Adenoid Hypertrophy in Adults: An Underdiagnosed Entity?

The adenoids (or pharyngeal tonsil) is a condensation of lymphoid tissue in the posterosuperior wall of the nasopharynx. It forms a part of Waldeyer’s ring of lymphoid tissue at the portal of entry of the upper respiratory tract [1]. In early childhood it is the fi rst site for immunological contact of inhaled allergens. Adenoids are present at birth, show physiological enlargement upto 6 years of age, atrophy at puberty and almost completely disappear by 20 years of age [2]. Clinical symptoms are common in young age due to small volume of nasopharynx and the increased frequency of upper respiratory tract infections. It appears to have an important role in the development of immunological memory in younger children [3]. Adenoid hypertrophy was considered uncommon in adults as examination of the nasopharynx by posterior rhinoscopy was inadequate. Many cases were misdiagnosed and accordingly maltreated [4]. However, in the current clinical practice, with the advent of nasal endoscopes and improved imaging modalities, adenoidal tissue is not uncommonly found in adults. Insipite of these developments, there is lack of data regarding adenoid hypertrophy in adults. We studied the varied presentation of two cases of adult adenoid hypertrophy who presented with nasal obstruction and snoring; and nonresolving chronic otitis media.