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Adenoids Hypertrophy
 

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
    • 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 )