Enlarged adenoids
Adenoids - enlarged
The adenoids are lymph tissues that sit in your upper airway between your nose and the back of your throat. They are similar to the tonsils.
Enlarged adenoids means this tissue is swollen.
Structures of the throat include the esophagus, trachea, epiglottis and tonsils.
Adenoids are masses of tissue located high on the posterior wall of the pharynx. They are made up of lymphatic tissue, which trap and destroy pathogens in the air that enter the nasopharynx.
Causes
Enlarged adenoids may be normal. They may grow bigger when the baby grows in the womb. The adenoids help the body prevent or fight infections by trapping bacteria and germs.
Infections can cause the adenoids to become swollen. The adenoids may stay enlarged even when you are not sick.
Maybe your child snores a lot. Maybe your child gets a lot of ear infections or has a lot of sore throats. There's a good chance your child has a problem with his adenoids. Let's talk about enlarged adenoids. The adenoids are glands located between the airway your child breathes into through their nose and the back of your child's throat. Like your child's tonsils, the adenoids can often become swollen. This may happen if the adenoids grow too large, instead of shrinking as your child gets older. If the adenoids continue to grow, your child may have bad breath, cracked lips, and a dry mouth. Your child might breathe a lot through his mouth. That's because his airway can become blocked, and he may have trouble breathing through his nose. Your child may even stop breathing at times during sleep. Your child's doctor will use a special mirror to see if the adenoids are swollen. Your child may also need an x-ray. Your child's doctor may try to treat the chronic swelling with medications such as antibiotics. If that doesn't work, your child may need surgery to remove the adenoids. If your child needs surgery, he will be given general anesthesia and be asleep and unable to feel pain. The surgeon will prop your child's mouth open with a small instrument, then remove the adenoid glands, while probably removing the tonsils at the same time. Your child will probably go home the same day as surgery. Surgery to remove the adenoids, called an adenoidectomy, is one of the most common reasons children have surgery. But surgery doesn't have to be all bad. Your child can look forward to a steady diet of pudding, ice cream, and other soft and fun foods, until they feel better. And hopefully your child can look forward to fewer sore throats and ear infections, and more normal breathing, in the future.
Symptoms
Children with enlarged adenoids often breathe through the mouth because the nose is blocked. Mouth breathing occurs mostly at night, but may be present during the day.
Mouth breathing may lead to the following symptoms:
- Bad breath
- Cracked lips
- Dry mouth
- Persistent runny nose or nasal congestion
Enlarged adenoids may also cause sleep problems. A child may:
- Be restless while sleeping
- Snore a lot
- Have episodes of not breathing during sleep (sleep apnea)
Children with enlarged adenoids may also have more frequent ear infections.
Exams and Tests
The adenoids cannot be seen by looking in the mouth directly. Your health care provider can see them by using a special mirror in the mouth or by inserting a flexible tube (called an endoscope) placed through the nose.
Tests may include:
- X-ray of the throat or neck
- Sleep study if sleep apnea is suspected
Treatment
Many people with enlarged adenoids have few or no symptoms and do not need treatment. Adenoids shrink as a child grows older.
Your provider may prescribe antibiotics or nasal steroid sprays if an infection develops.
Surgery to remove the adenoids (adenoidectomy) may be done if the symptoms are severe or persistent.
Maybe your child snores a lot. Maybe your child gets a lot of ear infections or has a lot of sore throats. Maybe your child needs to have his tonsils removed. If so, chances are your child also needs the adenoids removed. Let's talk about adenoid removal, or adenoidectomy. So, why do the adenoids need to be removed? The adenoids are glands, located between the airway your child breathes into through their nose, and the back of your child's throat. Like your child's tonsils, the adenoids can often become swollen. When this happens, your child's airway can become blocked, and he may have trouble breathing through his nose. Your child may even stop breathing at times during sleep. Typically, your child's doctor will use a special mirror to see if the adenoids are swollen. Your child may also need an X-ray. Often a child's swollen adenoids have been a problem for a while. The doctor may have tried to treat the chronic swelling with prescription medications, and if they are still causing problems, perhaps now it's time to remove them. So, let's go over what happens during an adenoidectomy. Your child will be given general anesthesia. He'll be unconscious and unable to feel pain. The surgeon will prop your child's mouth open with a small instrument, then remove the adenoid glands, and probably remove the tonsils as well. Your child will probably go home the same day as surgery. Complete recovery takes about one to two weeks. There might be some bleeding in your child's throat or mouth, so you'll want to encourage him to spit the blood out instead of swallowing it. Have him gently gargle often with baking soda mixed with water. Soft foods and cool drinks will make his throat feel better too. Adenoidectomy is one of the most common reasons children have surgery. But surgery doesn't have to be all bad. Your child can look forward to a steady diet of pudding, ice cream, and other soft and fun foods, until he feels better. And hopefully your child can look forward to fewer sore throats, ear infections, and more normal breathing, in the future.
When to Contact a Medical Professional
Contact your provider if your child has trouble breathing through the nose or other symptoms of enlarged adenoids.
References
Chi DH, Tobey A. Otolaryngology. In: Zitelli BJ, McIntire SC, Nowalk AJ, Garrison J, eds. Zitelli and Davis' Atlas of Pediatric Physical Diagnosis. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 24.
Wetmore RF. Tonsils and adenoids. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 411.
Version Info
Last reviewed on: 8/5/2023
Reviewed by: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
