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Adenoid Disorders


Clarence T. Sasaki

, MD, Yale University School of Medicine

Last full review/revision Jan 2020| Content last modified Jan 2020

Enlarged and inflamed adenoids, common among children, can make breathing difficult and lead to sleep disturbances and recurring ear infections.

  • Enlarged adenoids in children may result from infections.
  • Enlargement usually causes no symptoms but can occasionally cause difficulty breathing or swallowing and sometimes recurring ear or sinus infections or obstructive sleep apnea.
  • The diagnosis is based on nasopharyngoscopy.
  • Antibiotics may be used if a bacterial infection is present, and sometimes, if infections are recurring, the adenoids are removed.

Adenoids are collections of lymphoid tissue where the nasal passages connect with the throat. They help defend the body against infection by trapping bacteria and viruses entering through the throat and by producing antibodies. The adenoids are largest in children who are 2 to 6 years of age.

Locating the Adenoids

The adenoids are lymphoid tissue located behind the palate, where the nasal passages connect with the throat. The adenoids are not visible through the mouth.

Locating the Adenoids

Causes of Adenoid Disorders

Some preschool and adolescent children have relatively large adenoids that are not due to any problem. However, adenoids can become enlarged because they become infected with a virus or bacteria that cause throat infections (sore throat). Ongoing exposure to children who have bacterial or viral infections, such as children at child care centers, increases the risk of infection. In addition, allergies (such as seasonal allergies or year-round allergies), irritants, and, possibly, gastroesophageal reflux also can cause the adenoids to enlarge. Although extremely rare, cancer sometimes causes enlarged adenoids.

When enlarged, adenoids may block the nose or the eustachian tubes that connect the back of the throat to the ears. Usually, adenoids return to normal size once the cause of the problem is resolved. Sometimes they remain enlarged, particularly in children who have had frequent or chronic infections.

Symptoms of Adenoid Disorders

Most enlarged adenoids cause no symptoms. However, enlarged adenoids can give the voice a stuffy-nose quality (children sound as though they have a cold). Children with enlarged adenoids may have an abnormally shaped palate and position of the teeth. Children may also tend to breathe through their mouth and may also have chronic ear infections with hearing loss, nosebleedsbad breath, and cough.

Diagnosis of Adenoid Disorders

  • Nasopharyngoscopy

Doctors suspect enlarged adenoids in children and adolescents with characteristic symptoms, chronic ear infections, or recurring sinus infections. Usually, to view the back of the nose and throat, doctors insert a flexible viewing tube through the nose (called a nasopharyngoscope).

Treatment of Adenoid Disorders

  • Treatment of the cause
  • Sometimes adenoidectomy

If doctors think adenoids are enlarged because of allergies, they may give a nasal corticosteroid spray or other drugs, such as antihistamines, by mouth. If the cause appears to be a bacterial infection, doctors may give antibiotics. If these drugs are not effective or if doctors think they will not be useful, doctors may recommend surgical removal of the adenoids (called adenoidectomy).

Doctors may recommend adenoidectomy for children who have the following:

  • Frequent ear infections and persistent collections of fluid in the middle ears
  • Recurring nose bleeds or obstructions causing voice changes or disturbed sleep
  • Sinus infections

Adenoidectomy does not seem to decrease the frequency or severity of colds or cough.

Although it requires general anesthesia, adenoidectomy usually can be done on an outpatient basis. Children typically recover from adenoidectomy in 2 to 3 days.

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