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What are adenoid disorders?

The adenoids are masses of gland-like tissue, normally about three-fourths of an inch high and a fourth of an inch wide, that are located on the back wall of the throat above the soft palate.

As with the tonsils, the adenoids act as a kind of sieve, filtering out infectious organisms that enter the body through the nose or mouth. Children's adenoids grow between the ages of 3 and 5. Thereafter, they gradually shrink, virtually disappearing by the time of puberty. Sometimes, however, the adenoids grow abnormally large and become infected, a condition known as adenoiditis. This infection often occurs along with tonsillitis.

Severely enlarged adenoids may block the airway between the nose and throat, making it almost impossible to breathe through the nose. Such enlargement may also increase the incidence of middle-ear infections or block the eustachian tubes, preventing an adequate amount of air from reaching the middle ear and resulting in impaired hearing.

What causes adenoid disorders?

A child's adenoids may grow abnormally large for no particular reason. Enlarged adenoids set the stage for repeated upper respiratory and ear infections because they prevent nasal secretions from draining into the throat. The infections, which can be viral or bacterial, enlarge the adenoids creating a self-perpetuating cycle. Allergic reactions can also cause adenoiditis.

How are adenoid disorders diagnosed and treated?

A physical examination can determine whether the adenoids are enlarged, and further tests may be necessary to reveal the cause. Any discharge from the throat or ear is examined in the laboratory to see if a bacterial infection is present.

The usual treatment for infected adenoids is a course of antibiotics. Ear infections stemming from adenoiditis also require antibiotic treatment, plus nasal decongestants and antihistamines.

Medication is usually effective, but in rare cases, surgical removal of the adenoids (usually accompanied by tonsil removal) may be needed. This operation is most often performed on young children, since tonsil and adenoid tissue shrinks after age 10 and rarely causes any problems after that. Since the adenoids cannot be completely removed, it is not unusual for them to grow back, especially in young children.

What can I do myself?

Self-treatment of enlarged adenoids is not effective. To lower a child's risk of repeated sore throats and colds, which worsen adenoiditis, encourage frequent hand washing and avoid crowded, poorly ventilated classrooms and playrooms.

When should I see my doctor?

Any difficulty in breathing through the nose or pain in the ear calls for a medical consultation.

What will the doctor do?

The doctor can easily determine whether the adenoids are enlarged and identify any infection that may be present. Ear infections should be treated promptly.

If surgery is recommended, it can usually be done at the patient's convenience. The removal of tonsils and adenoids is one of the safest of all operations. It requires general anesthesia and usually involves an overnight stay in the hospital.

Postoperative bleeding may occur within the first 12 hours after surgery, but it is almost always easily controlled and rarely recurs.

There may be pain in the throat and ears for several days after surgery, and a soft diet is recommended. Children can usually go back to school a week after surgery, and adults can return to work in about the same length of time. Antibiotics may be prescribed for a week or so after the operation to reduce the possibility of infection at the site of the operation.

The course of adenoid disorders

Adenoids normally lose their protective function after about 5 years of age, and shrink during the following years. Enlarged adenoids may become a chronic problem, however, causing discomfort and leading to ear infections.

Are adenoid disorders dangerous?

They are not dangerous unless the adenoids are severely enlarged and result in breathing problems and ear infections.