Enlarged adenoids

Published by Bupa's Health Information Team, April 2011.

This factsheet is for parents of children who have enlarged adenoids, or for anyone who would like information about it.

The adenoids are small glands at the back of the throat, close to the tonsils. They usually disappear by adulthood. Enlarged adenoids can cause ear and breathing problems in children.

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.

For answers to frequently asked questions on this topic, see Common questions.

For sources and links to further information, see Resources.