Obstructive Adenoid Hypertrophy Research Articles

The interrelation between otorhinolaryngology and orthodontics in solving malocclusion and facial dysmorphisms caused by chronic adenotonsillitis

Abstract OBJECTIVES. The aim of this study was to reevaluate the implication of early diagnosis of chronic adenoid syndrome and tonsillar hypertrophy in the prophylaxis and control of facial and dental deformities in children. MATERIAL AND METHODS. The authors conducted a prospective study on 42 paediatric patients with chronic adenoid syndrome admitted in the ENT and Orthodontic Departments of “Sf. Spiridon” Emergency Hospital and “Sf. Maria” ENT Paediatric Department, Iasi, treated in collaboration with orthodontic and logopaedic specialists, with follow-up on the improvement of symptomatology and morphofunctional deficiencies. RESULTS. Late diagnosis and treatment of the obstructive adenoid hypertrophy can cause difficulty in managing cases, consequently maintaining the aesthetic deficiencies and morphofunctional disorders within a follow-up period of 2 years. Furthermore, we present the chronic complications due to obstructive adenoid hypertrophy (rhinosinusal and ear-related diseases, obstructive sleep apnea), as well as the progression of these cases after interdisciplinary approach. CONCLUSION. Chronic adenoiditis and tonsillar hypertrophy can increase the incidence of malocclusion in children, as well as causing changes in length and shape of the upper jaw and mandible, resulting in maxillofacial deformities.

Evaluation of the surface and the core cultures of adenoids in patients with recurrent adenotonsillitis, obstructive adenoid hypertrophy, and otitis media with effusion

Objective: To determine and to compare the core and the surface bacteriologies of the adenoids of the pediatric patients with obstructive adenoid hypertrophy, recurrent adenotonsillitis, and otitis media with effusion and to evaluate antibiotic susceptibility test patterns of the potential pathogen bacteria. Material and methods: This prospective study was performed on 230 pediatric patients operated for either OAH, RAT, and OME during the time period from April 2014 to July 2017 in the Otorhinolaryngology Clinic of Adıyaman University Education and Research Hospital. Results: The potential pathogen bacteria isolated from the adenoids' surfaces and cores of obstructive adenoid hypertrophy, recurrent adenotonsillitis, and otitis media with effusion groups were as follows: 33/148 (22.3%)-17/148 (11.5%), 9/61 (14.8%)-5/61 (8.2%), and 6/21 (28.6%)-3/21 (14.3%) (p>0.05). Conclusion: There was not statistical difference between the adenoids' surface and core cultures of obstructive adenoid hypertrophy, recurrent adenotonsillitis, and otitis media with effusion.

The Prevalence of Adenoid Hypertrophy among Children with Zika Related Microcephaly.

Upper respiratory obstruction is a common sequela in children with Zika-related microcephaly (ZRM). As a cross-sectional analysis nested in a cohort study, this study aims to investigate the prevalence of adenoid hypertrophy (AH) in children with ZRM and symptoms of respiratory obstruction. The data were collected in the first three years of life from children with ZRM who were followed in two reference centers for otorhinolaryngological care of patients with congenital Zika syndrome. Out of 92 children with confirmed ZRM, 57 were evaluated by nasopharyngoscopy after presenting with upper respiratory obstruction symptoms. In this study, 31 of the 57 (54%) children with ZRM who were evaluated had obstructive AH. Thirteen children with obstructive AH were submitted to surgery, which resulted in the complete resolution of symptoms for 11, partial resolution in 1, and no improvement in 1. No evidence of direct involvement by Zika virus (ZIKV) infection in the adenoid tissues was demonstrated by histology or immunohistochemistry. Our results suggest that there is a high prevalence and early presentation of AH in children with ZRM, with consequent upper airway obstruction causing upper airway obstructive disorder, secretory otitis media, and dysphagia.

Comparison of Flexible Nasopharyngoscopy with Plain Radiograph in the Assessment of Children with Adenoid Hypertrophy.

