Adenoids are a mass of lymphoid tissue situated in the throat behind the nose and the roof of the mouth (soft palate) and are not visible through the mouth without special instruments. Tonsils and adenoids are the body’s first line of defense as part of the immune system.
They “sample” bacteria and viruses that enter the body through the mouth or nose, but they sometimes become infected. At times, they become more of a liability than an asset and may even cause airway obstruction or repeated bacterial infections

Growth and Hyperplasia of Adenoids

The adenoids begin to grow in the first year of life, peak in size between age one and five, then slowly get smaller as a child grows. While the occasional teenager may still have adenoids big enough to cause blockage of the nose, this is rare and the adenoids typically shrink away before adolescence.
Adenoids Anatomy.ent

Adenoids Anatomy

What are the symptoms of adenoiditis, or enlarged adenoids? 

The symptoms of adenoiditis vary greatly depending on the cause of the infection, and can occur either suddenly or gradually. The following are the most common symptoms of adenoiditis. However, each child may experience symptoms differently.

Symptoms may include:

  • breathing through the mouth
  • noisy breathing
  • snoring
  • nasal speech
  • periods at night when breathing stops for a few seconds

Complications in adenoid hypertrophy

The adenoids are in the midline of the nasopharynx, and the Eustachian tubes open from either ear to the right and left of them. Eustachian tubes ventilate the middle ear.

Adenoid Anatomy.ent

Adenoid Anatomy

Very large adenoids will block the air passage in both the nose and the ears. This obstruction of normal air ventilation can lead to both sinusitis and otitis media (middle ear infections with effusion) with congestion, pain and some hearing loss.

Childhood obstructive sleep apnea (OSA) syndrome is characterized by episodic upper airway obstruction due to enlarged adenoids,that occurs during sleep.(Snoring and apnea). Therefore the child is sleepy, tired and drowsy during the day

Due to nasal airway obstruction caused by the enlarged adenoids the sense of smell is decreased and hence the child’s appetite.


Antibiotics initially may be used for recurring infection of the adenoids and adenoid hypertrophy. If medical management isn’t effective, surgery is indicated.

Adenoidectomy, the treatment of choice for adenoid hyperplasia, is commonly  recommended for the patient with recurrent or prolonged mouth breathing, nasal speech, adenoid facies, recurrent otitis media, constant nasopharyngitis, and nocturnal respiratory distress. This procedure usually eliminates recurrent nasal infections and ear complications and reverses secondary hearing loss.

Adenoidectomy should be performed in conjunction with tympanotomy tube placement when the adenoidal hypertrophy contributes to ear disorders. Antibiotics may be used to treat infection. Decongestants may be used to decrease edema.