ADULT ADENOID HYPERTROPHY AS A CAUSE OF NASAL OBSTRUCTION: CASE SERIES AND LITERATURE REVIEW

AbstractBackground: Enlargement of the adenoids is typically seen in childhood and usually regresses after puberty. When it persists or arises later in life, it is unusual and frequently missed as a possible cause of nasal blockage.Objective: To present a series of adult patients with adenoid hypertrophy who primarily complained of nasal obstruction, and to review the available evidence on its occurrence, clinical profile, and management.Methods: Over one year, four adults presenting with chronic nasal obstruction were evaluated at a tertiary ENT centre. Each patient underwent anterior rhinoscopy and diagnostic nasal endoscopy, with imaging reserved for selected cases. Adenoidectomy was performed, and outcomes were documented through clinical follow-up.Results: The patients (2 men, 2 women; mean age 33.7 years) presented with symptoms of nasal obstruction, often accompanied by snoring, postnasal discharge, or ear complaints. Endoscopy confirmed adenoidal tissue in all cases, and imaging excluded sinister pathology. Three underwent endoscopic adenoidectomy, and one underwent conventional curettage. All reported marked improvement, and histology confirmed benign lymphoid tissue in each case.Conclusion: Although rare, adenoid hypertrophy should be considered among the causes of nasal obstruction in adults. Nasal endoscopy is essential for diagnosis, with imaging useful to rule out malignancy. Endoscopic excision is a safe and effective treatment, providing excellent symptom relief. Greater clinical awareness may reduce misdiagnosis and improve management of this overlooked entity.