How to check for enlarged adenoids

Generally, checking whether the adenoids are enlarged involves a combination of direct observation and functional assessment. The main methods include nasopharyngoscopy, imaging studies, symptom evaluation, sleep monitoring, and physical examination. A detailed analysis is as follows:

1. Nasopharyngoscopy: This is the most direct method. Adults and cooperative children can undergo electronic nasopharyngoscopy, allowing doctors to directly observe the size, shape, and surface condition of the adenoids via a thin endoscope. For infants and young children, indirect nasopharyngoscopy using a mirror is more commonly used; it is simple to perform and non-invasive.

2. Imaging studies: Commonly performed using nasal CT or MRI. CT clearly displays the volume of the adenoids and their relationship with surrounding tissues, helping determine if the eustachian tube opening is compressed. MRI provides more precise evaluation of adenoid soft tissue and is preferred for children who are sensitive to radiation.

3. Symptom evaluation: Doctors assess symptoms through patient history. Chronic nasal congestion, mouth breathing, snoring during sleep, and runny nose may indicate adenoid hypertrophy. In children, associated signs such as difficulty concentrating and delayed growth and development further increase suspicion. The longer symptoms persist, the higher the likelihood of adenoid enlargement.

4. Sleep monitoring: For patients with prominent nighttime symptoms, overnight sleep studies record parameters such as respiratory rate and blood oxygen saturation. Frequent episodes of apnea and oxygen desaturation, combined with other findings, can confirm sleep-disordered breathing caused by adenoid hypertrophy.

5. Physical examination: The doctor examines for nasal mucosal congestion and tonsillar enlargement. In children, special attention should be paid to the presence of "adenoid facies"—characterized by a high-arched palate, malaligned teeth, and thickened lips—resulting from chronic mouth breathing. These features serve as important clinical clues.

Parents are advised to seek timely medical evaluation if they notice any abnormal symptoms in their child. Daily measures such as maintaining indoor air humidity, preventing recurrent colds, and minimizing inflammation of the adenoids can help reduce the risk of worsening hypertrophy.