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Enlarged Adenoid Tonsils
A. Carlson Merrow, Jr., MD, FAAP
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KEY FACTS

  • Terminology

    • Imaging

      • Clinical Issues

        TERMINOLOGY

        • Synonyms

          • Adenoids 
        • Definitions

          • Adenoid tonsils (AT): Exposed lymphoid tissue at posterior wall of nasopharynx
          • Enlargement may be chronic & idiopathic or acute/subacute with pathology (as from infection or neoplasm)
          • When AT chronically enlarged, may lead to obstructive sleep apnea (OSA) by obstructing posterior nasopharynx

        IMAGING

        • General Features

          • Radiographic Findings

            • CT Findings

              • MR Findings

                • Imaging Recommendations

                  DIFFERENTIAL DIAGNOSIS

                    CLINICAL ISSUES

                    • Presentation

                      • Demographics

                        • Treatment

                          Selected References

                          1. Murray R et al: Frequency and cause of readmissions following pediatric otolaryngologic surgery. Laryngoscope. 126(1):199-204, 2016
                          2. Fleck RJ et al: MRI sleep studies: use of positive airway pressure support in patients with severe obstructive sleep apnea. Int J Pediatr Otorhinolaryngol. 78(7):1163-6, 2014
                          3. Nayak KS et al: Seeing sleep: dynamic imaging of upper airway collapse and collapsibility in children. IEEE Pulse. 5(5):40-4, 2014
                          4. Donnelly LF: Magnetic resonance sleep studies in the evaluation of children with obstructive sleep apnea. Semin Ultrasound CT MR. 31(2):107-15, 2010
                          5. Dayyat E et al: Obstructive sleep apnea in children: relative contributions of body mass index and adenotonsillar hypertrophy. Chest. 136(1):137-44, 2009
                          6. Wasilewska J et al: Sleep-wake schedules in preschool children who snore. Adv Med Sci. 54(2):256-63, 2009
                          7. Mihaescu M et al: Computational modeling of upper airway before and after adenotonsillectomy for obstructive sleep apnea. Laryngoscope. 118(2):360-2, 2008
                          8. Donnelly LF: Obstructive sleep apnea in pediatric patients: evaluation with cine MR sleep studies. Radiology. 236(3):768-78, 2005
                          9. Shott SR et al: Cine magnetic resonance imaging: evaluation of persistent airway obstruction after tonsil and adenoidectomy in children with Down syndrome. Laryngoscope. 114(10):1724-9, 2004
                          10. Donnelly LF et al: Upper airway motion depicted at cine MR imaging performed during sleep: comparison between young Patients with and those without obstructive sleep apnea. Radiology. 227(1):239-45, 2003
                          11. Vogler RC et al: Age-specific size of the normal adenoid pad on magnetic resonance imaging. Clin Otolaryngol Allied Sci. 25(5):392-5, 2000
                          12. Jaw TS et al: Development of adenoids: a study by measurement with MR images. Kaohsiung J Med Sci. 15(1):12-8, 1999
                          Related Anatomy
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                          Related Differential Diagnoses
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                          References
                          Tables

                          Tables

                          KEY FACTS

                          • Terminology

                            • Imaging

                              • Clinical Issues

                                TERMINOLOGY

                                • Synonyms

                                  • Adenoids 
                                • Definitions

                                  • Adenoid tonsils (AT): Exposed lymphoid tissue at posterior wall of nasopharynx
                                  • Enlargement may be chronic & idiopathic or acute/subacute with pathology (as from infection or neoplasm)
                                  • When AT chronically enlarged, may lead to obstructive sleep apnea (OSA) by obstructing posterior nasopharynx

                                IMAGING

                                • General Features

                                  • Radiographic Findings

                                    • CT Findings

                                      • MR Findings

                                        • Imaging Recommendations

                                          DIFFERENTIAL DIAGNOSIS

                                            CLINICAL ISSUES

                                            • Presentation

                                              • Demographics

                                                • Treatment

                                                  Selected References

                                                  1. Murray R et al: Frequency and cause of readmissions following pediatric otolaryngologic surgery. Laryngoscope. 126(1):199-204, 2016
                                                  2. Fleck RJ et al: MRI sleep studies: use of positive airway pressure support in patients with severe obstructive sleep apnea. Int J Pediatr Otorhinolaryngol. 78(7):1163-6, 2014
                                                  3. Nayak KS et al: Seeing sleep: dynamic imaging of upper airway collapse and collapsibility in children. IEEE Pulse. 5(5):40-4, 2014
                                                  4. Donnelly LF: Magnetic resonance sleep studies in the evaluation of children with obstructive sleep apnea. Semin Ultrasound CT MR. 31(2):107-15, 2010
                                                  5. Dayyat E et al: Obstructive sleep apnea in children: relative contributions of body mass index and adenotonsillar hypertrophy. Chest. 136(1):137-44, 2009
                                                  6. Wasilewska J et al: Sleep-wake schedules in preschool children who snore. Adv Med Sci. 54(2):256-63, 2009
                                                  7. Mihaescu M et al: Computational modeling of upper airway before and after adenotonsillectomy for obstructive sleep apnea. Laryngoscope. 118(2):360-2, 2008
                                                  8. Donnelly LF: Obstructive sleep apnea in pediatric patients: evaluation with cine MR sleep studies. Radiology. 236(3):768-78, 2005
                                                  9. Shott SR et al: Cine magnetic resonance imaging: evaluation of persistent airway obstruction after tonsil and adenoidectomy in children with Down syndrome. Laryngoscope. 114(10):1724-9, 2004
                                                  10. Donnelly LF et al: Upper airway motion depicted at cine MR imaging performed during sleep: comparison between young Patients with and those without obstructive sleep apnea. Radiology. 227(1):239-45, 2003
                                                  11. Vogler RC et al: Age-specific size of the normal adenoid pad on magnetic resonance imaging. Clin Otolaryngol Allied Sci. 25(5):392-5, 2000
                                                  12. Jaw TS et al: Development of adenoids: a study by measurement with MR images. Kaohsiung J Med Sci. 15(1):12-8, 1999