How is adenoid hypertrophy in children treated?

  Sleep snoring is a problem for adults and for babies. When apnea occurs during snoring, it is called sleep apnea syndrome. In adults, this syndrome occurs mostly due to obstruction or collapse of the upper airway. People with nasal polyps, low hanging soft palate, thickening or growth of the uvula, enlarged and hypertrophied tonsils, and soft tissue hypertrophy and fatty deposits in the throat are at high risk for sleep apnea syndrome.  The pathogenesis of sleep apnea syndrome in babies is different from that of adults. Dr. Qi Zhong from the Department of Otolaryngology of Beijing Tongren Hospital said that snoring in children is mostly caused by adenoid hypertrophy, and some of them have enlarged tonsils in combination. Adenoids are lymphatic tissue in the nasopharynx, also known as nasopharyngeal tonsils. It proliferates with age and reaches its maximum level at the age of 6, and then gradually degenerates. However, if children repeatedly suffer from upper respiratory tract infections, due to the repeated stimulation of inflammation, the adenoids will become hypertrophic and increase nasal obstruction, affecting the drainage of the posterior nostril, and nasal secretions will stimulate the adenoids to continue to proliferate, forming a vicious circle of mutual cause and effect, causing nasal congestion, snoring, and secretory otitis media.  The main manifestation of adenoid hypertrophy is snoring during sleep, which can be accompanied by apnea and stifling awakening in severe cases. Severe adenoid hypertrophy has a great impact on the growth and development of children. Due to the frequent occurrence of apnea and stifled awakening, the sleep structure is disturbed and the affected children cannot enter deep sleep. During deep sleep is the peak period of growth hormone secretion, and disrupted sleep structure will reduce the secretion of growth hormone, leading to growth retardation in children. Apnea can cause transient hypoxia, which, if prolonged, can affect the child’s neurological development. Long-term increased airway resistance can cause high arching of the hard palate, resulting in a series of craniofacial developmental abnormalities such as deviated nasal septum, short and thick upper lip, and uneven tooth alignment, medically known as adenoid facies. Once the adenoid face appears, it is very difficult to recover even after treatment.  Zhong Qi said that parents should actively treat children who snore with apnea. In addition to systemic anti-inflammatory and symptomatic treatment, ephedrine can be given locally to reduce nasal congestion and improve drainage, but it is best to use ephedrine continuously for no more than one week. Zhong Qi emphasized that for children diagnosed with combined acute otitis media, ear spotting is a symptomatic treatment, but the root of the problem lies in the treatment of nasal disease. Those with solid adenoid hypertrophy exceeding 2/3 of the nasopharyngeal cavity should be treated surgically. At present, surgery is mostly performed by minimally invasive nasal endoscopic adenoidectomy, and the trauma can be basically healed by eating sterilized cold liquid food on the same day after surgery and non-heated light and soft food within a week.