Background:Obstructive adenoid hypertrophy is one of the commonest disorder seen in paediatric otorhinolaryngology clinics. It has a wide range of complications that can lead to cardiopulmonary and developmental problems; hence, early diagnosis and treatment are paramount in preventing the complications. Several modalities for the assessment of adenoid hypertrophy have been described in the literature, of which plain radiograph and flexible nasopharyngoscopy are the most popular. In this study, traditional method of evaluating adenoid hypertrophy (plain radiograph) has been compared with newer flexible nasopharyngoscopy.Materials and Methods:This is a cross-sectional study of randomly selected children with clinical diagnosis of obstructive adenoid disease. All eligible participants underwent clinical examinations, flexible nasopharyngoscopy and postnasal space X-ray. The findings were compared using the chi-square test and Pearson’s correlation test.Results:The age of the participants ranged between 2 and 10 years with mean of 4.5 ± 2.5 years. There were 79 (56.4%) males and 61 (43.6%) females. The adenoid hypertrophy observed using flexible nasopharyngoscopy among the participants ranged between 20 and 90% with mean of 67.4 ± 15.4%. The adenoid enlargement measured using adenoidal–nasopharyngeal ratio on plain radiograph ranged between 0.40 and 0.96 with mean of 0.7 ± 0.09. The Pearson’s correlation test revealed strong correlation between flexible nasopharyngoscopy and plain radiograph (r = 0.858, P = .000), and there was statistically significant association between the two methods (χ2 = 148.8, P = .000).Conclusion:There was a strong correlation between flexible nasopharyngoscopy and plain radiograph of the postnasal space in the assessment of obstructive adenoid disease in children.

Fractalkine (CX3CL1) and its receptor (CX3CR1) in children with hypertrophic adenoid and chronic otitis media with effusion

Abstract Background Adenoid hypertrophy (AH) is one of the possible causes of chronic inflammation in the middle ear. It has been suggested that CX3CL1 and its specific receptor (CX3CR1) could be related with the pathogenesis of some inflammatory diseases. The aim of the present study was to evaluate the role of CX3CL1 and CX3CR1 in the pathogenesis of AH with chronic otitis media with effusion (COME) in children. Materials and methods Adenoid tissue samples were obtained from 91 pediatric patients and divided into two groups: adenoidectomy only for AH (n: 47) and adenoidectomy in conjunction with ventilation tube insertion for AH + COME (n: 44). Expression levels of CX3CL1 and CX3CR1 genes were compared. Results Expression levels of CX3CL1 and CX3CR1 in hypertrophic adenoid tissue were not significantly different between the AH + COME and AH only groups. Although no significant difference was detected in the expression of CX3CL1 in the adenoid samples, the expression of CX3CR1 was higher in children older than 48 months. Conclusions When allergy, atopy and chronic adenoiditis does not exist to obstructive adenoid hypertrophy, inflammatory fractalkine chemokine expression levels in adenoid tissue was not observed to be increased in children with COME.

Comparison of dental arch measurements according to the grade and the obstructive character of adenoids

Obstructive adenoid hypertrophy is cited as one of the causes of mouth breathing and leads to disharmony in the development of orofacial structures. The objective of this study was to compare the measurements of dental arches according to the grade and the obstructive character of adenoids. A cross-sectional study was carried out with 86 children. The grade and the obstructive character of adenoids were determined from Holmberg and Cohen's radiographic methods respectively. Dental arch measurements were taken on dental casts. A t-test and a Chi2 test were performed respectively to compare the quantitative and qualitative variables of dental arches according to the obstructive character. An Anova test made it possible to compare the quantitative variables according to the grade as Holmberg defined it. For variables that showed significant differences, a Post Hoc test was used. The significance level was set at P=0.05. Subjects with obstructive adenoids had a shorter posterior mandibular length (P=0.04) and a greater overbite (P=0.04) than those with non-obstructive adenoids. Those with grade 4 had a greater arch depth (P=0.02) and were more prone to open bite(P=0.03). A prevention program involving the otorhinolaryngologist and the orthodontist for subjects with obstructive adenoids or grade 4 is necessary to minimize their influence on dental arch relationships.

The prevalence and impact of otitis media with effusion in children admitted for adeno-tonsillectomy at Dr George Mukhari Academic Hospital, Pretoria, South Africa

