Adenoid Facies and Snoring

An archaic term used to describe patients who exhibit a long, narrow face, short upper lip, open-mouth breathing, and a hyperactive swallowing pattern.

Adenoid facies is the long, open-mouthed, face of children with adenoid hypertrophy. Hypertrophy of the nasopharyngeal pad of lymphoid tissues (the adenoids) is the most common cause of nasal obstruction in children. The mouth is always open because upper airway congestion has made patients obligatory mouth breathers. Persistent mouth breathing due to nasal obstruction in childhood may be associated with the development of craniofacial anomalies such as the adenoid facies ( also called the “long face syndrome”. The most common presenting symptoms are chronic mouth breathing and snoring” The most dangerous symptom is sleep apnea.

The characteristic facial appearance consists of:

• underdeveloped thin nostrils

• short upper lip

• prominent upper teeth

• crowded teeth

• narrow upper alveolus

• high-arched palate

• hypoplastic maxilla

• Eustachian blockage causing glue ear-deafness

• The deafness and inattentiveness interferes with the learning

• child grows with lowered intelligence and understanding

Diagnosis

Enlarged adenoids are not easily identified on physical examination. Soft tissue lateral neck Xray (STLN) with neck extended or CT scan will show the size of the adenoid.of the nasopharynx provides a simple and cost-effective method for assessing the size of adenoids and the amount of post-nasal airway space remaining.

Treatment-

Adenoidectomy is the treatment of choice for adenoid hyperplasia and is commonly recommended for the patient with prolonged mouth breathing, Snoring and OSA,nasal speech, adenoid facies, and recurrent otitis media (glue ear).

Adenoidectomy is usually performed using adenoid curette and hemostasis achieved with suction electrocautery.

Adenoidectomy using Coblator is cumbersome.