Prevalence and clinical presentation of adenoid hypertrophy among children attending at pediatric outpatient department of a tertiary care general hospital of Dhaka

Abstract

Background: Adenoid hypertrophy (AH) and it consequences are common in the entire childhood period. This study was aimed to estimate the prevalence, to enumerate the presence of risk factors and pattern of presentations of AH among children attending at pediatric outpatient department.

Methods: This cross-sectional study was conducted at the general pediatric outpatient department (OPD) of BIRDEM General Hospital-2 (Women and Children), Dhaka from January 2017 to December 2020. All the children aged 1-18 years attending the OPD who had known risk factors or sign-symptoms of AH were underwent a lateral nasopharyngeal x-ray to confirm the presence of enlarged adenoid. Those children who had enlarged adenoid were analyzed in this study.

Results: A total of 20234 children attended the general pediatric OPD during the study period, of them, 463 had evidences of enlarged adenoid on lateral nasopharyngeal x-ray, giving a prevalence of 2.3%. The mean age of presentation was 100.6±58 months. Among the AH cases 86% had allergic sensitivity to house dust, 60% had allergic rhinitis, 55.5% had history of recurrent tonsillitis and 55.3% children were exposed to cigarette smoke especially at home. Most common presentation of AH was mouth breathing especially during sleep time (90.5%). Other common presenting features were nasal obstruction (83.6%), nasal discharge (73%), drooling of saliva (72.4%), daytime somnolence (65.2%) and snoring during sleep (61.8%). According to our study AH may be asymptomatic in 5% cases. However, it may be presented with complications such as OSA (obstructive sleep apnea) (26.6%), adenoid facies (13.8%) and otitis media with effusion with or without hearing impairment (12.5%). Eighty two (17.7%) need referral to ENT OPD for adenoidectomy. Most common indication for adenoidectomy was obstructive sleep apnea (41.5%).

Conclusion: Prevalence of adenoid hypertrophy among children attending at pediatric outpatient department was 2.3%, of them 17.7% had indication for adenoidectomy. Allergic sensitivity to house dust was the most common risk factors. Most common two clinical presentations were mouth breathing and nasal obstruction and most common complication was obstructive sleep apnea.

BIRDEM Med J 2022; 12(2): 111-116