IntroductionOtitis media with effusion (OME) is a leading cause of acquired hearing loss in children worldwide. However, previous South African studies have consistently reported the local paediatric OME prevalence to be lower than typically published in international literature. Furthermore, no South African studies have investigated OME in children with adenotonsillar hypertrophy. The objective of this study was to determine the prevalence of OME in children admitted for adeno-tonsillectomy at our institution in Pretoria, South Africa. In addition, the study sought to gauge the impact of OME on quality of life using a validated questionnaire (OM-6). MethodsA cross-sectional, observational study was conducted between July 2015 and May 2016 at the Otorhinolaryngology outpatient department at DGMAH. he study included 109 consecutively sampled children, aged 2–12 years (mean 6.1; 49.7% female). Pneumatic otoscopy and tympanometry were performed on all participants. Adenoid hypertrophy was quantified using he adenoid-nasopharyngeal ratio (ANR) on a lateral post-nasal space radiograph (Fujioka's method). The OM-6 questionnaire was completed for each participant. Pure tone audiometry was performed for participants diagnosed with OME. ResultsThe prevalence of bilateral OME was 11.9%. For unilateral OME, the prevalence was 22.9% and 16.5%, for the left and right ears, respectively (p > 0.05). The mean hearing loss (SD) was 19.8 dB (9.4). Clinically significant adenoid hypertrophy (ANR ≥ 0.71) was present in 43% of participants. There was no statistically significant (p > 0.05) correlation between the presence OME and adenoid hypertrophy. The mean total OM-6 survey score was 1.67 (SD ± 0.59) in children with OME, and 1.31 (SD ± 0.45) without OME, showing no statistically significant difference (p > 0.05). There was a significant (P < 0.05) correlation between OME and the presence of atopy. ConclusionAdeno-tonsillar pathology may play an aetio-pathological role in the development of OME. However, this may be due to the presence of biofilms rather than obstructive adenoid hypertrophy, given the lack of a significant (p > 0.05) correlation between adenoid hypertrophy and OME. Whilst OME was not found to impair quality of life in this population group, the validity of the OM-6 in the South African paediatric population requires further investigation.

COMPLICAÇÕES DA SÍNDROME FALCIFORME

O presente artigo de revisão integrativa aborda e ressalta as principais complicações da anemia falciforme da criança ao adulto. A Síndrome Falciforme é uma importante hemoglobinopatia genética, um tipo de patologia peculiar pela produção de eritrócitos com deformidades falcêmicas, que ocasiona complicações como litíase biliar, crise álgica, crise do sequestro esplênico, acidente vascular cerebral isquêmico, alterações oculares, alterações retinianas. Objetivo: Destacar as principais complicações da anemia falciforme na criança, no adolescente e adultos auxiliando os profissionais de saúde na assistência ao paciente que apresenta essa patologia. Metodologia do estudo: Com a utilização do meio de informação acadêmico via internet de artigos encontrados na (BVS) Biblioteca Virtual em Saúde, foram utilizados os seguintes descritores: Anemia falciforme AND complicações, Doença Falciforme, Anemia Falciforme e Complicações. Pesquisados 7.544 artigos relacionados às complicações da anemia falciforme, na qual 11 são abordados no presente trabalho, com a utilização bibliográfica do Manual de Hematologia, autor Hamerschlak, Nelson e no Manejo das complicações agudas da doença falciforme conforme Brunetta et al. Resultados: As complicações que predominaram em crianças no presente estudo foi a hipertrofia adenotonsilar obstrutiva acometendo mais de 55% e em adolescentes e adultos foram as alterações oculares com mais de 73% dos clientes. Conclusão: Embora a patologia falciforme seja pouco discutida e de grande prevalência no Brasil devido a miscigenação racial, o presente estudo ressalta as principais complicações causadas pela mesma, tendo as crianças que apresentam uma prevalência de hipertrofia adenotonsilar obstrutiva acima de 55% mostrado no seguinte estudo, na qual o profissional de saúde deve estar atento a sintomatologia para que haja o tratamento adequado e as informações fornecidas aos pais ou responsáveis sejam adequadas para cada cliente. O adulto portador da anemia falciforme tem como principal complicação alterações oculares 73%, na qual o cuidador deve ter atenção a essas ocorrências.

Adenoidectomy: comparison between the conventional curettage technique and the coblation technique in pediatric patients

