Adenoid Hypertrophy

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It  is  hypertrophy  of  the  lymphoid  tissues  in  the  nasopharynx;  presenting  with  mouth  breathing,  snoring sleep apnea and otitis media with effusion. It is reported mainly in children. 

Investigations

• Nasopharynx lateral view X-ray. 

Pharmacological Treatment

A: cetirizine (PO) 10mg nocte for 2weeks. Children: 5mg nocte for 2weeks 

AND 

A: 0.9% sodium chloride nasal spray/drops 4hourly for 2weeks 

AND 

B: azithromycin (PO) 500mg 24hourly for 3days. Children: 10mg/kg 24 hourly for 3days 

OR 

B:  amoxicillin + clavulanic  acid  (PO)  (FDC)  Adults:  625mg  (500mg  amoxicillin+125mg clavulanic acid) 8hourly for 7days  

Children: 375mg (250mg amoxicillin+ 125 Clavulanic acid) 12hourly for 7days

OR 

S:  cefixime  (PO)  Adults:  400mg  24hourly  for  7-14days. Children  ≥  6months  to  12years (weight below 45kg): 8mg/kg 24hourly for 7-14days 

OR  

C:  clarithromycin  (PO) Adults:  500mg 12  hourly  for  7-14days.  Children  ≥  6months: 15mg/kg/day in 2 divided doses for 7-14days 

AND 

A:  paracetamol (PO) 1gm 8hourly until fever is controlled: Children 10mg/kg body weight 8hourly until fever is controlled. 

Surgical management 

• Adenotonsilectomy/Adenotomy+/- Myringotomy and Gromet insertion 

Note: An adult with snoring upper aerodigestive tumours and Obstructive Sleep Apnea (OSA) should be  considered.