What contributors to the prominent nasopharyngeal airway obstruction can you find in this image?
Adenoidal hypertrophy is a well known cause of nasopharyngeal airway obstruction. However, in this index patient, an elongated uvula hanging down into the nasopharynx further narrows the air nasopharyngeal airway column.
Which is more clinically important? The size of the enlarged adenoids causing the nasopharyngeal airway narrowing, or the degree of nasopharyngeal airway narrowing irrespective of the size of the enlarged adenoids?
The degree of nasopharyngeal airway narrowing is the most important clinical consideration in patients with nasopharyngeal airway obstruction of any cause.
What is a potentially lethal complication associated with both adenoidal hypertrophy and an elongated uvula?
Obstructive sleep apnoea.
What pattern of breathing is this child likely to have? Nasal or mouth breathing?
Children with nasopharyngeal airway obstruction compensate by resorting to mouth breathing.
Marked narrowing of the nasopharyngeal and upper oropharyngeal airways by a combination of an enlarged, elongated uvula and adenoidal hypertrophy.
Note his mother's fingers (who held him for the exposure) projected over the orbit.