Adenoids Hypertrophy

What are adenoids?
Single pyramidal lymphoid tissue on posterior-superior nasopharynx > A part of the normal growth process > Not visible through the mouth

What is cause of adenoids hypertrophy? cause by chronic inflammation

Sign&Symptoms Nasal obstruction - mouth breathing (mostly at night) - dry mouth, cracked lips - persistent runny nose or nasal congestion - snoring - Obstructive sleep apnea ( snore and stop breathing ) Ear and sinus problem
- frequent ear infections (otitis media)
frequent sinus infection (sinusitis)
Voice - flat and toneless. Cardiopulmonary complications - Pulmonary hypertension - Cor pulmonale ( Right side heart failure ) - Right ventricular hypertrophy Weight loss or lack of weight gain - BMI < 19

Differential Diagnosis Other : - Obesity (BMI>25) Cause Organ Infection Airway obstruction Neoplasm Nose
Rhinitis
- Rhinopolypus
- FB in nose - Deviated septum - Nasal polyps Sinus
Sinusitis
- Chronic sinusitis - Mass or CA Tonsils & adenoids
Tonsillitis
- Adenoiditis
-Tonsil hypertrophy - Adenoids hypertrophy
Mass or CA
Trachea - Tracheitis
Trachea stenosis
- Mass or CA

Indication for admit
Moderate to severe
Sign of infection ( fever, leucocytosis, dyspnea, dehydrate )
Severe
Multiple nose, ear or sinus infections
- 7 episodes per year for 1 year
- 5 episodes per year for 2 years
- 4 episodes per year for 3 years
Obstructive Sleep Apnea
Cardiopulmonary complications
- Pulmonary hypertension
- Cor pulmonale ( right side heart failure )
- Right ventricle hypertrophy
Cancer ( rarely a cause )

Investigate
CBC
UA
X-ray neck, PNS
Imaging study ( CT scan )
In case normal physical examination
Sleep lab ( Ploy sommogram )
Add for surgery
PT,PTT
CxR

What is the treatment of adenoids hypertrophy?
Medical management
Penicillin is first line treatment
Beta-lactamase in recurrent or unresponsive (response in 1 month)
Surgery management
Adenoidectomy
Tonsiloadenoidectomy

Length of stay
ICD-10 : J35.2 = 2.5 days
ICD-9 : 474.12 = 2.5 days

Further slides for hyperlink

Antibiotics
Pennicillin
Amoxycilin, Ampicillin , Cloxacillin, Penicillin,Amoksiklave,Augmentin, Unasyn
Beta-lactames
Meropenam,Ertapenam(Invanz),
Impenam(Tienam)

Adenoidectomy
Ear infection
Recurrent nasal congestion
Sinus infection

Tonsiloadenoidectomy
Multiple nose, ear or sinus infections
( no sign of infection at least 2 wks.)
Obstructive Sleep Apnea
( persisting for at least 3 month )
Cardiopulmonary complication
Cancer ( rarely a cause )

Adenoids Hypertrophy

by Terdsak Rojsurakitti on May 31, 2009

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Adenoids Hypertrophy — Presentation Transcript