Diseases & Conditions
Adenoids are small lumps of lymphatic tissue nestled above the tonsils that help protect against upper respiratory tract infections.
Adenoid disorders—also known as adenoidism or adenoiditis—occur when the adenoids become swollen, making it hard to breathe or swallow.
Experts do not know why adenoidism is so common in toddlers and young children, although they suspect it may be due to frequent colds or allergies.
Typically, children with adenoid disorders speak with a nasal tone and breathe through their mouths. They may snore, have trouble swallowing, and periodically stop breathing while sleeping (a condition known as obstructive sleep APNEA). They also may have a raspy cough after awakening, bad breath, repeated ear infections or sore throats, persistent runny nose, labored and noisy breathing, snoring, or unusual sleep patterns.
Adenoid disorders are hard to detect because of the location of the adenoids, which cannot be seen by looking into the mouth. A special viewing instrument is needed.
In the past surgical removal of the adenoids (ADENOIDECTOMY) and tonsils in children was quite common. Today, before recommending surgery a doctor may ﬁrst suggest waiting to see if a child outgrows the problem. Adenoids grow most quickly during the ﬁrst ﬁve years of a child’s life; after this, they begin to shrink until they disappear by adolescence.
If the adenoid swelling persists, however, the doctor may ﬁrst recommend antibiotic treatment to eliminate possible bacterial infection. If the adenoid problem is caused by respiratory allergies, treatment may ease allergy symptoms and gradually reduce swelling.
If all other treatments fail and a child continues to suffer from an adenoid disorder, the doctor may recommend an adenoidectomy. The operation should be performed only after careful evaluation by an ear, nose, and throat specialist, or otolaryngologist. Most children should not have the operation until they reach school age. If a bacterial infection has occurred, surgery should be delayed until two to four weeks after it has cleared up.
According to the American Academy of Pediatrics, adenoid surgery is recommended if the swollen adenoids interfere with normal breathing or severely impair speech. Adenoid surgery should be considered if a child has had:
• seven severe episodes of STREP THROAT (or sore throat accompanied by high fever, swollen lymph nodes, and pus in the throat)
• ﬁve serious sore throats in each of two separate years, or three serious sore throats in each of three separate years
• swollen glands in the throat for six months or more despite antibiotic treatment
• recurrent EAR INFECTIONS that do not clear up even after treatment
• sleeping problems
Surgical removal of the adenoids. In this procedure, after general anesthesia the otolaryngologist removes the adenoids using a small tool with a basket on the end. Pressure is applied to minimize bleeding but stitches are not necessary. The surgery usually takes less than 30 minutes.
Most of these procedures are done on an outpatient basis. ACETAMINOPHEN (Tylenol, Tempra, Panadol) can ease pain. During recovery, the doctor will recommend a soft, bland diet with no hot, spicy, or coarse foods for about a week. Most children completely recover in two to three weeks, although they should avoid strenuous exercise for about a month. See also ADENOID DISORDERS.