Enlarged Adenoids

What is enlarged adenoids?

Enlarged adenoids refer to swollen lymphatic tissues at the back of the nose. These tissues are similar to tonsils.

Adenoids are lumpy clusters of spongy tissue that help protect children from getting sick. Like tonsils, adenoids help keep the body healthy by trapping harmful bacteria and viruses that are breathed in or swallowed. Adenoids also contain cells that make antibodies to help the body fight infections.

What is the cause?

Enlargement of the adenoids may occur naturally (beginning during fetal development), or it may be caused by long-term inflammation.

What are symptoms?

Swollen or enlarged adenoids are common. When this happens, the tonsils get swollen, too. Swollen or infected adenoids can make it tough for a child to breathe and cause these problems:

• Mouth breathing (mostly at night)
  
• Dry mouth
  
• Cracked lips
  
• Mouth open during day (more severe obstruction)
  
• Bad breath
  
• Persistent runny nose or nasal congestion
  
• Frequent ear infections
  
• Snoring
  
• Restlessness while sleeping
  
• Intermittent sleep apnoea

What is the diagnosis?

The adenoids cannot be seen by looking in the mouth directly, but can be seen with a special mirror or using a flexible endoscope through the nose. The tests may include x-ray and sleep apnoea studies.

What is the treatment?

If the enlarged or infected adenoids keep bothering the child and medicine doesn't stop them from coming back, the doctor may recommend surgically removing them with a procedure called an adenoidectomy. This may be recommended if the child experiences one or more of the following:

• difficulty in breathing
  
• sleep apnoea
  
• recurrent infections

Having the child's adenoids removed is especially important when repeated infections lead to sinus and ear infections. Badly swollen adenoids can interfere with ear pressure and fluid movement, which can sometimes lead to hearing loss. Therefore, kids whose infected adenoids cause frequent earaches and fluid buildup may need to get an adenoidectomy as well as ear tube surgery. And although adenoids can be taken out without the tonsils, if the child is having tonsil problems, they may need to be removed at the same time. A tonsillectomy with an adenoidectomy is the most common operation for children.

What are the possible complications?

Enlarged adenoids can cause health-threatening conditions such as chronic ear infections, sleep apnoea, pulmonary hypertension, and right-sided heart failure. If the child has difficulty breathing through the nose, you must contact your doctor.

What is the prevention?

Treating throat infections early may prevent the adenoids from becoming enlarged from long-term infection and inflammation. Adenoidectomy prevents the complications of long-term airway obstruction.