Adenoid Diseases

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Introduction 

  • A syndrome due to hyperplasia/hypertrophy of the adenoid tissue in the nasopharynx

Epidemiology

  • Commoner in children aged 2 - 6 years.

Clinical features

  • Nasal obstruction and mouth breathing
  • Snoring at night
  • Obstructive sleep apnoea
  • Progressive deafness due to secretory otitis media
  • Chronic infection of adenoid tissue may be present
  • Symptom may subside spontaneously as adenoid regress and become atrophic with age

Differential Diagnoses

  • Allergic rhinitis
  • Sinusitis
  • Otitis media

Complications

  • Sinusitis
  • Recurrent otitis media
  • Pneumonitis

Investigations

  • X-ray of nasopharynx
  • X-ray of sinuses and chest
  • Nasal endoscopy

Treatment Goals

  • To improve nasopharyngeal airway and nasal breathing
  • To treat concurrent infection

Non-drug Treatment

  • Adenoidectomy in severe cases

Drug Treatment

  • Decongestants
  • Pseudoephedrine syrup
    • 6-12 years: 30mg (5mL of syrup) orally 8 hourly
    • 2-5 years: 15mg (2.5mL) 4 - 8 hourly 

Or:

  • Ephedrine nasal drops (0.5%); instill into nostrils twice daily and at night time
  • Antibiotics
  • Amoxicillin syrup 125 - 250 mg orally 8 hourly for 5 - 7 days