Adenoid hypertrophy in adults

Background: Adenoid is a nasopharyngeal tonsil becomes active between 3 to 7 years of age. Starts involution by adolescence. Few of the occasions, the adenoid persists causing various symptoms including ear, nose, throat and facial deformities. It is also important while addressing the cause for nasal obstruction due to the co-existent adenoid tissue which may fail to diagnose pre-operatively becomes an on-table surprise.Methods: Adult patients above 16 years are subjected to study. Routine clinical examination done followed by diagnostic nasal endoscopy and the size of the adenoid tissue and other associated findings are recorded. Results: 100 patients were included in the study and gradings were done.Conclusions: We conclude the presence of adenoid tissue is due to persistence of a childhood problem, which is supported by presence of associated findings like high arched palate, supernumerary teeth.

Download Full-text

Fiberscopic Imaging of the Pediatric Nasopharynx

Diagnostic and Therapeutic Endoscopy ◽

10.1155/dte.1.153 ◽

1995 ◽

Vol 1 (3) ◽

pp. 153-157 ◽

Cited By ~ 1

Author(s):

Deyun Wang ◽

Peter Clement

Keyword(s):

Otitis Media ◽

Nasal Obstruction ◽

Eustachian Tube ◽

Correct Diagnosis ◽

Adenoid Hypertrophy ◽

Endoscopic Findings ◽

Adenoid Tissue

This study describes the endoscopic findings about the size of the adenoid tissue and the condition of the nasopharyngeal orifice of the eustachian tube. Results confirmed that only fiberscopic examination allows a thorough inspection of the nasopharyngeal anatomy to make a correct diagnosis and design therapeutic planning. When the presence of adenoid hypertrophy resulting in nasal obstruction, snoring, and/or otitis media was confirmed endoscopically, adenoidectomy proved to be highly efficacious in relieving these symptoms.

Download Full-text

The benefits of endoscopic look after curettage adenoidectomy

The Egyptian Journal of Otolaryngology ◽

10.1186/s43163-020-00027-z ◽

2020 ◽

Vol 36 (1) ◽

Author(s):

Mosaad Abdel-Aziz ◽

Ahmed Nassar ◽

Refaat Nashed ◽

Moatz Elsherbeeny ◽

Omar Sabry

Keyword(s):

Prospective Study ◽

Endoscopic Examination ◽

Nasal Endoscopy ◽

Adenoid Hypertrophy ◽

Adenoid Tissue ◽

Incomplete Removal ◽

One Year

Abstract Background Conventional curettage adenoidectomy (CCA) has a risk of incomplete removal of all adenoid tissue, and digital nasopharyngeal palpation is not enough to assess adenoid removal. The aim of this study was to evaluate the benefits of trans-oral endoscopic look of the nasopharynx (ELN) after CCA. Results This prospective study included 1900 children with adenoid hypertrophy. CCA was used for treatment, followed by ELN. Bleeding points and/or adenoid tissue remnants were recorded and managed. One year postoperatively, nasal endoscopy was performed to detect adenoid regrowth. ELN showed bleeding points in 17 patients (0.9%) and residual adenoid tissue remnants in 855 patients (45%). Intraoperatively, the lesions were cauterized and ablated under visualization. However, adenoid regrowths were detected in 263 (42%) out of 627 children (33%) who were subjected to endoscopic examination after 1 year of adenoid removal. Conclusions Trans-oral endoscopic look of the nasopharynx after CCA is a beneficial method in detection of adenoid remnants and bleeding points. Also, it could decrease symptomatic adenoid regrowth postoperatively.

Download Full-text

Role of mometasone furoate nasal spray versus saline nasal spray in treatment of adenoid hypertrophy: a prospective, randomized study

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20204186 ◽

2020 ◽

Vol 6 (10) ◽

pp. 1841

Author(s):

Rabia Monga ◽

Sanjeev Bhagat ◽

Vishal Sharma ◽

Dimple Sahni ◽

Harjinder Singh ◽

...

