Adenoidectomy is a surgical intervention performed to alleviate breathing and sleep problems caused by the excessive enlargement of the adenoids. This condition may manifest with symptoms such as difficulty breathing, snoring, and sleep apnea. The necessity of an adenoidectomy is determined based on the patient's complaints, the severity of symptoms, and the response to treatment.
What Is Adenoid Enlargement?
The adenoids act as a component of the immune system during childhood. Over time, they tend to shrink after puberty. However, in some individuals, especially children, the adenoids may enlarge beyond their normal size due to infections, allergies, and environmental factors.
Enlarged adenoids can manifest with various signs such as nasal congestion, mouth breathing, snoring, and hearing issues. These symptoms arise from the pressure on surrounding tissues due to the anatomical location of the adenoids. In cases where the eustachian tube function between the middle ear and the nose is impaired, fluid accumulation and hearing loss may also be observed.
What Are the Symptoms of Adenoid Enlargement?
Adenoid enlargement can present with many symptoms, often affecting the respiratory and auditory systems. Common symptoms include:
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Nasal congestion and constant mouth breathing
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Nighttime snoring
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Sleep apnea
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Restless and interrupted sleep
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Nasal speech and a nasal voice
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Temporary or persistent hearing problems
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Daytime fatigue
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Lack of concentration
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Feeding difficulties
These symptoms can directly affect the individual's quality of life and may negatively impact social interaction in some cases.
How to Recognize Adenoid Enlargement in Children?
Adenoid enlargement in children can be identified by certain behavioral and physical signs noticed by parents and people around the children. Symptoms include:
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Constantly walking with an open mouth
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Restlessness and snoring throughout the night
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Waking up sweating or not being able to breathe
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Waking up tired in the morning
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Shortened attention span
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Earache
When these signs are observed in a prolonged and recurring manner, it may indicate a condition related to adenoid enlargement. A definitive diagnosis can be made through clinical examination, nasopharyngeal endoscopy, and hearing tests.
Why Does Adenoid Enlargement Occur in Adults?
The adenoids are generally active in childhood tissue and tend to shrink toward adolescence. However, in some cases, the adenoid tissue can regrow into adulthood.
The main reasons for adenoid enlargement in adults include:
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Chronic upper respiratory tract infections: Frequent infections can lead to regrowth of the adenoids.
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Chronic inflammatory conditions such as allergic rhinitis and sinusitis: Long-term allergic or inflammatory processes may lead to adenoid tissue enlargement.
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Immune system diseases: Conditions affecting the body's defense system can lead to lymphoid tissue growth.
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Genetic factors: In some individuals, adenoid tissue may remain unchanged even in adulthood.
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Masses that can be confused with tumoral growths: Although rare, some masses in the adenoid region can present symptoms similar to adenoid enlargement.
In adults, adenoid enlargement can manifest with symptoms such as nasal congestion, postnasal drip, sleep disorders, and ear pressure. In the presence of these complaints, a detailed ear, nose, and throat examination may be necessary to investigate the underlying cause.
Under What Conditions Might Adenoid Enlargement Require Intervention?
Adenoid enlargement may not always require treatment. In some children, as they approach puberty, the adenoids may shrink. However, intervention may be necessary if it causes symptoms such as snoring, sleep apnea, and nasal congestion. Conditions requiring medical intervention include:
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Diagnosis of obstructive sleep apnea
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Persistent nasal congestion and habitual mouth breathing
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Predisposing factor for recurrent nasal diseases such as sinusitis
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Causing recurrent middle ear infections
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Frequent recurrent middle ear infections
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Feeding difficulties
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Chronic mouth breathing adversely affecting facial and jaw development
How Is Adenoidectomy Performed?
Adenoidectomy is performed quickly under general anesthesia. The adenoid tissue is removed from the mouth using special curettes and extracted by an otorhinolaryngology specialist surgeon.
The adenoid tissue is carefully removed within a few minutes, and then the surgeon inspects the nasal cavity with endoscopy. After ensuring that there are no residual tissues, the surgery is completed.
Post-Adenoidectomy Recovery Process
The recovery process after adenoid surgery may vary from person to person. Typically, mild pain, swelling, and nasal congestion may occur in the first few days post-surgery. These symptoms gradually decrease and usually improve within the first week following surgery.
It is important to use the medications as prescribed by the doctor, use drops or sprays to moisturize the nasal interior, and avoid strenuous exercise, nose squeezing, or blowing activities for a certain period after the surgery.
Frequently Asked Questions
Can adenoid enlargement shrink on its own?
Yes, the adenoids are an active immune tissue during childhood and tend to shrink during adolescence. This process usually leads to a reduction in adenoid symptoms, but it can progress differently in each individual. In some children, the enlarged adenoids may persist and cause health issues, necessitating careful evaluation instead of delaying intervention.
Can adenoid enlargement recur?
Even after the complete removal of the adenoid tissue, residual lymphoid tissues may regrow in some individuals over time. This condition is mainly observed in children who underwent early surgery; however, regrowth does not always present symptoms. Reassessment should be conducted based on symptoms in case of regrowth.
Can adenoid enlargement cause hearing loss?
Yes, adenoid enlargement can impair the function of the eustachian tube and prevent ear ventilation, leading to fluid accumulation in the middle ear. This condition can cause hearing loss in children and negatively affect language development and academic performance.
Does adenoid enlargement affect facial development?
Long-term mouth breathing habit can affect facial and jaw development. This condition is known as adenoid facies and can lead to narrowing of the upper jaw, dental structure changes, forward displacement of the lower jaw, and a long facial appearance. Early detection and treatment can positively affect the child's facial aesthetics and jaw functions in later ages.