ear, nose, and throat disorders
Adenoid Disorders
Diagnosis of Adenoid Disorders
Flexible nasopharyngoscopy Adenoid hypertrophy is suspected in children and adolescents with characteristic symptoms, persistent Otitis Media (Serous) , or Children with Velopharyngeal Insufficiency , eg, due to velocardiofacial syndrome, may produce a hypernasal speech (ie, sounding as if too much air escapes through the nose) that must be differentiated from the hyponasal speech (ie, as with a congested nose) of adenoid hypertrophy. The standard for office assessment of the nasopharynx is flexible nasopharyngoscopy. Sleep tape recording, often used to document snoring, is not as accurate or specific. A sleep study may help define the severity of any sleep disturbance due to chronic obstruction. Lateral x-ray imaging does not provide sufficient or accurate evidence of adenoid size and is not routinely recommended for evaluation. CT or MRI may be considered in children when there is a high index of suspicion for angiofibroma or cancer. 