A significant number of patient inquiries are about ENT disorders in children, and many of them are about adenoid hypertrophy in children. This is related to the fact that there is only one baby in the family nowadays and parents are very careful in observing their children. In fact, adenoidal hypertrophy has always had a certain incidence, but in the past, parents had many children and considered snoring not a serious disease and were ignored. So what is adenoidal hypertrophy all about? Is there any impediment to snoring in children? First of all, let’s get to know what adenoids are. Adenoids are also known as pharyngeal tonsils. Located at the junction of the top of the nasopharynx and the posterior wall, the outer shape resembles half a peeled orange, with an uneven surface and 5-6 longitudinal grooves, with the central groove being the deepest, forming the central crypt. At its lower end, the depression of the embryonic cranio-buccal sac is sometimes visible, which clinically becomes the pharyngeal sac. This area is prone to bacterial retention and is called pharyngeal bursitis when inflammation is present. The longitudinal groove of the pharyngeal tonsils contains a large number of openings for mucus glands, whose mucus has the effect of cleaning the longitudinal groove. There is no fibrous tissue envelope between the pharyngeal tonsils and the pharyngeal wall, so it is not easy to perform complete pharyngeal tonsillectomy. The pharyngeal tonsils are developed since birth and are largest at the age of 6-7 years, and gradually shrink after the age of 10 years. They disappear completely or have only a few remnants when they reach adulthood. If the adenoids are hyperplastic and cause symptoms, it is called adenoid hypertrophy, which is a pathological phenomenon. Often, children with adenoid hypertrophy are prone to secretory otitis media. This is because the enlarged adenoids cause blockage of the pharyngeal opening of the eustachian tube. The cause of adenoid hypertrophy is mainly inflammation of the nasopharynx and its adjoining areas or repeated stimulation of the adenoids by the inflammation of the adenoids themselves, resulting in pathological hyperplasia of the adenoids. The common ones are recurrent attacks of acute and chronic nasopharyngitis, and various acute infectious diseases in childhood. Inflammation of the nose and sinuses can also involve the adenoids through their mucous membranes; conversely, adenoid hypertrophy can block the posterior nostrils and aggravate the inflammation of the nose and sinuses. Children over 5 years of age with adenoid hypertrophy are often combined with chronic tonsillitis, which can lead to secretory otitis media and hearing loss. What are the common symptoms of adenoid hypertrophy in children? In general, the symptoms are diverse, but respiratory symptoms are the main ones. Local symptoms 1. Ear symptoms Adenoid hypertrophy or lymphoid hyperplasia at the mouth of the eustachian tube can block the pharyngeal orifice of the eustachian tube, causing secretory otitis media on that side. Conductive deafness and tinnitus may appear. Sometimes it can lead to purulent otitis media. Ear symptoms can sometimes be the first symptoms of adenoid hypertrophy. 2, nasal symptoms Hypertrophic adenoids and mucopurulent secretions can block the posterior nostril, secretions can also accumulate in the nasal cavity, not easy to blow, often combined with rhinitis and sinusitis and symptoms of nasal congestion and runny nose. There may be open-mouth breathing, speech occlusive nasal sound and sleep snoring and other symptoms. Adenoid hypertrophy is one of the most common causes of obstructive sleep apnea hypoventilation syndrome in children. Long-term nasal congestion and open-mouth breathing can cause facial bone development disorders, such as long maxilla, high arch of hard palate, protruding upper incisors, uneven dental alignment leading to malocclusion, sagging jaw, thick lips, upturned upper lip, hanging lower lip, and mostly accompanied by deviated nasal septum, coupled with mental depression, dull facial expression, the so-called adenoid face. 3, throat and lower respiratory tract symptoms: secretions flow down and stimulate the respiratory tract mucosa, may appear paroxysmal cough, easy to complicate bronchitis, may have low fever. The lymph nodes in the jaw angle may be enlarged. Systemic symptoms are mainly chronic toxicity and reflex neurological symptoms. Nasopharyngeal secretions are often swallowed by the affected children into the stomach, causing gastrointestinal activity disorders, resulting in anorexia, vomiting, indigestion, and then malnutrition. Symptoms such as night terrors, excessive dreaming, enuresis, teeth grinding, unresponsiveness, inattention and irritability may also occur. Sometimes dull head pain is felt. It can be seen that long-term sleep snoring still has an effect on the affected children. However, it is not necessarily necessary to operate for sleep snoring. We should still consult the ENT department and decide whether to operate after necessary examination and careful evaluation. For children who are cooperative, outpatient fiberoptic rhinolaryngoscopy can determine the degree of adenoid hypertrophy. If the child does not cooperate, X-ray lateral nasopharyngeal radiographs should be performed to determine the degree of posterior nostril obstruction. Then, we will combine the clinical symptoms, the size of snoring, the relationship between snoring and body position, the developmental characteristics of facial shape, the size of tonsils and the presence of apnea to decide whether to operate. The specific indications for surgery are 1.Adenoid hypertrophy causing open mouth breathing, snoring or occlusive nasal sound. 2. Adenoid hypertrophy obstructs the pharyngeal orifice of the eustachian tube and causes hearing loss due to secretory otitis media; or causes recurrent purulent otitis media, which cannot be cured for a long time. 3.Adenoid face has been formed, and there are wasting and developmental disorders. 4.Adenoid hypertrophy with recurrent inflammation of the nasal cavity and sinuses, or frequent upper respiratory tract infections. Adenoidectomy surgery has progressed rapidly in recent years, and has developed from the original empirical scraping to the nasal endoscopic removal with a clear-vision electric cutter, and from the original somewhat “cruel” local anesthesia surgery to humane general anesthesia surgery, which can control the depth range of excision and avoid damage to the surrounding normal structures, making the complications of surgery almost The surgical complications are close to zero. This method provides good visualization, intuition, complete resection, reliable hemostasis, and less recurrence. Alternatively, low-temperature plasma radiofrequency can be used for adenoid ablation, which has the advantages of safety, no or little bleeding, easy operation, good efficacy, and fast recovery. However, the cost is higher. Because the disposable plasma tip is about 3000 yuan. Our hospital has been carrying out these two new technologies for one year and the results are very satisfactory. Patients can choose either of these surgical procedures according to their condition. The success of the surgery is ensured. It is also important to note that for children with concurrent tonsillar hypertrophy it is often necessary to remove both tonsils at the same time to receive better results.