Adenoids

The adenoids are fleshy lumps of tissue that are located at the back of the inside of the nose and at the top of the throat. They are out of sight, so you can't see them when your child opens their mouth.

Everyone is born with adenoids, and they are biggest when children are around 3 to 5 years old. They start to shrink when children reach around 5 to 8 years of age. They are usually gone altogether by the time children become teenagers.

Together with the tonsils, the adenoids' function is to trap and destroy germs that enter your child's mouth and nose. They are part of the immune system and help fight infections.

Enlarged adenoids can cause or contribute to problems such as:

• ear infections — enlarged or inflamed adenoids can block the tubes that drain the middle ear, causing fluid to build up in the ear (glue ear), which can lead to infections and hearing problems
• difficulties breathing from the nose — this can cause children to breathe through their mouth, which may become dry and/or cause bad breath
• ongoing sinusitis
• difficulty sleeping

If enlarged adenoids block children's breathing through their nose, they may contribute to obstructive sleep apnoea (OSA). This means they have brief pauses (apnoeas) in their breathing during the night for a few seconds. They may also snore. The pauses in breathing can occur a few times each night.

OSA in children is different to OSA in adults. If significant and untreated, OSA in children may affect your child's growth and development.

If your doctor thinks your child may have a problem with their adenoids, they will ask about your child's symptoms and do a physical examination.

They may also refer your child for:

• x-rays or other scans
• nasal endoscopy, where a thin, flexible tube with a lighted camera on the end is inserted into the nose or throat to look at the nasal passages and adenoids
• a sleep study, if your child's sleep is affected

In most children, enlarged adenoids don't need treatment. Since the adenoids usually shrink and disappear by the teenage years, most adenoid problems will also resolve.

Enlarged adenoids are rarely treated, but your child may get antibiotic treatment for related infections, such as ear or sinus infections.

However, if symptoms are very severe — such as your child having difficulty breathing or obstructive sleep apnoea — an ear, nose and throat (ENT) specialist may recommend the adenoids are removed (adenoidectomy). Your doctor may also suggest removing the adenoids if your child has repeated middle ear infections.

Sometimes, children who are having their tonsils removed will have their adenoids removed at the same time.

For more information about adenoidectomy (the surgical removal of adenoids) see the Sydney Children's Hospitals Network website.

Call healthdirect on 1800 022 222 at any time to speak to a registered nurse (known as NURSE-ON-CALL in Victoria) for more information and advice.