Abstract The aim of this study was to compare the advantages and disadvantages of the coblation technique with the standard conventional curettage technique in the operation of adenoidectomy in pediatric patients. This was a prospective randomized clinical study. From January 2010 to December 2014, 200 patients presented with obstructive adenoid hypertrophy. Their ages ranged between 3 and 10 years. The patients were classified randomly into two equal groups: group A was subjected to conventional curettage adenoidectomy and group B was subjected to coblation-assisted adenoidectomy. Operative time and intraoperative blood loss were recorded. Patients were scheduled for follow-up on the first day and first and second postoperative weeks. They were asked to record their pain and discomfort on a standardized Wong–Baker faces pain rating scale from 0 (no pain) to 10 (severe pain). Postoperative complications and/or recurrences were also recorded. Follow-up was for at least 1 year, with re-examination of the nasopharynx by means of endoscopy and/or lateral nasopharyngeal radiography. The conventional curettage adenoidectomy group recorded significantly less operative time and the coblation-assisted adenoidectomy group recorded significantly less intraoperative blood loss and also lower incidences of postoperative bleeding and adenoid recurrence. Both groups demonstrated insignificant difference as regards postoperative pain. The use of the coblation technology in adenoidectomy gave more advantage to the procedure with regard to less intraoperative blood loss and lower incidences of postoperative bleeding and recurrence rate.

Is it safe to perform adenotonsillectomy in children with Down syndrome?

This retrospective review aims to evaluate the postoperative morbidity and mortality of 30 patients with Down syndrome who underwent adenotonsillectomy between June 2012 and December 2015 in a tertiary referral center. Mean age was 7.8 with a range of 3-12. There were 20 (66.6%) male and ten (33.3%) female patients. Mean follow-up was 23months with a range of 7-43months. 23 (76.6%) of 30 patients had been operated due to obstructive tonsillar and adenoid hypertrophy, whereas seven (23.3%) of them operated for chronic recurrent infections. All of the patients had undergone adenotonsillectomy operation; one patient had also bilateral tympanostomy tube insertion. Hospital stay was noted 1.3days in average with a range of 1-3days. Anesthetic complications of persistent bradycardia and postextubation respiratory difficulty occurred in two (6.6) patients. Patient who had intraoperative bradycardia necessitated intensive care unit stay and pacemaker implantation during follow-up. 3 (10%) patients had late onset hemorrhage between days 7 and 10 and required intraoperative bleeding control. We did not experience any other morbidity and mortality except the abovementioned ones. In conclusion, adenotonsillectomy in patients with Down syndrome is a worthwhile operation with certain risks and these operations should better be performed by the tertiary referral centers which have the capacity to deal with the complications.

Does the type of rhinitis influence development of otitis media with effusion in children?

Otitis media with effusion (OME) is characterized by the presence of fluid in the middle ear cavity behind an intact eardrum and is considered a multifactorial condition with Eustachian tube dysfunction as the underlying pathophysiologic condition. One of the most debated causes of OME is allergy, in particular allergic rhinitis. The aim of this paper is to review the role of rhinitis in the development of OME and in particular the role of both allergic (AR) and non-allergic rhinitis (NAR). Most of the recent literature confirms the role of AR in the development of OME, while there are few reports on the role of NAR. In non-allergic children affected by obstructive adenoid hypertrophy, the presence of mast cells in the nasal smear was associated with a high risk of developing a chronic OME.

Relation of mean platelet volume with obstructive adenoid hypertrophy in children

ObjectiveAdenoid hypertrophy (AH) is a common etiology of chronic upper airway obstruction. Upper respiratory tract obstruction may cause chronic alveolar hypoventilation and pulmonary vasoconstriction. In one previous study in patients with obstructive sleep apnea (OSA), it has been claimed that mean platelet volume (MPV), an indicator of platelet activation is increased and that MPV has an important role in the pathophysiology of cardiovascular diseases. We investigated in our study if MPV can be used as an indicator of obstruction due to adenoid hypertrophy. MethodsOur study includes 61 children that underwent adenoidectomy with a mean age of 7.12 (±2.373). White blood cell, platelet count, MPV, platelet crit and platelet distribution width levels were measured before and 3 months after adenoidectomy. Children’s symptoms for upper airway obstruction (UAO) (presence of snoring, mouth breathing or difficulty in breathing during sleep, obstructive breathing or apnea during sleep) were questioned in the preoperative and postoperative period by a standardized questionnaire. ResultsThere was no significant difference between preoperative and postoperative mean values of MPV, hemoglobin, platelet count (p>0.05). White blood cell levels were significantly higher in the preoperative period values compared with postoperative period values (p<0.05). Preoperative UAO scores were significantly higher than the postoperative UAO scores. After stratification of the degree of obstruction (as mild, moderate and severe) there was no significant difference in between groups in terms of MPV values. ConclusionThere was no significant relation between MPV levels and obstructive adenoid hypertrophy.