Keyword(s):

Nasal Obstruction ◽

Nasal Spray ◽

Clinical Symptoms ◽

Randomized Study ◽

Mometasone Furoate ◽

Nasal Endoscopy ◽

Prospective Randomized Study ◽

Common Symptom ◽

Adenoid Hypertrophy ◽

Obstructive Sleep

Background: Adenoid hypertrophy is a common disorder in the paediatric population, presenting with multiple signs and symptoms ranging from nasal obstruction to obstructive sleep apnoea. Most common symptom is usually nasal airway obstruction. This prospective, randomized study aims to evaluate the efficacy of mometasone furoate spray in reducing size and clinical symptoms in patients with adenoid hypertrophy compared to saline spray.Methods: 60 patients in the age group of 3-11 years were enrolled in the study. Five symptoms were included that were hypo nasal speech, snoring, night cough, open mouth breathing and nasal obstruction which were scored as never=0, mild (sometimes)=1, moderate (less than 50% of times)=2, and severe (constant)=3. Diagnosis of adenoid hypertrophy was made on basis of nasal endoscopy.Results: Significant improvement was seen in individual as well as overall symptom score in group A as compared to group B after 8 weeks of treatment (p<0.001). There was significant improvement in mean adenoid grade as per nasal endoscopy at 8 weeks post therapy (p<0.001) which was not seen after 4 weeks of therapy.Conclusion: Intranasal steroid sprays have good role in decreasing the symptoms of adenoid hypertrophy and has reduced number of adenoidectomies required. The long-term effects as well as optimal duration of therapy is still controversial and needs to be studied further.

Download Full-text

Adenoidectomy: Conventional or Endoscopic Assisted?

Clinical Rhinology An International Journal ◽

10.5005/jp-journals-10013-1312 ◽

2017 ◽

Vol 10 (2) ◽

pp. 74-77

Author(s):

Anuj K Goel

Keyword(s):

Nasal Obstruction ◽

Pediatric Population ◽

Complete Removal ◽

Adenoid Hypertrophy ◽

Success Rates ◽

Radiological Investigation ◽

Suppurative Otitis Media ◽

Adenoid Tissue ◽

Number Of Patients ◽

Chronic Adenoiditis

ABSTRACT Objectives Adenoid hypertrophy is known as the most common cause of nasal obstruction in children; thus, adenoidectomy is one of the most commonly performed surgical procedures in the pediatric population. We performed both conventional and endoscopic-assisted adenoidectomies in 54 patients. Our objectives were to compare the efficacy of both methods in terms of subjective and objective relief of symptoms, safety, recurrence, and postoperative morbidity. Materials and methods Fifty-four patients were studied and were diagnosed depending upon clinical examination and radiological investigation. The patients were operated by either conventional or endoscopic-assisted adenoidectomy (EAA). Intraoperative and postoperative complications were looked for. After discharge from the hospital, the patients were called for follow-up on 1st week, 3rd week, 2nd and 4th month, and patients were asked for relief of symptoms and examined for nasal disease and for recurrence. Results Adenoid hypertrophy was seen commonly in children and the most common presenting complaints were nasal obstruction, mouth breathing, and snoring. The patients were diagnosed to have chronic adenoiditis, chronic adenotonsillitis, with or without chronic suppurative otitis media. More number of patients became symptom free with EAA as compared with conventional adenoidectomy. Conclusion Conventional adenoidectomy and EAA both have comparable success rates. Endoscopic-assisted adenoidectomy allows complete removal of adenoid tissue, thereby reducing the chances of developing recurrent adenoid obstructive symptoms and reducing the bacterial reservoir in the nasopharynx. How to cite this article Goel AK. Adenoidectomy: Conventional or Endoscopic Assisted? Clin Rhinol An Int J 2017;10(2):74-77.

Download Full-text

Surgery to relieve nasal obstruction: outcome for 366 patients operated on by one senior surgeon

European Archives of Oto-Rhino-Laryngology ◽

10.1007/s00405-021-06696-7 ◽

2021 ◽

Author(s):

Lars Aksel Pedersen ◽

S. Dölvik ◽

K. Holmberg ◽

C. Ahlström Emanuelsson ◽

H. Johansson ◽

...

Keyword(s):

