What are adenoids? Adenoids are immune tissue located high behind the nose, where they cannot be seen by simply looking into the mouth. They are largest during childhood and usually become smaller with age. When enlarged or repeatedly inflamed, they can affect nasal breathing, sleep and middle-ear function.
Symptoms of enlarged adenoids Possible signs include persistent mouth breathing, a blocked-nose voice, chronic nasal discharge, snoring, restless sleep and pauses in breathing. Enlarged adenoids may block the opening of the Eustachian tubes, contributing to middle-ear fluid, recurrent ear infections or temporary hearing difficulty. Hearing problems can affect speech and school performance.
Causes Adenoids may enlarge naturally as part of childhood immune activity. Repeated infections, allergy and chronic nasal inflammation may also contribute. Size alone does not determine whether treatment is necessary; the effect on breathing, sleep and ears is more important.
Diagnosis Assessment includes the child’s symptoms, sleep history, ear and nose examination and hearing evaluation when required. The adenoids may be assessed with a small flexible nasal endoscope or, in selected cases, imaging. A sleep study may be considered when obstructive sleep apnea is suspected.
Treatment Mild symptoms may be observed because adenoids often shrink with age. Saline care and treatment of allergy or infection may help selected children. Adenoidectomy may be considered when obstruction causes significant mouth breathing, snoring or sleep apnea, or when persistent middle-ear fluid and recurrent ear problems are linked to the adenoids.
Adenoidectomy The operation is performed under general anaesthesia through the mouth, without an external scar. It is often a day procedure and may be combined with tonsil surgery or ear tubes. Recovery is usually shorter than tonsillectomy, but temporary nasal blockage, sore throat, bad breath or a change in voice may occur.
When should a child be assessed? Arrange evaluation for breathing pauses, regular loud snoring, persistent mouth breathing, hearing concerns, delayed speech, recurrent ear infections, poor growth or significant daytime behavioural changes.
This article is for general education and does not replace an individual paediatric ENT assessment.
Frequently Asked Questions
Do adenoids shrink with age?
They usually become smaller during later childhood and adolescence.
Can enlarged adenoids affect hearing?
Yes. They may contribute to middle-ear fluid and temporary hearing loss.
Can they cause sleep apnea?
Yes, particularly when enlarged adenoids combine with large tonsils or other airway narrowing.
Is surgery always required?
No. Mild symptoms may be observed or treated medically depending on the cause.
Is there an external scar after adenoidectomy?
No. The adenoids are removed through the mouth.
This information is for education only and does not replace medical assessment or treatment by a qualified physician.