Publication:

Persistent adenoids and their secondary effects

Background Regression of adenoids is assumed to be a physiological phenomenon at puberty. However, it has been found that it can persist well beyond adolescence into early adulthood, cascading a series of after effects in the upper respiratory tract that can cause considerable morbidity leading to public health problems. This study aimed to explore the clinicopathological features of persistent adenoids and their secondary effects on the upper respiratory tract.

Methods This was a prospective controlled study of 100 eligible patients in the age group of 15-60 years presenting with enlarged adenoids confirmed by nasal endoscopy. Equal number of controls without enlarged adenoids was also taken. Both the groups were evaluated for secondary effects like chronic rhinosinusitis, otitis media with effusion, chronic otitis media and Eustachian tube dysfunction. The relationship between adenoid enlargement in adults and secondary effects was analysed statistically.

Results Seventy-seven patients with persistent adenoids had some or the other secondary effect. Eustachian tube dysfunction was present in 21, otitis media with effusion in 10, chronic otitis media in 29 and chronic rhinosinusitis in 33. In the control group only 46 had secondary effects. The association between the presence of adenoids and secondary effects was statistically significant.

Conclusions Adenoids can persist into early adulthood and majority of them can have secondary effects. Chronic rhinosinusitis was the commonest in this study. Careful evaluation by means of nasal endoscopy is required to identify them. This is crucial for the timely treatment of this condition in order to prevent the associated secondary effects.