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Adenoid Hypertrophy

Enlargement of the nasopharyngeal lymphoid tissue causing nasal obstruction, mouth breathing, snoring, and obstructive sleep apnea in children.

Written by: Saygı Hospital Health Guide Editorial Board
Published:

This content is for general information; please consult your physician for diagnosis and treatment.

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What is Adenoid Hypertrophy?

The adenoids (pharyngeal tonsil) are a mass of lymphoid tissue at the nasopharyngeal roof, part of Waldeyer's ring. They normally grow from infancy, peak in size around age 5–7, then involute by adolescence. Pathologic hypertrophy results from chronic infection, allergic inflammation, or environmental triggers (smoke, pollutants).

Obstruction of the nasopharyngeal airway leads to mouth breathing, hyponasal speech, postnasal drip, and obstructive sleep-disordered breathing. Mass effect on Eustachian tube orifices causes recurrent otitis media with effusion, conductive hearing loss, and speech delay. Long-term untreated cases may produce adenoid facies (long face, open mouth, dental malocclusion).

Diagnosis: clinical history, mouth breathing, snoring, lateral neck X-ray (adenoid-to-nasopharyngeal ratio >0.7) or flexible nasal endoscopy (gold standard). Polysomnography is indicated when OSA is suspected. Allergy workup considered in chronic rhinitis.

Symptoms

Chronic mouth breathing and open-mouth posture
Loud snoring and witnessed apneic events
Hyponasal speech ("clogged-nose" voice)
Recurrent ear infections, conductive hearing loss
Postnasal drip, chronic cough, halitosis
Restless sleep, daytime fatigue, behavioral problems
Failure to thrive in severe OSA
Adenoid facies in long-standing cases

Risk Factors

Age 3–7 years
Recurrent upper respiratory infections
Allergic rhinitis, atopy
Passive smoking, air pollution
Daycare attendance and viral exposures
Gastroesophageal reflux
Family history of adenotonsillar disease

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Persistent mouth breathing and snoring beyond age 3
  • Witnessed apneas, gasping during sleep — urgent ENT and sleep evaluation
  • Recurrent otitis media with effusion lasting >3 months
  • Speech or hearing concerns
  • Failure to thrive or behavioral changes
  • Chronic nasal congestion unresponsive to medical therapy

Treatment Methods

01
Medical therapy first-line: intranasal corticosteroids (mometasone, fluticasone) for 6–12 weeks, antihistamines if atopy, treatment of GERD
02
Adenoidectomy indicated for: OSA confirmed by polysomnography, chronic OME with hearing loss/speech delay, recurrent ear infections requiring ventilation tubes, severe nasal obstruction unresponsive to medical therapy
03
Surgical technique: curette, microdebrider, or coblation under general anesthesia, often combined with myringotomy/tubes or tonsillectomy when indicated
04
Postoperative care: pain control with paracetamol/ibuprofen, soft diet 5–7 days, monitor for primary or secondary bleeding
05
Outcomes: 80–90% improvement in nasal breathing, sleep, and OME symptoms; recurrence <5%
06
Allergy management for atopic patients reduces recurrence
07
Speech therapy for residual hyponasality after surgery in selected cases

Which Department to Visit?

You can visit our KBB (Kulak Burun Boğaz) department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.