A 9 year old boy presented with recurrent otitis media.X ray shows the following features.What can be the most possible diagnosis?
A. Retropharyngeal Abscess
B. Infectious Mononucleosis
C. Adenoid Hypertrophy
D. Tonsillar Papillomatosis
Ans:C. Adenoid Hypertrophy.
Image shows:The adenoids are enlarged and are narrowing the nasopharyngeal airway.
CLINICAL FEATURES OF ADENOID ENLARGEMENT
- Nasal obstruction is the commonest symptom
- Mouth breathing.
- Recurrent URTI,Nasal discharge, sinusitis, epistaxis, voice change-Rhinolalia Clausa.
- ET obstruction: Conductive hearing loss- CSOM, SOMAdenoid facies: elongated face with dull expression, open mouth, prominent and crowded upper teeth, hitched up upper lip, high arched palate
- Adenoid is a common cause of Eustachian Disease
- Pulmonary hypertension and Cor pulmonale
- Aprosexia – lack of concentration.
- Failure to thrive.
ASSESMENT OF ADENOID ENLARGEMENT
- Size of adenoids may well be assessed using lateral radiograph of nasopharynx and Nasal Endoscopy and CT scan is not necessary
- For the treatment of enlarged adenoids when symptoms are not marked breathing excercise, decongenstant nasal drops and antihistaminics are used and when symptoms are marked, adenoidectomy is done.