Kothekar Amey, Vallur Srujan
Department of ENT, INHS Asvini, Mumbai, India.
Department of ENT, 12 Air Force Hospital, Akash Vihar, Kunraghat, Gorakhpur , 273002 India.
Indian J Otolaryngol Head Neck Surg. 2022 Oct;74(Suppl 2):1067-1072. doi: 10.1007/s12070-020-02142-y. Epub 2020 Sep 11.
Adenoid tissue is considered as first line immunological defence mechanism in childhood. Adenoid hypertrophy in children is a common cause of nasal obstruction. It usually gets atrophied by puberty. Adenoid hypertrophy persisting in adults is a cause of nasal obstruction. A randomized prospective study was conducted on adult patients aged above 20 years of age presenting with bilateral nasal obstruction at a tertiary care hospital, for duration of 20 months from January 2018 to August 2019.The differential diagnosis of adenoid hypertrophy was evaluated and role of endoscopic adenoidectomy was studied. The various associated causes of adenoid hypertrophy in adults showed previous history of adeno-tonsillectomy, allergy, deviated nasal septum and smoking. In all cases endoscopic assisted adenoidectomy was performed. Post adenoidectomy patients were asymptomatic in 21 cases, partial improvement in 6 cases and failure in 3 cases. Enlarged adenoid in adults should be considered in the differential diagnosis of cases suffering from bilateral nasal obstruction, or presenting as a nasopharyngeal mass with aural problems. Endoscopic adenoidectomy is safe and reliable. The nasal endoscope aids in removal of adenoid completely with good haemostasis, without any injury to Eustachian tube.
腺样体组织被认为是儿童时期的第一道免疫防御机制。儿童腺样体肥大是鼻塞的常见原因。它通常在青春期萎缩。成人腺样体肥大持续存在是鼻塞的一个原因。在一家三级护理医院,对2018年1月至2019年8月期间年龄在20岁以上、出现双侧鼻塞的成年患者进行了一项为期20个月的随机前瞻性研究。评估了腺样体肥大的鉴别诊断,并研究了内镜下腺样体切除术的作用。成人腺样体肥大的各种相关原因包括既往腺样体扁桃体切除术史、过敏、鼻中隔偏曲和吸烟。所有病例均行内镜辅助腺样体切除术。腺样体切除术后,21例患者无症状,6例部分改善,3例失败。对于双侧鼻塞或表现为伴有耳部问题的鼻咽部肿块的病例,在鉴别诊断中应考虑成人腺样体肿大。内镜下腺样体切除术安全可靠。鼻内镜有助于完全切除腺样体,止血良好,且不会对咽鼓管造成任何损伤。