Enlarged adenoids in children may result from infections.
Enlargement usually causes no symptoms but can occasionally cause difficulty breathing or swallowing and sometimes recurring ear or sinus infections or obstructive sleep apnea.
The diagnosis is based on nasopharyngoscopy.
Antibiotics may be used if a bacterial infection is present, and sometimes, if infections are recurring, the adenoids are removed.
Adenoids are collections of lymphoid tissue Lymphoid organs The immune system is designed to defend the body against foreign or dangerous invaders. Such invaders include Microorganisms (commonly called germs, such as bacteria, viruses, and fungi) Parasites... read more where the nasal passages connect with the throat. They help defend the body against infection by trapping bacteria and viruses entering through the throat and by producing antibodies. The adenoids are largest in children who are 2 to 6 years of age.
Locating the Adenoids
The adenoids are lymphoid tissue located behind the palate, where the nasal passages connect with the throat. The adenoids are not visible through the mouth.
Causes of Adenoid Disorders
Some preschool and adolescent children have relatively large adenoids that are not due to any problem. However, adenoids can become enlarged because they become infected with a virus or bacteria that cause throat infections ( sore throat Sore Throat Sore throat is pain in the back of the throat. The pain can be severe and is usually worsened by swallowing. Many people with sore throat refuse to eat or drink. Sometimes pain is also felt... read more ). Ongoing exposure to children who have bacterial or viral infections, such as children at child care centers, increases the risk of infection. In addition, allergies (such as seasonal allergies or year-round allergies), irritants, and, possibly, gastroesophageal reflux also can cause the adenoids to enlarge. Although extremely rare, cancer sometimes causes enlarged adenoids.
When enlarged, adenoids may block the nose or the eustachian tubes that connect the back of the throat to the ears. Usually, adenoids return to normal size once the cause of the problem is resolved. Sometimes they remain enlarged, particularly in children who have had frequent or chronic infections.
Symptoms of Adenoid Disorders
Most enlarged adenoids cause no symptoms. However, enlarged adenoids can give the voice a stuffy-nose quality (children sound as though they have a cold). Children with enlarged adenoids may have an abnormally shaped palate and position of the teeth. Children may also tend to breathe through their mouth and may also have chronic ear infections Chronic Middle Ear Infection in Children Chronic middle ear infection results from recurring infections that may damage the eardrum or lead to formation of a cholesteatoma, which in turn promotes more infection. Chronic middle ear... read more with hearing loss, nosebleeds Nosebleeds Some people get nosebleeds rather often, and others rarely get them. There may be just a trickle of blood or a strong stream. If people swallow the blood, they often vomit it because blood is... read more , bad breath Bad Breath Bad breath is a frequent or persistent unpleasant odor to the breath. Certain diseases produce substances that are detectable on the breath, but these odors are typically mild and not considered... read more , and cough Cough in Children Cough helps clear materials from the airways and prevent them from going to the lungs. The materials may be particles that have been inhaled or substances from the lungs and/or airways. Most... read more .
Diagnosis of Adenoid Disorders
Doctors suspect enlarged adenoids in children and adolescents with characteristic symptoms, chronic ear infections Overview of Middle Ear Infections in Young Children Middle ear infection is infection of the space immediately behind the eardrum. Middle ear infections (otitis media) may occur in older children and adults (see Otitis Media (Acute)) but are... read more , or recurring sinus infections Sinusitis Sinusitis is inflammation of the sinuses, most commonly caused by a viral or bacterial infection or by an allergy. Some of the most common symptoms of sinusitis are pain, tenderness, nasal congestion... read more . Usually, to view the back of the nose and throat, doctors insert a flexible viewing tube through the nose (called a nasopharyngoscope).
Treatment of Adenoid Disorders
Treatment of the cause
If doctors think adenoids are enlarged because of allergies, they may give a nasal corticosteroid spray or other drugs, such as antihistamines, by mouth. If the cause appears to be a bacterial infection, doctors may give antibiotics. If these drugs are not effective or if doctors think they will not be useful, doctors may recommend surgical removal of the adenoids (called adenoidectomy).
Doctors may recommend adenoidectomy for children who have the following:
Frequent ear infections Otitis Media (Secretory) Secretory otitis media is an accumulation of fluid in the middle ear. Secretory otitis media occurs when acute otitis media has not completely resolved or allergies cause blockage of the eustachian... read more and persistent collections of fluid in the middle ears
Recurring nose bleeds Nosebleeds Some people get nosebleeds rather often, and others rarely get them. There may be just a trickle of blood or a strong stream. If people swallow the blood, they often vomit it because blood is... read more or obstructions causing voice changes or disturbed sleep
Adenoidectomy does not seem to decrease the frequency or severity of colds or cough.
Although it requires general anesthesia, adenoidectomy usually can be done on an outpatient basis. Children typically recover from adenoidectomy in 2 to 3 days.