Adenoids, also known as pharyngeal tonsils, are a group of lymphatic tissues, similar to the (palatine) tonsils, that attach to the posterior wall of the nasopharynx. If infected during childhood, the adenoids can become enlarged and inflamed, which may cause permanent hypertrophy. Enlarged adenoids can impede breathing and interfere with sinus drainage, making the child susceptible to sinusitis, as well as obstructing the eustachian tube, which can lead to middle ear infections. Children with adenoid hypertrophy or infected adenoids can often have their adenoids surgically removed along with their tonsils. What are the clinical signs of adenoid hypertrophy? Local symptoms In children with a small nasopharyngeal cavity, if the adenoids block the posterior nostril and the pharyngeal orifice of the eustachian tube, they may cause symptoms in the ear, nose, throat, and other areas. (1) Ear symptoms: obstruction of the pharyngeal orifice of the eustachian tube causes secretory otitis media, resulting in hearing loss and tinnitus. (2) Nasal symptoms: It is often complicated by rhinitis and sinusitis, with symptoms such as nasal congestion and runny nose. When speaking with an occlusive nasal sound, snoring sound when sleeping, and sleep apnea in severe cases. (3) Pharynx, larynx and lower respiratory tract symptoms: Adenoid hypertrophy in children can cause blockage of the nose, resulting in backflow of nasal snot to the pharynx and irritation of the mucous membrane of the lower respiratory tract, often causing nighttime bouts of coughing, which can easily lead to bronchitis. (4) Adenoid face: due to the narrow nasopharynx of children, when adenoid hypertrophy, due to nasal congestion affects breathing and mouth open breathing, long-term mouth breathing, airflow impact on the hard palate will make the hard palate deformation, high arch, over time, the development of the face will be deformed, the upper lip short thick cocking, lower jaw sagging, nasolabial fissure disappeared, hard palate high arch, teeth alignment is not neat, upper incisors protrude, poor bite, nasal septum flattening, etc., the nasal septum flattening. The facial muscles are not easy to move and lack of expression, looking like a piggyback or ugly duckling, which is called “adenoid face” in medical science. (1) Malnutrition: The child shows anorexia, vomiting, indigestion, and then malnutrition. (2) Developmental deformities: poor breathing and inadequate lung expansion can lead to thoracic deformities, chicken chest, funnel chest, and even induce pulmonary heart disease. (3) Slow reaction: poor breathing at night can cause long-term oxygen deprivation and endocrine dysfunction in children, resulting in growth disorders. Parents may find that children have poor concentration, mood swings, night terrors, teeth grinding, night sweats, bedwetting and other symptoms. In addition, long-term breathing through the mouth, the nose is not ventilated, easy to cause the head ischemia, hypoxia, mental depression, headache, dizziness, memory loss, slow reaction and other phenomena. (4) Adenoid hypertrophy is one of the most common causes of obstructive sleep apnea hypoventilation syndrome (OSAHS). Excessive snoring and breath-holding during sleep are the two main symptoms. Open-mouth breathing during sleep, excessive sweating, morning headache, daytime sleepiness, and learning difficulties are also common symptoms. It should be noted that snoring caused by adenoid hypertrophy in children is often neglected by parents, but it mostly constitutes the cause of snoring together with tonsillar enlargement, so special attention should be paid to the presence of apnea, and adenoids should be checked in hospital if necessary. Electronic laryngoscope and nasal endoscope can easily examine adenoids, and lateral nasopharyngeal film also has high reference value. (5) Decreased immunity: Since children need a lot of oxygen for development, snoring will make children seriously lack of oxygen during sleep, which will directly lead to insufficient oxygen supply for brain development and reduce secretion of growth-promoting hormone, which will not only affect children’s height, but also decrease body resistance.