Some children snore when they sleep, and parents don’t care at first, thinking they are sleeping well. But after a while, it was discovered that the child was sometimes actually woken up, and his personality had changed, and even his appearance had gradually changed. When I went to the hospital for a checkup, the doctor said that this was due to adenoid hypertrophy and that it had to be removed surgically. Today, we will introduce you to adenoids and their related scientific knowledge. What are adenoids? Adenoids, also called pharyngeal tonsils and proliferators, are lymphoid structures similar to the tonsils, which are attached at the base of the nasopharynx at the junction of the parietal and posterior walls (red position in the picture above), between the two sides of the pharyngeal fossa. It looks a little like a peeled orange. The dangers of adenoid hypertrophy Adenoid hypertrophy in children is more common in clinical practice and has attracted more and more attention from parents and doctors. The adenoids are generally largest at the age of 6 or 7, and gradually degenerate and shrink at the age of 10 or so. The adenoids are often enlarged and enlarged by repeated colds, and then they do not shrink when the cold gets better. Because of the location of the adenoids, their enlargement can cause a series of nasal, pharyngeal and ear symptoms. Adenoid hypertrophy or concomitant tonsillar hypertrophy in children can cause obstructive sleep apnea hypoventilation syndrome. The symptoms of this disorder are sleep snoring with breath-holding (i.e., apnea) and open-mouth breathing. The incidence of obstructive sleep apnea syndrome in children is about 0.7%-3% average 2%, mainly occurs in 2-6 years old, apnea, hypoxia will affect the growth and development of children to varying degrees, such as causing abnormalities in respiration, development, neurocognition, etc., and even cause sudden death in children in serious cases. Long-term breathing through the mouth, under the impact of airflow, the hard palate is high arched, which will make the facial development deformed, appearing short and thick upper lip cocking, lower jaw sagging, nasolabial groove disappeared, upper incisors protruding, poor bite, etc.. Due to the restricted movement of facial muscles, the child’s face lacks expression, which is called “adenoid face” in medical science. The enlarged adenoids and tonsils can obstruct upper airway breathing, making children prone to recurrent upper respiratory tract infections, rhinitis and sinusitis, resulting in further enlargement of the tonsils and adenoids, forming a vicious circle that is not easily relieved. Adenoid hypertrophy in children also causes inflammation of the nasal cavity and sinuses that cannot be easily drained, compression or obstruction of the eustachian tube (the passage between the middle ear cavity and the nasal cavity) inflammation of the adenoids themselves, and poor elasticity of the eustachian tube cartilage in children, all of which can cause exudative otitis media. According to clinical statistics, the incidence of exudative otitis media among children hospitalized with obstructive sleep apnea hypoventilation syndrome is 74.3%. Therefore, children with obstructive sleep apnea hypoventilation syndrome should be more alert to oozing otitis media. So how to diagnose adenoid hypertrophy? 1. Finger palpation. The oldest method of palpation, the doctor has to put his finger into the child’s mouth. It has long been discontinued by doctors because it is often bitten by the child and there is no picture record to quantify it. 2.Lateral nasopharyngeal film 3.CT examination 4.Nasopharyngoscopy: this examination is the most visual examination, there is no radiation damage, and is dynamic observation under the breathing movement of the child, so it is the first clinical choice. The nasopharyngoscope is inserted through the nostrils of the child, which is not particularly painful but may cause fear and crying in children during the examination, so it is recommended for children who can cooperate. What kind of children should undergo adenoidectomy? The indications for adenoidectomy are 1) frequent snoring, breath-holding, and poor breathing; 2) frequent colds with rhinitis and sinusitis; 3) secretory otitis media with adenoids pressing on the eustachian tube, or inflammation of the adenoids themselves, and otitis media not easily healed. Some parents have to ask, is it necessary to remove all adenoids? How many methods of surgery are there? Can surgery solve the snoring symptoms? If adenoidal hypertrophy snoring affects breathing or causes some complications, it should be removed. There are three methods to remove adenoids: 1:scraping method, 2:power system cutting method, and 3:plasma ablation method. The best of these three methods is the plasma ablation method. If it is the symptoms caused by adenoid hypertrophy, then the snoring problem can be solved after removal.