Adenoiditis

Adenoiditis is inflammation of the adenoids, the pharyngeal tonsils located in the nasopharynx. It can be acute or chronic and is most common in children; adults are affected less often.

Causes include viral infections, such as those that cause upper respiratory infections, and bacterial infections, with organisms like Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. Adenoid hypertrophy and allergic airway disease can contribute to chronic obstruction and recurrent infections.

Symptoms of acute adenoiditis include fever, nasal congestion, nasal discharge, sore throat, ear pain, and snoring or mouth breathing at night. Chronic adenoiditis presents with persistent nasal obstruction, mouth breathing, nasal discharge, snoring, sleep disturbances, and recurrent ear infections.

Diagnosis is based on history and physical examination. Visualization of enlarged adenoids via oropharyngeal examination or nasopharyngoscopy is common. Imaging such as lateral neck radiographs or CT is reserved for unclear cases or evaluation of complications.

Treatment depends on cause and severity. Acute viral adenoiditis is managed with supportive care and antipyretics; antibiotics may be used if bacterial infection is suspected or symptoms worsen. For chronic obstruction or recurrent infection, intranasal corticosteroids may help symptoms; adenoidectomy is considered when there is frequent infection, persistent obstruction, or sleep-disordered breathing, sometimes with tonsillectomy. Prevention focuses on general measures such as vaccination and avoiding tobacco smoke exposure.

Prognosis is generally good after appropriate treatment, though adenoids can regrow in some children. Complications can include otitis media with effusion, recurrent sinusitis, and sleep apnea.