Beneficial Effect ◽

Nasal Obstruction ◽

General Health ◽

Surgical Skills ◽

Nasal Endoscopy ◽

Experienced Surgeon ◽

Senior Surgeon ◽

Significant Difference ◽

Before And After ◽

The Mean

Abstract Background Studies of patient-rated outcome in septoplasty and turbinoplasty most frequently involve several surgeons with varying surgical skills, techniques and experience. The aim of the present study was to evaluate outcome based on one experienced surgeon. Methods Three hundred and sixty-six consecutive patients referred for nasal obstruction were included. All the patients were examined with nasal endoscopy before and after decongestion, they filled out a nose VAS and rated their overall general health before and three to six months after surgery. The patients underwent septoplasty, septoplasty plus turbinoplasty or turbinoplasty. Results The mean nose VAS for nasal obstruction (0–100) preoperatively was 64.7 for all patients. Patients undergoing septoplasty (n = 159) were younger than patients undergoing septoplasty + turbinoplasty (n = 79) or patients undergoing turbinoplasty alone (n = 128). The nose VAS for nasal obstruction improved significantly in all three groups and 25% had a normal nose VAS after surgery in the septoplasty and septoplasty + turbinoplasty groups compared to only 8% in the turbinoplasty alone group. There was no significant difference in the improvement in nasal obstruction between septoplasty and septoplasty + turbinoplasty, but the septoplasty + turbinoplasty group experienced a significantly greater improvement in general health. Conclusions In 366 patients operated on by one experienced surgeon, septoplasty and septoplasty + turbinoplasty were more effective at relieving nasal obstruction than turbinoplasty alone. Septoplasty + turbinoplasty resulted in a greater improvement in general health than septoplasty alone, despite the same improvement in nasal obstruction, indicating a beneficial effect of additional turbinoplasty in septoplasty.

Download Full-text

Letter To The Editor

PEDIATRICS ◽

10.1542/peds.46.4.651 ◽

1970 ◽

Vol 46 (4) ◽

pp. 651-651

Author(s):

Jill M. Forrest ◽

Margaret A. Menser ◽

J. D. Harley

Keyword(s):

Diabetes Mellitus ◽

Glucose Tolerance ◽

Clinical Examination ◽

Congenital Rubella ◽

Letter To The Editor ◽

Routine Clinical Examination ◽

Glucose Tolerance Tests ◽

Original Report

We were most interested to read of Plotkin and Kaye's two children with congenital rubella and diabetes mellitus. Since our original report of five cases referred to by those writers, we have found three further patients under 30 years of age with this combination of disorders.1 Each of these three patients had no evidence of diabetes mellitus on routine clinical examination and urinalysis in 1967. However, when reviewed this year all three patients had glucose tolerance tests indicative of diabetes.

Download Full-text

Relationship between Responses to Bronchodilation Testing and to Nasal Decongestion Testing in Patients with Allergic Rhinitis Alone

European Journal of Inflammation ◽

10.1177/1721727x0900700305 ◽

2009 ◽

Vol 7 (3) ◽

pp. 153-160 ◽

Cited By ~ 2

Author(s):

G. Ciprandi ◽

A. Pistorio ◽

M.A. Tosca ◽

I. Cirillo ◽

G.L. Marseglia

Keyword(s):

Allergic Rhinitis ◽

Skin Prick Test ◽

Nasal Obstruction ◽

Clinical Examination ◽

Positive Response ◽

Bronchial Obstruction ◽

Prick Test ◽

Large Group ◽

Lower Airways

A remarkable relationship exists between upper and lower airways. Bronchial obstruction is a paramount feature of asthma as well as nasal obstruction of allergic rhinitis (AR). This study aims to evaluate the response to both bronchodilation and decongestion testing and their relationships in a large group of patients with moderate-severe persistent AR alone. Two hundred eleven patients with moderate-severe persistent AR were prospectively and consecutively evaluated. Clinical examination, skin prick test, spirometry, bronchodilation test, rhinomanometry, and decongestion test were performed on all patients. Seventeen subjects (8%) did not respond to any of the tests, 55 subjects (26.1%) were responders only to the decongestion test, 31 (14.7%) only to the bronchodilation test, and 108 subjects (51.2%) responded to both these tests. Longer AR duration was significantly associated with positive response to both tests (p<0.01). In conclusion, this study provides the first evidence that patients with moderate-severe persistent AR may frequently show reversibility to both bronchodilation and decongestion tests.

Download Full-text

Role of mometasone furoate nasal spray in children with adenoid hypertrophy: impact on life style changes

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20203578 ◽

2020 ◽

Vol 6 (9) ◽

pp. 1709

Author(s):

Venkatesha B. K. ◽

Ravi Shekhar

Keyword(s):

