Enlarged Adenoids

Adenoids are small tissues located at the back of the throat. They are similar to the tonsils, and located right above them. Both adenoids and tonsils are part of the immune system.

Adenoids are present at birth, and they grow until a child is between the ages of 3 and 5. Normally, they begin to shrink after around age 7. They shrink considerably in adulthood.

• The adenoids can cause problems if they become enlarged. Fortunately, they are not an essential part of the immune system. Enlarged adenoids are generally treated by removal.

During the early years, adenoids help protect infants from infection. They trap bacteria and viruses when they enter the body. Adenoids that become infected usually become enlarged, but resume their normal size when the infection subsides. However, in some instances, the adenoids remain enlarged, even once the infection is gone.

• Enlarged adenoids can also be caused by allergies. Some children have enlarged adenoids from birth.

Enlarged adenoids can cause a number of symptoms, including:

• blocked, stuffy nose
• ear problems
• problems sleeping
• snoring
• sore throat
• difficulty swallowing
• swollen glands in the neck
• problems breathing through the nose
• glue ear (fluid build-up in the middle ear, which can cause hearing problems)
• cracked lips and dry mouth (from breathing problems)
• sleep apnea (irregular breathing during sleep)

The doctor will first ask about the symptoms your child is experiencing. Then your child will receive a physical exam. The doctor will use a special mirror and insert a small, flexible telescope (endoscope) through the nose to view the adenoids. Your child may need a blood test to check for infection.

In severe cases, your child may need to undergo a sleep study. This will determine if he or she is suffering from sleep apnea. During the study, your child will sleep overnight at a facility while his or her breathing and brain activity are monitored using electrodes. The study is painless, but it can be difficult for some children to sleep in a strange place.

Enlarged adenoids are usually removed. The procedure is fairly simple and carries minimal risk. This surgery is called an adenoidectomy. If a child has been having frequent tonsil infections, the doctor might remove the tonsils as well. The tonsils and adenoids are often removed at the same time.

Your child will be given a mild sedative before surgery to help calm him or her, and is then placed under general anesthesia. The surgery lasts no more than two hours.

After the adenoids are removed, your child might experience:

• a sore throat
• minor bleeding
• earaches
• a blocked nose

The doctor will prescribe an antibiotic to protect against any infection. Your child may also receive a mild pain reliever for the first few days. In addition, children are urged to drink cold, icy drinks, like milkshakes and ice cream, and to avoid any warm foods for the first seven days.

Symptoms should clear up in a few weeks.