Enlarged Adenoids in Corpus Christi, TX
Enlarged adenoids, clinically termed adenoid hypertrophy, are among the most common reasons children are referred to an otolaryngologist. The adenoids are a mass of lymphoid tissue in the nasopharynx, the space directly behind the nasal passages. When the adenoids become sufficiently large, they partially or completely obstruct the posterior nasal airway and the openings of the Eustachian tubes, producing a cluster of recognizable symptoms that significantly affect a child’s sleep, breathing, hearing, and development. At Corpus Christi ENT Sinus & Allergy, Dr. Todd M. Weiss evaluates children with suspected adenoid hypertrophy and provides evidence-based medical and surgical treatment options.
Why Do Adenoids Enlarge?
The adenoids normally grow during early childhood, reaching peak size between ages three and seven, and then gradually shrink during adolescence. Factors that promote abnormal or persistent enlargement include:
- Recurrent viral upper respiratory infections — the most common cause of temporary adenoid enlargement
- Recurrent bacterial infections — particularly Group A streptococcus and Haemophilus influenzae
- Allergic rhinitis — chronic nasal mucosal inflammation promotes lymphoid hyperplasia
- Gastroesophageal reflux — acid exposure in the nasopharynx contributes to adenoid inflammation
- Anatomical factors — a smaller nasopharynx relative to adenoid size
Signs and Symptoms of Enlarged Adenoids
Nasal and Breathing Symptoms
- Persistent nasal obstruction and mouth breathing — often the most apparent sign
- Chronic nasal discharge (clear or mucopurulent)
- Nasal voice quality (hyponasal speech — speaking as if holding the nose)
- Snoring during sleep
- Obstructive sleep apnea: episodes of labored breathing, gasping, or witnessed apneas during sleep; restless sleep and bedwetting may be associated
- Adenoid facies: the characteristic facial appearance of long-standing severe nasal obstruction — open-mouthed posture, elongated face, high-arched palate, and dental crowding
Ear Symptoms
- Recurrent acute otitis media — Eustachian tube dysfunction from adenoid obstruction promotes middle ear disease
- Otitis media with effusion (glue ear) — persistent middle ear fluid causing conductive hearing loss
- Ear pressure or popping
Sinus and Throat Symptoms
- Recurrent or chronic rhinosinusitis — the adenoid pad serves as a bacterial reservoir seeding the sinuses
- Chronic postnasal drip and throat clearing
- Halitosis from chronically infected adenoid tissue
Diagnosis
Diagnosis of adenoid hypertrophy is typically made clinically based on the characteristic symptom profile and physical examination findings. Nasal endoscopy provides direct visualization of the nasopharynx and the adenoid pad. Lateral neck X-ray is a simple imaging study that can demonstrate the ratio of adenoid tissue to nasopharyngeal airway space. A sleep study (polysomnography) may be ordered when obstructive sleep apnea is suspected.
Treatment Options
Medical Management
For mild to moderate adenoid hypertrophy without significant obstructive sleep apnea or recurrent ear infections, a trial of nasal corticosteroid spray (which can modestly reduce adenoid size), saline nasal irrigation, and treatment of underlying allergic rhinitis is appropriate.
Adenoidectomy
When symptoms are refractory to medical management, or when obstructive sleep apnea, recurrent ear infections, or recurrent sinusitis are present, adenoidectomy is the definitive treatment. The procedure is safe, well-tolerated, and highly effective. When combined with tonsillectomy (adenotonsillectomy), it provides comprehensive treatment for obstructive sleep apnea and recurrent tonsillitis in children. When combined with tympanostomy tube placement, it reduces the rate of subsequent ear infections and the need for further tube placements.
Schedule an Appointment Today
If your child has chronic mouth breathing, snoring, or recurrent infections from enlarged adenoids, we can help. Call us at (361) 320-6130 or connect with us online to schedule a consultation.