Adenoids- what are they and when should they be removed?
What are adenoids?
- The adenoids are fleshy lumps of immune tissue located in the back of the nose in children.
- Their job is to fight infection, the same as lymph nodes (glands) elsewhere in the body.
- Hairs and mucus in the nose trap viruses and bacteria that are breathed in- and the adenoids make antibodies and white cells that destroy these germs.
- Adenoids cannot be seen when you look into your mouth or throat (though you can see your tonsils, which perform a similar job)
- In smaller children, adenoids play a very active role in fighting infection, but as the immune system matures, they are less important. They tend to shrink through childhood, and may be completely gone by the time the teens are reached.
Why do adenoids get enlarged?
- Adenoids may enlarge temporarily if a child is fighting an infection, which is their normal function.
- But sometimes they become more permanently enlarged, and cause problems such as difficulty breathing through the nose.
- Hay fever or allergic rhinitis may also contribute to enlarged adenoids
What are the symptoms of enlarged adenoids?
- a constantly blocked nose
- a nasal quality to the voice
- a tendency to “mouth-breathe” (this may cause a dry, sore throat at times)
- bad breath
- snoring at night, which may lead to unsettled sleep
- Obstructive sleep apnoea (OSA) – episodes occur where the child stops breathing for a few seconds at a time, followed by periods of snoring. OSA can lead to fatigue, behavioural issues and other health problems over time.
- middle ear infections or “glue ear”- the tubes that normally drain the middle ears open into the back of the throat, and enlarged adenoids can block them. This can lead to hearing and speech problems in some cases.
What is the treatment for enlarged adenoids?
- Often no treatment is needed as they start to shrink when a child is over 5 years old.
- Steroid nasal sprays may help hay fever/allergic rhinitis and thus reduce the size of the adenoids
- Surgery is sometimes needed
When do adenoids need to be removed?
- As adenoids naturally shrink and disappear during early childhood, in most cases, no surgery is needed.
- However if a child is experiencing significant ongoing health problems due to their adenoids, such as obstructive sleep apnoea or recurrent middle ear infections, surgery may be considered.
- Your GP may refer you to an Ear, Nose and Throat specialist. They may pass a camera into the back of the throat to take a look at the adenoids to find out how big the adenoids are, and if surgery is likely to help.
If you have further questions about your child’s adenoids, speak to your GP. You can also read more about Obstructive Sleep Apnoea (OSA) in children at the Royal Children’s Hospital website.