What are the adenoids?

They are fleshy lumps of tissue that are out of sight located at the back of the inside of the nose and at the top of the throat.

Together with the tonsils, they trap and destroy germs that enter the child’s mouth and nose. They are part of the immune system and help to fight infections.

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.

What problems can occur with adenoid?

If the adenoids get infected, becoming swollen and enlarged, they can cause problems such as:

• ear infections — swollen 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 becomes dry, leading to bad breath
• ongoing sinusitis
• difficulty sleeping

If enlarged adenoids block children’s breathing through their nose, they may contribute to obstructive sleep apnoea. This means they occasionally stop breathing for a few seconds and snore in between. The brief stops in breathing can occur a few times each night.

How are adenoid problems diagnosed?

If your doctor thinks your child may have a problem with their adenoids, they will talk to you and your child and examine them. They may also arrange for:

• x-rays or other scans
• a scope, 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

How are adenoid problems treated?

In most children, enlarged or infected adenoids don’t need treatment. Since the adenoids usually shrink and disappear by the teenage years, any adenoid problems will disappear too.

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

However, if symptoms are too severe — such as a child having difficulty breathing or obstructive sleep apnoea — an ear, nose and throat specialist may recommend the adenoids are removed. 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.