Enlarged adenoids

About enlarged adenoids

The adenoids are two small lumps of tissue (glands) at the back of a child’s throat. They help to fight ear, nose and throat infections.

Adenoids tend to be at their largest in children. Your child’s adenoids grow in size from birth and cause the most problems between the ages of four and six. They start to shrink as your child gets older, and have usually disappeared completely by the time your child reaches adulthood.

Enlarged adenoids can cause a blockage in your child’s throat, making it more difficult for him or her to breathe.

This can be a particular problem when your child is sleeping as he or she will have to breathe through their mouth rather than their nose. This can make your child snore and he or she may also temporarily stop breathing for a few seconds.

If your child’s adenoids are swollen they can block or cover the tubes that join the nose to the ear (the Eustachian tubes). These tubes help to drain fluid from your child’s ears and keep the right amount of pressure in the ears. If they stop working properly your child may have problems hearing or develop an ear infection.

Symptoms of enlarged adenoids

The symptoms of enlarged adenoids can be very similar to other conditions, for example the common cold or inflamed sinuses (sinusitis). This means it can be difficult to know what is causing any symptoms. The common symptoms of enlarged adenoids may include:

  • a runny nose
  • cough
  • a blocked nose
  • snoring
  • sleep apnoea (when your child briefly stops breathing when he or she is asleep)
  • ear infections and glue ear (a build up of sticky fluid in the ear)

If your child has any of these symptoms and they don’t get better on their own, you should see your GP.

Complications of enlarged adenoids

If your child’s adenoids are persistently swollen it can affect his or her breathing and sleep, cause ear infections and affect his or her hearing. These problems can cause more complications.

If your child’s sleep is being affected by snoring and sleep apnoea then he or she may be very tired during the day. This can lead to poor behaviour and a short attention span, or your child may become hyperactive.

Regular ear infections or a build up of sticky fluid in the ear (glue ear) can cause hearing loss. This varies from child to child. If your child has mild hearing loss, he or she won’t be able to hear faint or distant noises. Severe hearing loss can cause more serious problems and your child may develop speech and language problems or fall behind in their learning.

Causes of enlarged adenoids

The exact causes of enlarged adenoids aren’t clear. In some cases an infection (adenoiditis) or allergy can cause your child’s adenoids to become enlarged, but some children have enlarged adenoids with no obvious cause.

Diagnosis of enlarged adenoids

Your GP will ask about your child’s symptoms and examine him or her. Your GP may also ask about your child’s medical history.

If your child regularly gets problems associated with enlarged adenoids, your GP may refer him or her to an ear, nose and throat (ENT) surgeon for further investigation.

Treatment of enlarged adenoids

Your child's adenoids will shrink as he or she gets older. So you may decide to wait and see if any nose and ear problems get better over time, rather than having treatment. Your doctor will discuss the risks and benefits of treatment with you.

Medicines

If your child has symptoms such as pain or a fever you can give him or her over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.

Surgery for enlarged adenoids

If your child has swollen adenoids because of regular infections, or if large adenoids are affecting your child’s day-to-day life and development, your doctor may refer you to an ENT surgeon to discuss an operation to remove them.

The operation to remove your child’s adenoids is called an adenoidectomy. An adenoidectomy involves removing the adenoids through your child’s mouth. The operation is done under general anaesthesia so your child will be asleep throughout the procedure.

If your child has other related health problems, such as ear or tonsil infections, then the surgeon may also insert grommets or suggest adenoid and tonsil removal. Grommets are tiny plastic tubes fitted into the eardrum to help treat glue ear.

Can my child still fight off infections without adenoids?

Answer

Yes. Your child should still be able to fight off infections without adenoids.

Explanation

The adenoids are only a small part of your child’s immune system and help to fight infection. They trap bacteria and viruses that enter your child’s body through his or her nose and mouth. Adenoids help to prevent chest and throat infections.

However, your child’s body has other ways of fighting infection as well as adenoids. This means that, in general, if your child’s adenoids are taken out he or she will still be able to fight infection. 

What's the difference between the adenoids and the tonsils?

Answer

Adenoids and tonsils are very similar. They are made of the same type of tissue and both help the body to fight infection. However they are located in different parts of the throat.

Explanation

Both the adenoids and the tonsils are made of tissue called lymphoid tissue. Lymphoid tissue helps your child’s body to fight infection.

Your tonsils are on either side of the back of your throat. You can see them when you open your mouth. The adenoids are higher up in your throat and further back, where your nose meets your throat.

Like adenoids, your tonsils often shrink as you get older and play less of a role fighting off infection. Tonsils can also become infected in the same way that adenoids can. If this happens often, you can have an operation to remove your tonsils.

Will having an adenoidectomy help stop my child from getting a cold?

Answer

No, having his or her adenoids out will not stop your child from getting colds and other viruses.

Explanation

A cold is a viral infection of the nose and throat. You can still catch a cold if you have had your adenoids removed. Having an adenoidectomy has not been shown to reduce the number of colds children get, or how severe their colds are.

If your child has enlarged adenoids however, having an adenoidectomy may make nasal congestion (stuffiness) less of a problem for your child when he or she has a cold. It may also help to reduce the number of middle ear infections your child gets, if this has been a problem.