Lingual choristoma with gastric and respiratory epithelium in a neonate-prenatal MRI of lingual cyst

The aim of the present study was to evaluate the role of the different forms of chronic rhinitis in the pathogenesis of otitis media with effusion in children affected by obstructive adenoid hypertrophy.81 patients, aged between 4 and 15 years (mean age of 6.9 years), affected by obstructive adenoid hypertrophy were evaluated. All patients underwent accurate history taking, physical examination with endoscopy of the nasopharynx, skin prick test, nasal cytology and hearing evaluation.Nasal citology showed that 21% of patients had a non-allergic rhinitis (NAR) subtype, 17.4% NAR overlapping with infectious rhinitis (IR), 29.6% IR, 4.9% allergic rhinitis (AR), 2.5% AR overlapping with IR and the remaining 24.6% a negative cytology. The presence of OME was positively correlated with neutrophils (p = 0.01) and mast cells (p = 0.022), while it was negatively correlated with the presence of eosinophils (p = 0.02) and bacteria (p = 0.02).A chronic rhinitis was present in more than 70% of children with AH and 60% of them showed OME. Nasal cytology together with SPT showed that AR was rarely present in this group of children, while the mast-cells and neutrophils positively correlated with OME.

Lipoma in unusual head and neck region: Case series of 4 patients

The aim of the present study was to evaluate the role of the different forms of chronic rhinitis in the pathogenesis of otitis media with effusion in children affected by obstructive adenoid hypertrophy.81 patients, aged between 4 and 15 years (mean age of 6.9 years), affected by obstructive adenoid hypertrophy were evaluated. All patients underwent accurate history taking, physical examination with endoscopy of the nasopharynx, skin prick test, nasal cytology and hearing evaluation.Nasal citology showed that 21% of patients had a non-allergic rhinitis (NAR) subtype, 17.4% NAR overlapping with infectious rhinitis (IR), 29.6% IR, 4.9% allergic rhinitis (AR), 2.5% AR overlapping with IR and the remaining 24.6% a negative cytology. The presence of OME was positively correlated with neutrophils (p = 0.01) and mast cells (p = 0.022), while it was negatively correlated with the presence of eosinophils (p = 0.02) and bacteria (p = 0.02).A chronic rhinitis was present in more than 70% of children with AH and 60% of them showed OME. Nasal cytology together with SPT showed that AR was rarely present in this group of children, while the mast-cells and neutrophils positively correlated with OME.

A study of the role of different forms of chronic rhinitis in the development of otitis media with effusion in children affected by adenoid hypertrophy

ObjectiveThe aim of the present study was to evaluate the role of the different forms of chronic rhinitis in the pathogenesis of otitis media with effusion in children affected by obstructive adenoid hypertrophy. Methods81 patients, aged between 4 and 15 years (mean age of 6.9 years), affected by obstructive adenoid hypertrophy were evaluated. All patients underwent accurate history taking, physical examination with endoscopy of the nasopharynx, skin prick test, nasal cytology and hearing evaluation. ResultsNasal citology showed that 21% of patients had a non-allergic rhinitis (NAR) subtype, 17.4% NAR overlapping with infectious rhinitis (IR), 29.6% IR, 4.9% allergic rhinitis (AR), 2.5% AR overlapping with IR and the remaining 24.6% a negative cytology. The presence of OME was positively correlated with neutrophils (p=0.01) and mast cells (p=0.022), while it was negatively correlated with the presence of eosinophils (p=0.02) and bacteria (p=0.02). ConclusionsA chronic rhinitis was present in more than 70% of children with AH and 60% of them showed OME. Nasal cytology together with SPT showed that AR was rarely present in this group of children, while the mast-cells and neutrophils positively correlated with OME.

Malondialdehyde level and adenosine deaminase activity in adenoid tissue of patients with OME and obstructive adenoid hypertrophy

ObjectiveThe aim of our study was to determine and compare adenosine deaminase (ADA) activity and malondialdehyde (MDA) level in adenoid tissue of patients with or without otitis media with effusion (OME). MethodsThe study included 30 patients undergoing adenoidectomy due to obstructive adenoid hypertrophy (OAH) or OME. Tissue MDA level was measured by the method of Okawa with modification and tissue ADA activity by the method of Giusti. We measured, superoxide dismutase (SOD) and catalase (CAT) activities as well. ResultsIn patients with OAH, mean tissue MDA level and ADA activity were 4.13±0.90nmol/mg Pr and 0.39±0.04U/mg Pr, respectively, which were significantly higher than those of OME group (1.43±0.41nmol/mg Protein and 0.22±0.04U/mg Pr, respectively) (P<0.05). SOD and CAT activities were found to be increased in patients with OAH when compared to the OME group but they did not reach statistically significant level (P=0.06 and 0.05 respectively). ConclusionsThe present study showed the presence of measurable ADA activity in adenoid tissue, and also significant increases in both tissue MDA level and ADA activity in OAH tissue when compared to adenoid tissue of the patient with OME. However, the significance of changes in MDA and ADA activation in the pathogenesis of OAH requires further study.

