Question

My child says there’s something blocking their nose, causing difficulty in breathing, and they are always breathing through their mouth. A neighbor’s child also has this issue, and it might be adenoid hypertrophy. I’m not sure and would like to know what tests are needed for adenoid hypertrophy?

Answer

The examination project for adenoid hypertrophy includes:

  1. The child breathes through the mouth, sometimes showing a typical “adenoid face.”
  2. Lateral nasopharyngeal radiograph: This measures the degree of obstruction in the nasopharyngeal airway.
  3. CT scan: Axial CT images show deformation and narrowing of the nasopharyngeal cavity, thickening of the posterior wall soft tissue with uniform density.
  4. Oropharyngeal examination reveals a high and narrow hard palate, with mucous secretions flowing down from the nasopharynx, often accompanied by hypertrophied palatine tonsils.
  5. Palpation: Nasopharyngeal palpation with fingers can feel soft mass-like objects at the top and posterior wall of the nasopharynx.
  6. Anterior rhinoscopy shows a large amount of secretions in the nasal cavity, with mucosal swelling.
  7. Fiberoptic nasopharyngoscopy reveals lobulated lymphoid tissue with longitudinal fissures on the top and posterior wall of the nasopharynx, resembling half a peeled small tangerine. It often blocks more than two-thirds of the posterior nares. This is currently the most commonly used method for adenoid examination.