Adenoids are a lymphoid tissue that lies at the back of the nose at the top of the throat, behind the soft palate. Like any other lymphatic tissue, they respond to infection. When people have viral infections, adenoids and tonsils (made of the same type of tissue) enlarge to fight the infection.
As a child grows, their adenoids also grow. The adenoids reach peak size between the ages of 5-7. As the child gets older, the adenoids atrophy, or waste away, as the body finds other ways to fight the infection. By the teenage years, adenoids are usually very small, if not undetectable.
Let’s take a closer look at adenoids, problems that can occur with adenoids, and why removal or other procedures may be necessary.
Two main problems occur in children’s adenoids. The first is enlarged adenoids, caused by infection. This can lead to nasal obstruction and, therefore, troubled breathing through the nose. A first indication of enlarged adenoids is often seen when a parent brings in a child to see a doctor, complaining that during sleep their child breathes through the mouth, that he or she drools a lot, or that they snore. If a child’s adenoids remain enlarged, they can cause recurrent infections that result in the child having ongoing issues with poor airflow through the nasal passage.
Another problem that adenoids can cause is ear infections. Because the adenoids sit at the top of the throat, behind the soft palate, the Eustachian tube can be blocked by enlarged adenoids. This makes the child more susceptible to ear infections. And, because a child’s Eustachian tube is not fully formed yet, enlarged adenoids can also result in a collection of fluid that can re-infect, causing chronic ear infection.
Mouth breathing, breathing through the mouth while eating, constantly wiping the nose in an upward direction, snoring, and other signs might be signs that you should take your child to the doctor to see if their adenoids are infected or enlarged.
Symptoms of an acute or chronic adenoid infection can include fever, excessive sinus drainage, a thick cough, breathing through the mouth, and thick yellow and green nasal discharge.
In younger children, the doctor will order an x-ray of the side of the neck, which can tell him or her whether or not the adenoids are inflamed. In older children, the doctor can make a definitive diagnosis with a flexible tube that can explore the adenoidal area.
Often, the doctor might prescribe a nasal spray or other type of allergy medication to rule out allergic rhinitis prior to treating for an adenoid problem. Because the symptoms are so similar, this is a less invasive way to eliminate the possibility that the child has an allergy problem rather than an adenoid problem.
If that treatment isn’t effective, the doctor will typically prescribe antibiotics. If the child responds to the antibiotics, but the symptoms return as soon as the course is finished, it can be a sign that there is a chronic adenoid infection.
If the doctor has determined that a child has a chronic adenoid infection or overly enlarged adenoids that cause breathing obstruction, he or she might decide that the best course of action is to remove the adenoids altogether. This simple surgery, called an adenoidectomy, can prevent recurrent ear and adenoid infections and can help the child breathe easier.
The doctor may also decide to take out the tonsils, insert ear tubes or both during the adenoid removal procedure. These combination procedures are very common in pediatric ENT care and can result in fewer sick days and happier children.