EN group (p = 0.009). [pagepressjournals.org]

  Unilateral tonsillar hypertrophy should always raise suspicion of a tumor. The most common tonsillar tumor in children is lymphoma (1). Conclusions 1. [czytelniamedyczna.pl]

  Full text ABSTRACT Introduction: the association between the adenoid hypertrophy, tonsillar hypertrophy maxillofacial alterations and the teeth occlusion, have been widely documented by several authors in children with sleep-disordered breathing. [medigraphic.com]

  There might also be a genetic link, as tonsillar hypertrophy often runs in families. [healthline.com]

• Mouth Breathing

  From Wikidata Jump to navigation Jump to search upper respiratory tract disease characterized by the unusual growth of the adenoid tonsil; has symptom snoring, has symptom hyponasality, has symptom otitis media with effusion, has symptom mouth breathing [wikidata.org]

  MATERIALS AND METHODS: Eighty-six mouth-breathing children (male 54.65%, mean age 7.0 ± 2.2 years) were randomly selected from a hospital population. [ncbi.nlm.nih.gov]

  All patients with adenoid hypertrophy suffer of nasal obstruction, mouth breathing in addition to other symptoms. [alliedacademies.org]

  All the patients were satisfied with the improvement in breathing difficulty, snoring and mouth breathing. When the patients were followed over 18 months there was no residual tissue in the nasopharynx or any recurrence. [webmedcentral.com]

• Halitosis

  The adenoids are located at the back of nose and when enlarged, may cause nasal obstruction, recurrent sinusitis, post nasal drip, sleep apnea, chronic runny nose, halitosis and even chronic cough. [childrensnational.org]

  As the disease progresses, patients manifest with chronic mouth breathing, sleep disturbances, nasal obstruction, rhinorrhea, swallowing difficulties, snoring, cough, epistaxis, and halitosis. [symptoma.com]

  Chronic adenoiditis can also cause chronic or recurrent nasopharyngitis, rhinosinusitis, epistaxis, halitosis, and cough. [merckmanuals.com]

Adenoid hypertrophy is best diagnosed by means of flexible nasopharyngoscopy. This investigation is indicated when the manifestations presented above are present or when the patient presents with recurrent sinusitis, otitis media, or persistent ear effusions. When obstructive sleep apnea is suspected, a sleep study is called for in order to gather information about its severity. Radiological evaluation, such as the lateral neck X-ray should be avoided unless more severe pathology, such as neoplasia or angiofibroma, is suspected. However, if a radiography is performed, due to the fact that it is still considered a valid and reliable test [7] [8], the physician should assess not the absolute dimensions of the adenoids, but the degree of obstruction they cause. If adenoids are very small or absent, an immune deficiency should be investigated, while severely enlarged masses may suggest lymphatic malignancy.

Adenoid flora occasionally needs to be assessed. It is usually composed of group A beta-hemolytic streptococci, but Staphylococcus aureus, Streptococcus pneumoniae, and Haemophilus influenzae may also be encountered. Anaerobic bacteria may be found in the core of the adenoids [9]. Other possibly present bacteria include Enterococcus species, Staphylococcus epidermidis, Streptococcus viridans, Escherichia coli, Pseudomonas, Moraxella, Klebsiella, Neisseria, Prevotella, Fusobacterium, Peptostreptococcus, and Bacteroides species [10] [11]. Chronic adenoid infection could lead to the obstruction of the nasopharyngeal Eustachian tube orifice and consequent recurrent otitis media. Therefore, a complete examination of an ear, nose, and throat is useful in all patients.

Biopsy specimens reveal reactive hyperplasia of B-cells and inflammatory infiltrates consisting of polymorphonuclears, plasmocytes, or eosinophils [2] [12].

• Neisseria Gonorrhoeae

  gonorrhoeae, Corynebacterium diphtheriae, Chlamydophila pneumoniae, and Mycoplasma pneumoniae.[4][5][2] Fusobacterium, Peptostreptococcus, and Prevotella species have also been identified as anaerobic organisms involved in causing infectious adenoid [ncbi.nlm.nih.gov]

• Corynebacterium Diphtheriae

  […] bacterial species have been implicated in contributing to infectious adenoid hypertrophy including alpha-, beta-, and gamma-hemolytic Streptococcus species, Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus, Neisseria gonorrhoeae, Corynebacterium [ncbi.nlm.nih.gov]

BACKGROUND: The effect of topical mometasone for adenoid hypertrophy treatment is well established. Nevertheless, the influence of atopy on this treatment remains ill defined. [ncbi.nlm.nih.gov]

