Therapeutic Approaches in Chronic Adenoiditis

Abstract

Adenoid tissue diseases (acute adenoiditis, adenoid hypertrophy, and chronic adenoiditis) typically occur in childhood. Adenoid hypertrophy seems to be related to many factors, such as infections, passive smoking, and low vitamin D levels, while the role of allergy still remains controversial. Chronic adenoiditis incidence has increased in recent years, as a result of higher rates of upper airway infections and biofilm formation, with multiple potential clinical complications. Diagnosis is typically clinical, with physical examination and nasal endoscopy. The treatment can be medical or surgical. Non-surgical treatment of chronic adenoiditis with intranasal steroids and leukotriene inhibitors has proven to be effective, reducing the size of the adenoid tissue and symptoms. On the other hand, adenoidectomy is one of the commonest ENT surgical procedures with excellent outcomes and rare adverse events. Curettage adenoidectomy is widely used by many ENT surgeon, but presents risk of residual adenoidal tissue, especially in peritubaric and superior nasopharynx regions. In the last years, different surgical techniques have been proposed to reduce surgical risk and morbidity, such as electrocautery adenoidectomy, microdebrider adenoidectomy, and coblation adenoidectomy. Intranasal or transoral endoscopes enabled a great control of surgical field and a complete removal of adenoid tissue.