The adenoids are masses of gland-like tissue located on the back wall of the throat above the soft palate. Adenoids like tonsils help filter out infectious organisms that enter the body through the oral cavities (nose or mouth). Children’s adenoids grow between the ages of three and five and gradually shrink, virtually disappearing by puberty. At times the adenoids grow abnormally large and become infected (aka adenoiditis). Severely enlarged adenoids may block the airway between the nose and throat making it difficult, almost impossible to breathe through the nose, increasing the incidence of middle-ear infections or block the eustachian tubes. A child’s adenoids may grow abnormally large for no particular reason. Allergic reactions can also cause adenoiditis.
A physical examination can determine whether the adenoids are enlarged, and further tests may be necessary to reveal the cause. Any discharge from the throat or ear is examined to determine the presence of bacterial infection. Adenoids and ear infections are usually treated by antibiotics, plus nasal decongestants and antihistamines. Although medication is often effective, in rare and severe cases, surgical removal of the (often accompanied by tonsil removal) may be necessary. It is not unusual for adenoids to grow back since they can’t completely be removed.
An ENT should be seen if any difficulty is noticed in breathing through the nose or severe pain in ears are present. The ENT can easily determine whether the adenoids are enlarged and identify any infection that may be present. Operations require general anesthesia and usually involves an overnight stay in the hospital. Postoperative bleeding may occur within the first 12 hours after surgery, and there may be pain in the throat and ears fro several days after surgery. Prostoperative bleeding may occur within the first 12 hours after surgery, but it is almost always easily controlled and rarely recurs. Pain in the throat and ears for several days after surgery may persist and a soft diet may be recommended. Antibiotics are often prescribed for a week postoperatively to reduce the risk of infection at the site of the operation.
Adenoids normally lose their protective function after about 5 years of age and shrink during the following year. However, enlarged adenoids may become a chronic problem and be the cause of recurrent ear infections. Although adenoids are not dangerous, severely enlarged adenoids may result in breathing problems and recurrent ear infections.
It is recommended that children be seen regularly by a family doctor or a pediatrician to ensure appropriate adenoid and tonsil size.