Adenoids Hypertrophy
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Adenoids Hypertrophy

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Adenoids Hypertrophy Adenoids Hypertrophy Presentation Transcript

  • 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 View slide
  • 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 View slide
  • 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 )