Is your child complaining of difficulty in breathing? Do they frequently suffer from a common cold and find it more comfortable to breathe through their mouth? Pay attention if you notice symptoms such as facial changes and alterations in their voice, as these could indicate adenoid enlargement, a condition commonly seen in children.
Adenoids are clusters of tissue located at the back of the throat, positioned above the tonsils. Composed of lymphoid tissue, they serve an important role in the body's defense against foreign microbes. Adenoids are present from birth, reach their largest size around the age of six, gradually shrink during puberty, and typically disappear completely by the age of twenty.
Some children develop a tendency for lymphoid enlargement, commonly known as hyperplasia, which includes adenoids. When these children experience frequent episodes of the common cold, upper respiratory tract infections such as pharyngitis, tonsillitis and sinusitis, it can result in persistent adenoid infection succeeded by adenoid growth.
If your child experiences the following clinical features, they may suffer adenoid hypertrophy.
Mouth breathing:
Blockage of the nasal passage is one of the most common symptoms of enlarged adenoids that leads to breathing from the mouth. This may also interrupt feeding and suckling in a child, as respiration and swallowing cannot coincide.
Sinusitis:
Due to persistent runny nose and infection, sinuses in the face can also get infected. On the other hand, sinusitis can lead to increased growth of the adenoids.
Nasal symptoms:
Nosebleeds and a noticeable change in the child's voice are common indications. The obstruction in the nasal passage causes a loss of nasal quality in their voice. Moreover, a runny nose with a wet and bubbly consistency is often observed.
Hearing loss:
The adenoid mass tends to block the tube that connects the throat to the ear (the eustachian tube), which results in changes in the eardrum due to pressure and hearing loss as the sound cannot be adequately conducted through the ear canal. Fluctuating hearing loss is seen when waxing and waning of adenoid mass causes intermittent obstruction in the ear.
Facial changes:
Also called adenoid facies, nasal passage obstruction and breathing via mouth result in a dull expression, elongation of face, crowding of upper teeth and pinched appearance of the nose.
The child may also show a lack of concentration, ear infection, and the aforementioned symptoms. According to an article in the National Library of Medicine, some children may also experience obstructive sleep apnea and gastro-oesophageal reflux.
Diagnosis:
The otorhinolaryngologist may confirm the symptoms and make a diagnosis with the help of an endoscope. An X-ray may also be used for the same.
Treatment:
If the symptoms are not aggravated, breathing exercises and nasal drops can help relieve the condition. In most children, adenoids regress and surgery may not be recommended.
When individuals experience significant symptoms due to adenoid enlargement, a surgical procedure known as adenoidectomy is performed. This surgery typically lasts up to two hours. Following the procedure, the child may encounter certain post-surgical effects such as earache, sore throat, and nasal congestion. Analgesic medication may be prescribed to alleviate pain. It is recommended that the child consumes cold food items like milkshakes and ice creams while avoiding warm foods for at least a week after the surgery.
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