Patients were divided into 2 groups: The 1st (control) - 28 patients with standard treatment of AH and the 2nd (main) - 25 patients with standard treatment and physiotherapy: Intranasal, oral laser irradiation and ultrasonic cavitation treatment (10 procedures [scitechnol.com]

[…] consideration than the degree to which they encroach on the nasopharyngeal airway: if no adenoidal tissue after age 6 months, suspect an immune deficiency if enlarged adenoids persist well after childhood, suspect lymphatic malignancy Treatment and prognosis [radiopaedia.org]

A growing body of research suggests that certain populations have a particularly poor prognosis following A&T. [aadsm.org]

Prognosis Hypertrophied adenoids are a normal part of growing up and should be respected for their important role in the development of immunity. [healthofchildren.com]

[…] non-specific symptoms, such as: Choanal atresia Pyriform aperture stenosis Allergic rhinitis Acute or chronic sinusitis Nasal polyposis Intranasal encephalocele Nasal dermoid Nasopharyngeal neoplasm Acute otitis media Chronic serous otitis media Cholesteatoma Prognosis [ncbi.nlm.nih.gov]

Diagnostics Treatment Adenoid hypertrophy Summary Epidemiology Etiology Clinical features Diagnostics Treatment [amboss.com]

OBJECTIVE: Adenoid hypertrophy (AH) is a common etiology of chronic upper airway obstruction. Upper respiratory tract obstruction may cause chronic alveolar hypoventilation and pulmonary vasoconstriction. [ncbi.nlm.nih.gov]

In summary, chronic adenoid hypertrophy is the most common etiology of pediatric sleep disordered breathing. [aadsm.org]

Adenoid hypertrophy is a common childhood condition with unclear etiology and potentially severe consequences. The disease consists of increased adenoid tonsils and represents one of the most frequent surgical indications in this age period. [symptoma.com]

Etiology Both inflammatory and infectious causes should be considered. [radiopaedia.org]

Epidemiology Adenoid hypertrophy is the most common cause of nasal obstruction in children. Epidemiological data refers to the US, unless otherwise specified. [amboss.com]

Martin-Luther-University Halle-Wittenberg, Germany [email protected] 2 Department of Radiology, Martin-Luther-University Halle-Wittenberg, Germany. 3 Department of Otorhinolaryngology, Martin-Luther-University Halle-Wittenberg, Germany. 4 Department of Epidemiology [ncbi.nlm.nih.gov]

Department of Biostatistics & Clinical Epidemiology Christian Medical College and Hospital Vellore India 2. Dept. of ENT Speech & Hearing Christian Medical College & Hospital Vellore India [link.springer.com]

The Annals of otology, rhinology, and laryngology. 2017 Jul [PubMed] Bhattacharyya N,Lin HW, Changes and consistencies in the epidemiology of pediatric adenotonsillar surgery, 1996-2006. [knowledge.statpearls.com]

In one previous study in patients with obstructive sleep apnea (OSA), it has been claimed that mean platelet volume (MPV), an indicator of platelet activation is increased and that MPV has an important role in the pathophysiology of cardiovascular diseases [ncbi.nlm.nih.gov]

[…] patient: case report. 61 Alaula LS...Alhedaithy R 31381360 2019 30 Airway challenges in bilateral temporomandibular joint ankylosis with adenoid hypertrophy: a case report. 61 Jain G...Chug A 31245271 2019 31 Otitis media with effusion in children: Pathophysiology [malacards.org]

Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 126. [medlineplus.gov]

Chronic upper airway obstruction and cardiac dysfunction: anatomy, pathophysiology and anesthetic implications. Paediatric Anaesth. 2004;14:75-83. 2. Sie KC, Perkins JA, Clarke WR. Acute right heart failure due to adenotonsillar hypertrophy. [arquivosdeorl.org.br]

Pathophysiology Colonic polyps, or adenomas, are benign epithelial neoplasms that arise from the epithelial cells lining the colon. [emedicine.medscape.com]

Further studies are necessary to evaluate their possible therapeutic role in preventing recurrent tonsillitis and treating postoperative patients to help normalize their blood levels of antioxidants. [ncbi.nlm.nih.gov]

Adenoidectomy may be recommended when tympanostomy tube surgery (http://en.wikipedia.org/wiki/Tympanostomy_tube) failed to prevent ear infection. [medical-dictionary.thefreedictionary.com]

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