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Suggest Treatment For Adenoid Hypertrophy In A Child

Posted on Sat, 20 Jun 2015

Question: Hi My daughter who is aged 3years and 6 months currently has foam in her mouth while sleeping. She also snores a lot and has sleeping problems occasionally. Her breathing is not very normal while as sleep and sometimes difficult to breath through the nose and end up breathing with the mouth open.

An x-ray was conducted -Digital Adenoid ( Post Nasal Space) with the below result.

Opacity of soft tissue density is noted projected in the posterior wall of the hypo-pharynx
The rest of the demonstrated lower airway appear well pneumatized.
The demonstrated base of the skull, skull vault and cervical spine appear within normal limit.
The overlaying soft tissue appear normal.

CONCLUSION: Adenoid Hypertrophy

She has been treated for two weeks with Loratadine (Allergy 1mg/ml Syrup)

Kindly advice if there is a drug she could use to bring it down or if she may require surgery.
Thank you

Answered by Dr. Naveen Kumar Nanjasetty (2 hours later)

Brief Answer:
You need to use steroid and saline nasal spray...

Detailed Answer:
Hi

Thanks for posting the query

I have gone through the history thoroughly and understood the problem. I'll try my best to help you with this query.

The report says that the child is having enlarged adenoids behind the nose which is the prime cause for the nasal obstruction and mouth breathing.

Initially, you need to try using steroid nasal spray such as momentasone and saline nasal spray to reduce the size of the adenoids and clear the nasal secretions.

You need to use this for at least a couple of months. If the symptoms do not get better, adenoids has to be removed in order to clear the nasal obstruction.

Also, you need to follow the below measures:
1. Give plenty of warm water for drinking.
2. Avoid giving chilled food and beverages.
3. Change the pillow cover every night before putting the child to bed.

Hope I have answered the query; I'll be available for the follow up queries.

Regards
Dr. Naveen Kumar N
ENT and Head & Neck Surgeon

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Naveen Kumar Nanjasetty (9 hours later)

Many thanks for the clarification. This is well on line with what i have been told before and therefore gives plenty comfort and hope.
I can assume it is also part of the reason she frequently has flu and catarh.
May i request if you can send me the recommended prescription & dosage of the drugs to use?
Once again i thank you for the insight and support.
Regards

Answered by Dr. Naveen Kumar Nanjasetty (5 hours later)

Brief Answer:
Momentasone 1puff in each nostril once a day...

Detailed Answer:
Hi

Thanks for writing back

You need to use 1puff in each nostril once a day for at least 2 months. Also you can use saline nasal spray as frequently as possible to clear up the clogged nasal secretions.

Hope this clarifies your doubts. Wish you good health.

Regards
Dr. Naveen Kumar N
ENT and Head & Neck Surgeon

Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Vaishalee Punj