Nasopharyngeal tonsil, commonly called ‘Adenoids’ is a defense tissue located in the posterior region of nasopharynx. The tissue which is present during the birth shows physiological changes and will completely disappear by the age of 20. However in the case of recurrent attacks of rhinitis, sinusitis or chronic tonsillitis, it may get infected which results in adenoid hypertrophy.
Enlarged and infected adenoids may cause nasal, aural and general symptoms. Nasal obstruction, nasal discharge, sinusitis and voice change are some of nasal symptoms, in which the former is the most common one which leads to mouth breathing. The inflammation of adenoids will cause otitis media which in turn result in malfunctioning of the Eustachian tube, which is responsible for pressure regulation and drainage of middle ear secretions into the nasopharynx. The accumulation of middle ear fluid may cause retracted tympanic membrane with fluctuating conductive (temporary) hearing loss.
HOW ADENOID HYPERTROPHY CAN BE IDENTIFIED?
If the doctor thinks the child has a problem with the adenoids, it can identify the presence of adenoid hypertrophy by examination of postnasal space using flexible endoscopy. In addition to that X- ray of nasopharynx will reveal the size of adenoids and also the extent to which nasopharyngeal air space has been compromised. An audiologist can confirm the presence of conductive hearing loss using impedance audiometry along with pure tone audiometry to identify the degree of hearing loss for the child.
HOW HEARING LOSS CAN BE RESOLVED IN ADENOID HYPERTROPHY?
Infected adenoids can be treated using medical, pharmacological or surgical methods. When symptoms are not marked, breathing exercises, decongestant nasal drops or antibiotics for ear and sinus infections can cure the condition without resort to surgery. It is essential to treat the ear infections that cause reduced hearing sensitivity, which in time changes to permanent hearing loss. In case of recurrent otitis media associated with ear pain, breathing difficulty or sleep apnea, it is essential to undergo adenoidectomy (removal of adenoids) which can resolve the adenoid and related infections that in turn helps to improve the hearing sensitivity overtime.
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