Adenoids are a mass of lymphoid tissue located at the back of the nasal passage. Similar to tonsils, adenoids are part of the immune system and help to trap pathogens that enter through the mouth and nose. They are particularly prominent in children but tend to shrink and can become nearly invisible by adulthood. 

 

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Adenoids help protect the body from viruses and bacteria. They produce antibodies to help fight infections. They are relatively large in children because children are constantly being exposed to new pathogens for the first time, requiring a robust immune response.

 

Adenoids usually get bigger when a child is growing and are often bigger by the time a child is 6 or 7 years old. After that, they usually start to get smaller as the child becomes a teenager. According to a 2023 study issued in the journal StatPearls, about 34.5 per cent of children globally have large adenoids at some point. Even though large adenoids often get smaller on their own as kids grow older, they can sometimes cause serious problems. Adenoids can sometimes become problematic, especially in children, due to their size or if they become infected. 

 

Dr. Satish Nair, Head & Neck Onco Surgeon at Apollo Hospitals Bengaluru, in his informational video on YouTube explains about the symptoms and causes of adenoids in children.

 

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Common issues include:

• Enlarged Adenoids: Can be caused by repeated infections or can be naturally large. This can lead to difficulty breathing through the nose, snoring, and sleep apnea.
• Adenoiditis: This is the inflammation of the adenoids, usually due to infection. Symptoms may include sore throat, stuffy nose, swollen neck glands, difficulty breathing, and ear problems.

 

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Symptoms of Enlarged Adenoids

Enlarged adenoids can cause a range of symptoms in children due to the blockage or restriction they create in the airways and the issues they can cause with the ears. 

• The enlarged adenoids can block the nasal passages, making it hard for a child to breathe through their nose.
• The blockage in the nasal passage can cause snoring. In some cases, it can cause sleep apnea, where a child may stop breathing for short periods during sleep.
• Because the adenoids are located near the back of the nasal passage, their enlargement can affect the sound of the child's voice, giving it a nasal quality.
• Enlarged adenoids can block the Eustachian tubes, which connect the middle ear to the throat, leading to fluid buildup and infection in the ear (otitis media).
• The buildup of fluid in the middle ear can also affect hearing, making it difficult for the child to hear clearly.
• The enlarged adenoids can make swallowing uncomfortable and may be associated with a sore throat.
• Mouth breathing and the potential for infection in the adenoids can lead to bad breath.
• Children with enlarged adenoids may have a constant cold or nasal congestion because of the obstruction and the increased risk of infection.

If your child exhibits any of these symptoms, especially if they're persistent, it's a good idea to consult with a pediatrician or an ENT (Ear, Nose, and Throat) specialist. They can diagnose the issue and recommend the best treatment options.

 

Diagnosis

Doctors may use several methods to diagnose enlarged adenoids or adenoiditis, including:

• Physical examination
• Medical history evaluation
• X-rays or endoscopy to view the adenoids directly
• Sleep studies in cases where sleep apnea is suspected

 

Treatment

Adenoidectomy is often recommended to treat enlarged adenoids by taking out the adenoid glands in your child. These glands are tiny lumps of tissue located behind the nose, higher up in the throat. In adults, adenoids are seen as a leftover part of the body that doesn't serve any function. 

 

An adenoidectomy is usually done for kids who are between 1 and 7 years old. This is because the adenoids start to get smaller by themselves when a child is around 7 years old, and by the teenage years, they're almost entirely gone.

 

Sometimes, antibiotics can also work if there's an infection, and nasal steroid sprays may help reduce the size of the adenoids.

 

What Happens During Adenoidectomy?

• The child will be given general anesthesia, which means they will be asleep and won't feel any pain during the surgery.
• The surgeon will use special tools to remove the adenoid glands from the back of the throat. The procedure usually takes around 15 to 30 minutes.
• The child's vital signs, such as heart rate and blood pressure, will be closely monitored throughout the surgery.

 

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Recovery

• After the surgery, the child will be taken to a recovery room where they will wake up from the anesthesia. They may feel groggy or nauseous initially.
• Initially, the child may be restricted to a soft diet to avoid irritating the throat. Clear fluids are usually recommended at first, followed by gradually introducing soft foods as tolerated.
• The child may need to take it easy for a few days after the surgery. 
• A follow-up appointment will be scheduled with the doctor to check on the child's recovery and to remove any packing or stitches if necessary.

 

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Possible Complications

• While uncommon, some bleeding from the surgical site may occur after the adenoidectomy. Contact the doctor if bleeding is persistent or excessive.
• The child may experience some throat discomfort or pain after the surgery. The doctor may prescribe pain medication to help manage any discomfort.
• There is a risk of infection following surgery. There could be signs of infection including fever, increasing pain, or redness and swelling at the surgical site.
• In rare cases, swelling of the throat tissues after surgery may cause breathing difficulties. This requires immediate medical attention.

 

It's essential to follow the doctor's instructions carefully regarding post-operative care to ensure a smooth recovery process. If you have any concerns or notice any unusual symptoms after the adenoidectomy, don't hesitate to contact the doctor for guidance.

 

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