Adenoid disease

Introduction

Adenoid Disease is a manifestation of hyperplasia/hypertrophy of the adenoid tissue in the nasopharynx.
It usually occurs in children aged 2-6 years.
Excessively large adenoids may cause
obstruction of the nasopharyngeal airway with symptoms of nasal obstruction.
Large adenoids may encroach on the
Eustachian tube openings causing secretory otitis media with deafness in the child.
Chronic infection of adenoid tissue is also often present.
Symptoms usually subside spontaneously as adenoids regress physiologically and become atrophic with age.

Symptoms and clinical features of Adenoid disease

  1. Nasal obstruction and mouth-breathing
  2. Progressive deafness due to secretory otitis media
  3. Snoring at night
  4. Obstructive sleep apnoea

Differential diagnoses

  • Allergic rhinitis
  • Sinusitis
  • Otitis media

Complications of Adenoid disease

  1. Sinusitis
  2. Recurrent otitis media
  3. Pneumonitis

Investigations

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

Treatment for Adenoid disease

Treatment objectives

  1. To significantly improve nasopharyngeal airway and thereby improve nasal breathing
  2. Treat concurrent infection

Non-drug treatment

  • Adenoidectomy in severe cases

Drug treatment

A. Decongestants

  • Psuedoephedrine syrup

Child

  • 6-12 years: 30mg (5mL of syrup) orally every 8 hours;
  • 2-5years 2.5mL

Or:

  • Ephedrine nasal drops (0.5%)

Instil into nostrils twice daily and at night time

B. Antibiotic

  • Amoxicillin syrup 125 – 250 mg orally every 8 hours for 5-7days.