What tests should be done for adenoid hypertrophy

Adenoids hypertrophy is also called swollen tonsils. This disease usually occurs in children because children's throats are very fragile. Especially when they have a cold, it is very easy to cause tonsillitis, which leads to hypertrophy of the tonsils. This disease cannot be cured, but it will slowly degenerate as the child grows. So what kind of examinations are needed for adenoids hypertrophy?

Children's adenoids, also known as pharyngeal tonsils, are a type of lymphoid tissue. Generally, they slowly degenerate around the age of 9-12. However, some children suffer from adenoids hyperplasia due to influenza or long-term rhinitis, upper respiratory tract infection, sinusitis and other problems. Such patients must undergo nasopharyngeal fiberscopic examination to determine the surface condition of the lesion, which helps to differentiate it from other lesions. CT examination can show soft tissue shadows on the posterior wall of the nasopharynx. Larger ones can protrude into the nasal cavity, causing nasal congestion in the patient, and invade the Eustachian tube to cause tinnitus or secretory otitis media and mastoiditis.

1. Lateral nasopharyngeal film is an X-ray examination. Its advantages are that it is economical, quick and easy for children to complete the examination. Doctors can determine whether the adenoids are enlarged by measuring the width of the airway. If the airway width is 1 to 5 mm, it is considered severe adenoid hypertrophy. If the airway width is 6 to 10 mm, it is moderate adenoid hypertrophy. If the airway width is greater than 11 mm, it is normal. When taking a lateral nasopharyngeal radiograph, be sure to choose a time when the child is inhaling through the nose. At this time, the anterior-posterior diameter of the nasopharyngeal cavity is the largest, which is the true width of the nasopharyngeal cavity. Otherwise, it will not be able to truly and objectively reflect the degree of adenoid hypertrophy. In addition, the complex structure of the head and pharynx, as well as many other factors, can affect the quality of the lateral nasopharyngeal radiograph, causing a certain difference between the measured adenoid size and the actual size. Another disadvantage of the lateral nasopharyngeal radiograph is that it is impossible to observe the tissue structure around the adenoids and the changes in the airway cannot be observed dynamically.

Second, CT scan of the nasopharynx can reflect the changes in the size of the adenoids and the width of the airways from multiple levels, and can observe the pharyngeal recesses, Eustachian tube pharyngeal openings, occipital bone and other structures around the adenoids, as well as the conditions of the sinuses and middle ear mastoids. Because children with enlarged adenoids, if they have a long history of illness and severe blockage, may suffer from sinusitis and otitis media at the same time, therefore, nasopharyngeal CT can help doctors observe these three parts at the same time. The disadvantage of nasopharyngeal CT is that the tomographic scan cannot directly reflect the degree of adenoids blocking the posterior nares, cannot help doctors directly judge the degree of obstruction in children, and cannot provide a basis for surgery. This is the biggest disadvantage of nasopharyngeal CT in the examination of children with adenoids hypertrophy. Both nasopharyngeal CT and nasopharyngeal lateral radiographs are examinations performed under X-rays, which pose certain radiation hazards.

3. Fiber optic nasopharyngeal endoscopy. This is the most intuitive and effective method of the three examinations! The doctor uses a fiber electronic laryngoscope to pass through the child's nasal cavity, not only to directly observe the adenoids, but also to observe the condition of the nasal cavity while passing through the nasal cavity. By observing the size of the nasal conchae, whether there is secretion in the nasal cavity, the amount and color of the secretion, it can be determined whether the child has both rhinitis and sinusitis. Nasopharyngeal endoscopy can observe whether there is congestion on the surface of the adenoids and whether there is purulent secretion, and directly determine the degree of adenoid inflammation! In addition, the proportional relationship between the adenoids and the posterior nasal cavity can be estimated, which can more intuitively determine the degree of adenoids blocking the posterior nasal cavity. It is also possible to observe the tissue structure around the adenoids and the dynamic changes of the airway. With the advancement of technology, the body of the fiber electronic nasopharyngeal endoscope is thinner, children can tolerate it better, the lens has higher pixels, the adenoids are displayed more clearly, and it has a magnification function, and has the functions of recording and taking pictures, which is more convenient. The disadvantage of the fiberoptic electronic nasopharyngeal endoscope is that it requires the cooperation of the child. The child's nasal cavity is narrow, and sometimes mucus accumulates in the nasal cavity, causing unclear images, but a skilled examiner can completely overcome the above shortcomings.