What are adenoids?

Adenoids are tonsil-like glands located at the back of the nose, above the roof of the mouth, at the intersection of the nostrils, throat and the eustachian tubes. During childhood, they form part of the body's defence system against infection. Their main function is to capture substances that could be harmful to the body (bacteria, viruses or dust) as they are breathed in, before they reach the lungs. Once captured, they process these substances and activate an immune response.

Adenoids increase in size from birth, until the child is around 4 years old, and then shrink until they have almost disappeared in adulthood.


What conditions can affect the adenoids

Adenoids can become enlarged or swollen, usually due to infections or allergies. This is common, and is often accompanied by swollen tonsils. The adenoids may recover on their own and in most cases, they aren’t serious enough to impact the child’s day-to-day life. However, swollen or enlarged adenoids can sometimes cause problems, including:

A persistent blocked nose and the associated difficulty breathing through it leads to the child breathing through the mouth, which can cause a dry throat and, in turn, problems such as a sore throat, trouble swallowing, bad breath, and voice alterations.


Medical tests for enlarged adenoids

Adenoids cannot be seen through the mouth like the tonsils. The specialist will need to perform a physical examination of the nose, throat, and ears to assess whether they have increased in size. A lateral x-ray of the pharynx may also be performed to see the size. In severe cases where there is associated sleep apnoea, a sleep apnoea study should be performed to assess the intensity of the episodes.


What causes adenoid problems?

Enlarged adenoids usually occur due to bacterial or viral infections. The adenoid tissue may swell temporarily as it fights an infection in the airway, and may recover. The adenoids themselves can also become infected, and repeated infections of the respiratory tract, such as colds or flu can lead to persistent swelling.

Some adenoid problems may be caused by the streptococcus virus or the Epstein-Barr virus, among others.

Patients with enlarged adenoids are also at increased risk of tonsillitis, and may experience headaches and sore throats more often.


Treatments for enlarged adenoids

The first thing the specialist will do is prescribe antibiotics to combat the infection in the tonsils, adenoids, and sinuses. This will lower mucus production and clear the nostrils, but not all the inflammation.

If breathing problems and difficulty sleeping are impacting the child’s life, the doctor will probably recommend surgical removal of the adenoid glands (adenoidectomy). If the child also frequently suffers from tonsillitis, the tonsils will likely be removed at the same time (tonsillectomy), which reduces the risk of complications.

The operation is performed under general anaesthetic and consists of scraping the adenoids away with an instrument known as a curette or burning them away using heat from a high-frequency electrical current generated by a special diathermy instrument.

The procedure is relatively quick. The child will be kept under observation for a few hours (occasionally overnight if the procedure was performed late in the day), and when the doctor is satisfied that they are recovering normally, they will be able to go home, usually in the same day.


Which specialist treats adenoid problems?

Any problems with the adenoids are treated by a paediatric otolaryngologist.

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