Nasal Obstruction ◽

Nasal Spray ◽

Statistical Tests ◽

Nasal Congestion ◽

Sleep Apnea Syndrome ◽

Mometasone Furoate ◽

Nasal Discharge ◽

Adenoid Hypertrophy ◽

Obstructive Sleep ◽

Life Style Changes

Background: Adenoid hypertrophy (AH) is a common cause of upper airway obstruction and obstructive sleep apnea syndrome (OSAS) in children having major impact on child’s growth and development. Symptoms like nasal congestion, mouth breathing, nasal discharge, snoring, day time sleepiness, hyponasal voice, ear popping, and craniofacial abnormalities are observed. Adenoidectomy is considered the treatment of choice for symptomatic children. Co-existing medical illnesses and choice of surgical treatment is governed by the paediatricians and apprehensive parents. Need for conservative treatments in alleviating symptoms have been tried. Topical, intranasal administered, steroid preparations have been proven effective in the literature.Methods: In this prospective study, 35 symptomatic children (3-12 years) with adenoid hypertrophy were included. Each of the symptoms was scored from 0 (absent) to 4 (severe) over Visual Analogue Scale (VAS). Nasal obstruction index was calculated. Results of mometasone furoate nasal spray 100 microgram/day used once daily at the interval of 8 weeks and 12 weeks were analysed using statistical tests. Results: A statistically significant reduction in nasal obstruction index and other symptoms were noted at the end of third month follow up.Conclusions: Mometasone furoate nasal spray caused improvements in outcomes of nasal obstruction, snoring, total nasal symptoms, ear symptoms and overall quality of life.

Download Full-text

Prevalence of Gerlach tonsil: a mucosa associated lymphoid tissue aggregation in the nasopharynx

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20205399 ◽

2020 ◽

Vol 7 (1) ◽

pp. 39

Author(s):

Ramesh Varadharajan ◽

Sonee Thingujam

Keyword(s):

Lymphoid Tissue ◽

Nasal Polyposis ◽

Chronic Sinusitis ◽

Past History ◽

Endoscopic Examination ◽

Adult Patients ◽

Nasal Endoscopy ◽

Adult Study ◽

History Of ◽

Serous Otitis Media

Background: The major aggregate of mucosa associated lymphoid tissue located in the nasopharynx is the adenoid. The minor aggregate located in the nasopharynx is the Gerlach tonsils or tubal tonsils. The Gerlach tonsils are well described in the text books. But unlike the adenoids they are rarely visualized during routine endoscopic examination. Several studies conducted in children for recurrence of adenoids or serous otitis media after surgery; have reported tubal tonsil hypertrophy widely. This study in adults aims to see the prevalence of Gerlach or tubal tonsils visible during nasal endoscopy.Methods: The case records of 155 adult patients, aged between 18-50 years, who underwent pre-operative diagnostic nasal endoscopy for the management of septal deviations, chronic Sinusitis, nasal polyposis or eustachian dysfunction between Jan. 2019 to March 2020 are retrospectively reviewed and the endoscopy findings analyzed and presented. Results: Gerlach tonsil hypertrophy is reported to be more prevalent in children than in adults. When hypertrophied, the Gerlach tonsils can cause symptoms in adults also and can be visualized during nasal endoscopy. In this adult study, we report a 0.6% incidence of Gerlach tonsil hypertrophy. Conclusions: The possibility of a Gerlach tonsil hypertrophy is to be remembered during nasal endoscopy in adult patients presenting with symptoms of eustachian dysfunction and past history of allergic rhinitis and adeno tonsillectomy. Comparing the size of the contra lateral torus tubaris and the eustachian tube opening during the act of swallowing is helpful in diagnosis.

Download Full-text

Isolated Sphenoid Sinus Mucocele: A Rare Case and Review of Literature

Journal of Postgraduate Medicine Education and Research ◽

10.5005/jp-journals-10028-1154 ◽

2015 ◽

Vol 49 (2) ◽

pp. 91-93

Author(s):

Karan Gupta ◽

Satheesh Kumar Sunku

Keyword(s):

Nasal Obstruction ◽

Clinical Examination ◽

Endoscopic Sinus Surgery ◽

Sphenoid Sinus ◽

Rare Case ◽

Sinus Surgery ◽

Review Of Literature ◽

Postnasal Drip

ABSTRACT Isolated sphenoid sinus mucoceles are uncommon and difficult to diagnose clinically owing to the inaccessibility of the sphenoid sinus to clinical examination. A case of infected sphenoid sinus mucocele in which the patient complained of progressive nasal obstruction and postnasal drip without any other classical features of sphenoid sinus mucocele is discussed here. The pathology of mucocele and endoscopic sinus surgery as the treatment has been discussed in this article. How to cite this article Gupta K, Virk RS, Sunku SK. Isolated Sphenoid Sinus Mucocele: A Rare Case and Review of Literature. J Postgrad Med Edu Res 2015;49(2):91-93.

Download Full-text