Fiberendoscopy for Adenoid Evaluation in Children

An enlarged adenoid (adenoid hypertrophy), commonly referred to as the “third tonsil,” is one of the most frequent causes of upper airway symptoms in children. It is strongly associated with chronic nasal obstruction, mouth breathing, snoring, sleep-disordered breathing, and recurrent middle ear disease. Flexible nasal fiberendoscopy is the most accurate, safe, and reliable diagnostic method for directly assessing adenoid size and its clinical impact.

When should a child undergo an adenoid examination?

If a child persistently breathes through the mouth, has frequent colds and chronic nasal congestion, snores or experiences pauses in breathing during sleep (suspected sleep apnea), recurrent middle ear infections, hearing difficulties, or fluid behind the eardrum (otitis media with effusion), an otorhinolaryngology examination and adenoid assessment are recommended. Enlarged adenoids can cause poor sleep quality, fatigue, restlessness, and may also negatively affect hearing.

How is fiberendoscopy performed in children?

The examination is performed in the clinic, without the need for general anesthesia. A thin, flexible camera (fiberendoscope) is gently introduced through the nostril after applying a local anesthetic in the form of a spray. The child sits independently or on a parent’s lap, with a careful and reassuring approach by the physician and assistant. The examination lasts 1–2 minutes and is not painful, although it may be mildly uncomfortable.