Adenoid Hypertrophy

Adenoid hypertrophy (adenoid vegetation) is a pathological enlargement of the lymphoid tissue of the pharyngeal tonsil located in the nasopharynx. It is the result of chronic antigenic stimulation. The condition leads to airway obstruction and impaired function of the auditory tube.

This is one of the most common pathologies in pediatric otorhinolaryngology. The pharyngeal tonsil is part of the Waldeyer ring and performs an immune function. Its enlargement is a protective reaction that becomes pathological when it causes persistent clinical symptoms.

Aetiology and pathophysiology

Adenoid hypertrophy is caused by frequent respiratory infections and allergic inflammation, which create a constant antigenic load on the lymphoid tissue. Grades I, II and III are distinguished depending on the degree of the nasopharynx obstruction. They determine the severity of clinical manifestations.

Clinical Significance

The key clinical manifestation is persistent difficulty in nasal breathing leading to mouth breathing, nighttime snoring, and obstructive sleep apnea (OSA). Blockage of the auditory tube openings causes recurrent otitis media and hearing loss. Nasopharyngeal endoscopy is the gold standard diagnostic procedure.

Treatment of this condition depends on its degree and symptoms. Conservative therapy (intranasal glucocorticosteroids) is used for grades I-II. In case of grade III and complications (OSA, otitis, hearing loss) surgical treatment (adenoidectomy) is indicated.

Differential Diagnosis

Adenoid hypertrophy should be distinguished from adenoiditis, which is an active inflammation of the adenoid tissue. Hypertrophy can occur without inflammation, while adenoiditis is accompanied by edema, hyperemia, and purulent effluent.