The baby became ugly because of enlarged adenoids!

Author: Tang Zhiyuan, deputy chief physician of Shenzhen University General Hospital

Reviewer: Zhang Qingfeng, Chief Physician, Shenzhen University General Hospital

“The flowers are the same year after year, but the people are different year after year.” Watching their children grow up, become more handsome and beautiful day by day, the old father and mother are very pleased.

Figure 1 Copyright image, no permission to reprint

However, the mouth breathing caused by adenoid hypertrophy has become a "stumbling block" on the road to becoming handsome and beautiful. Becoming handsome and beautiful is like sailing against the current. If you don't move forward, you will fall behind. Therefore, only by knowing yourself and the enemy can you win every battle.

Based on clinical experience, the author has compiled 16 questions about adenoids hypertrophy that parents are concerned about, hoping that it will be helpful to everyone.

1. Where are the adenoids? What is adenoid hypertrophy?

Adenoids are lymphatic tissues under the pharyngeal mucosa, located at the junction of the top and back walls of the nasopharynx, between the pharyngeal recesses on both sides. Adenoids hypertrophy, as the name suggests, is the pathological proliferation of the adenoids due to repeated stimulation of inflammation, which causes corresponding symptoms.

2. Does enlarged adenoids cause allergic rhinitis and sinusitis? Or does allergic rhinitis and sinusitis cause enlarged adenoids?

Hypertrophic adenoids can block the posterior nares, causing local accumulation of secretions and poor drainage, aggravating allergic rhinitis and sinusitis. The increased secretions of allergic rhinitis and sinusitis stimulate the proliferation and hypertrophy of adenoids. The two influence each other and aggravate each other's development.

3. How to treat allergic rhinitis and adenoids hypertrophy?

The treatments for allergic rhinitis are divided into drug therapy and immunotherapy. Drug therapy generally includes antihistamines, nasal corticosteroids, anti-leukotrienes and decongestants, etc.; specific immunotherapy is desensitization therapy.

Treatments for adenoid hypertrophy include medication and surgery. Nasal glucocorticoids are generally recommended as treatment drugs. If medication can relieve the symptoms of adenoid hypertrophy, then surgery is not necessary; if conservative medication treatment is ineffective, surgery can be used.

4. If medication is used to treat adenoids hypertrophy, when should the medication be started?

Drug treatment should be used within 3 months of the early discovery of adenoid hypertrophy, and nasal corticosteroid spray is generally recommended.

5. Nasal glucocorticoids are often used to treat adenoid hypertrophy. Which hormone is better? How to use hormones?

Mometasone furoate nasal spray and fluticasone propionate nasal spray are generally recommended. Nasal glucocorticoids should be used under the guidance of a doctor according to symptoms and age.

6. Will the use of hormones to treat adenoids affect the growth of children? Will it cause children to mature early?

No, nasal glucocorticoids are used to treat adenoids hypertrophy. They have very low systemic bioavailability, the amount inhaled through the nose is also very small, and they only work locally, with almost no effect on the whole body.

7. When is surgery necessary for enlarged adenoids? If not, how should I take care of myself?

When enlarged adenoids cause symptoms such as open mouth breathing, snoring during sleep, facial changes, rhinitis, sinusitis and otitis media, and the drug treatment is ineffective, surgical treatment is recommended. If surgery is not performed, you must pay attention to avoid colds, flu and contact with allergens. Allergic rhinitis and sinusitis can aggravate adenoids hypertrophy, so you must control allergic rhinitis and sinusitis.

8. Why is it that the same method of treating adenoids hypertrophy works well for some people but has almost no effect on others?

Each patient's specific condition is different, and there are many factors that affect adenoids hypertrophy, so the same treatment may have different effects on different patients. If other airway obstructive diseases such as tonsil hypertrophy, allergic rhinitis and sinusitis are also present, they also need to be treated at the same time.

9. Will the disease recur after adenoidectomy? If it recurs, how should it be treated?

Clinically, adenoidectomy is performed under endoscopy, and the surgical field of view is very clear, so the surgeon can generally accurately and completely remove the adenoids, and the probability of postoperative recurrence is very small. However, long-term inflammatory stimulation of sinusitis and allergic rhinitis after surgery may cause adenoids to recur. However, if regular treatment is given after surgery, the probability of adenoids hypertrophy recurring will be even smaller. In addition, even if it recurs, as long as the adenoids hyperplasia does not exceed 50%, it generally does not cause symptoms and does not require treatment.

10. Children may develop adenoids hypertrophy at different ages. Why?

Adenoids exist after a child is born, are most prominent when they are 6 to 7 years old, and gradually shrink after they are over 10 years old. The reason why children may have different ages of adenoid hypertrophy is not only because of the different conditions of the children themselves, but also because the families of the children discover and pay attention to it at different times.

11. Is it necessary to intervene once adenoids hypertrophy is confirmed?

Adenoids hypertrophy combined with sleep apnea syndrome (snoring and mouth breathing) are the best surgical indications. In addition, patients with recurrent or chronic secretory otitis media and sinusitis should undergo adenoidectomy as soon as possible. Secretory otitis media and sinusitis in children are closely related to adenoids hypertrophy, and adenoidectomy has become a routine surgery for the treatment of secretory otitis media and chronic sinusitis in children. If accompanied by tonsil hypertrophy, adenoidectomy can be performed at the same time as tonsillectomy.

12. Is the child breathing through his mouth due to a blocked nose caused by rhinitis or due to enlarged adenoids?

Common causes of mouth breathing include allergic rhinitis, adenoids hypertrophy, and tonsil hypertrophy. All three may exist at the same time, or one or two of them may exist.

13.What are the characteristics of adenoid facies? How to identify them?

When children have enlarged adenoids, they may develop abnormal facial features due to nasal congestion and long-term mouth breathing, including elongated maxilla, deformed and arched hard palate, uneven teeth, protruding upper incisors, thick lips, and lack of expression.

14. How does adenoids hypertrophy make children ugly?

Adenoid hypertrophy can cause mouth breathing. Normally, the tongue is located at the top of the mouth, which can offset the pressure from the cheeks. However, in children who breathe through their mouths, the tongue is located at the bottom of the mouth, unable to relieve the pressure on the cheeks. The maxilla is pushed in, the dental arch forms a V shape, the face becomes longer and narrower, buck teeth grow, and the mandible is retracted.

Figure 2 Copyright image, no permission to reprint

15.Does a child have buck teeth due to enlarged adenoids?

There are many factors that cause buck teeth, generally including genetic factors, bad habits during children's menstrual period, enlarged adenoids or tonsils, etc. Among them, mouth breathing caused by enlarged adenoids or tonsils is the main factor.

16. If a child becomes ugly due to enlarged adenoids, and wants to become beautiful and handsome again, is it enough to just remove the adenoids?

No. Adenoids removal can control the continued development of facial features, so the timing of treatment is very important. For children with enlarged adenoids, it is important to seize the critical opportunity of early treatment. Many older children seen in clinical practice have developed severe adenoid facial features and dental deformities due to long-term mouth breathing. At this time, the adenoids may not be large. Even if surgery is performed again, the adenoid facial features that have been formed are irreversible, and a greater cost is required to go to dentistry for orthodontic treatment, and even orthognathic surgery may be required in the future.