Radiosurgical correlation of obstructive adenoids in children

The aim of this prospective work was to study the radiological and surgical correlation of adenoid size in children symptomatic with obstructive adenoid hypertrophy, and carried out at Tertiary care referral teaching hospital. Data of 25 randomly selected patients were used for analysis. Post nasal space images (lateral soft tissue neck X-ray) were analyzed using Fujioka's method. Surgical findings based on endoscopic picture of choanal view using 0-2.7mm endoscope were analyzed. The comparison between the two results was subjected for statistical analysis. A total of 25 cases were included in the study. The mean age was 7±0.45years. The findings showed good correlation between adenoid sizes on X-ray films compared to the size seen intraoperatively using the methods mentioned above. The current study showed positive correlation between adenoid size on lateral view X-ray films and surgical findings. X-rays can be used as a helpful diagnostic tool when post nasal endoscopy is not available or not possible.

Obstructive Adenoid Hypertrophy in the Adult: A Case Report

Case definition: Adenoidal enlargement is a common paediatric problem. The adenoid vegetation most usually involutes between the ages of 10-12 years, and rarely persists into adult life. Objective: To highlight the significance of adenoid vegetation as a differential diagnosis of nasal obstruction in adults. Case Report: This paper presents a case of persistent symptomatic obstructive adenoid vegetation in a 23 year old Nigerian adult female student. Conclusion: Although adenoidal tissue normally undergoes involution during late childhood period, it may persist into adult life and present as a cause of nasal obstruction.Keywords: Obstructive adenoid vegetation, Symptomatic, Adult.

Do Children with Adenotonsillar Hypertrophy have Lower IGF-1 and Ghrelin Levels than the Normal Children?

This study was designed to determine serum insulin-like growth factor-1 (IGF-1) and plasma ghrelin levels in male children with adenoid and tonsillar hypertrophy and compare them with healthy controls. This study included 29 male prepubertal children between the ages of 6.5 and 10 years (mean age 8.8 +/- 2.5 years) with obstructive adenoid and tonsillar hypertrophy and 20 normal male controls between the ages of 5.7 and 10.8 years (mean age 8.2 +/- 2.9 years). Plasma ghrelin and serum IGF-1 levels were measured at 8.30, in the morning. Children with adenoid and tonsillar hypertrophy had significantly depressed serum IGF-1 levels (203 +/- 150 ng ml(-1)) and plasma ghrelin levels (175 +/- 66 pg ml(-1)) compared with healthy controls (354 +/- 242 ng ml(-1) and 243 +/- 93 pg ml(-1), respectively, P < 0.05). Depressed levels of ghrelin in children with adenoid and tonsillar hypertrophy lead to decreased appetite and insufficient energy intake. Lower serum levels of IGF-1 in children with adenoid and tonsillar hypertrophy may be secondary to deficient growth hormone stimulation by ghrelin.

Adenoid Hypertrophy in Adults: Clinical and Morphological Characteristics

This study compared the aetiology and pathological characteristics of adult and childhood adenoid hypertrophy (AH). Clinical and morphological features and accompanying otolaryngological pathologies were recorded in 40 adults and 23 children undergoing adenoidectomy for obstructive AH. Both AH forms were similar in terms of symptomatology and associated inflammations. There were, however, significant differences in otitis media rate, with effusion and dullness, and retraction in the eardrum both more prevalent in childhood AH. Adult AH was associated with nasal septum deviation in 25.0% of patients. Histopathological features of adenoidal lymphoid tissue were dissimilar in the two groups: numerous lymph follicles with prominent germinal centres was the chief finding in childhood adenoids, whereas adult adenoids showed chronic inflammatory cell infiltration and secondary changes (e.g. squamous metaplasia). These results underline the importance of considering AH as a cause or contributing factor in nasal obstruction and related pathologies in adults and supports the theory that it represents a long-standing inflammatory process rather than being a novel clinical entity.