The Clinical and Pathological Study of the Adenoid Vegetation Above the Age of 20

Park, Seong Kook; Choi, Eun Seok; Choi, Jung Bae; Kang, Mi Seon

Abstract

BACKGROUND AND OBJECTIVES
The adenoid increases progressively in size during early childhood, reaching a maximum at the age between 3 and 7. It begins to atrophy and involute after puberty and almost disappears before the age of 20. However, a few authors stated that persistence of the adenoid in adult life is not uncommon and the nasopharyngeal lymphoid tissue can undergo prominent or even marked hyperplasia in adults. We investigated clinical and pathological features of the patients who underwent adenoidectomy at ages beyond 20. SUBJECTS AND METHOD: A retrospective study was performed on 18 patients who underwent adenoidectomy due to adenoid vegetation from October 1997 to December 2002 at Pusan Paik Hospital and they compared the results with children of ages 3 to 10 years. To evaluate hypertrophy, adenoidal-nasopharyngeal ratios (A/N ratio) obtained using simple linear measurements from lateral skull radiographs were described. To investigate pathologic features, all excised adenoids were fixed in neutral 10 % formalin and serial sections of 5 microM thick were prepared and stained by Haematoxylin and Eosin. RESULTS: The A/N ratios of the studied patients were from 7.5 to 9.0. The main symptom of the patients was snoring. Others were nasal obstruction, postnasal drip and frequent upper respiratory infection. The prominent pathologic findings in the patients were increased squamous metaplasia of the surface epithelium and parenchymal fibrosis. CONCLUSION: Snoring and nasal obstruction were often caused by adenoid enlargements in adults. Because the examination of the nasopharynx was inadequate, many cases of enlarged adenoid in adults were misdiagnosed. Pathologic features of enlarged adenoid in adults were slightly different from those in children.