Adenoiditis and Adenoid Hypertrophy
If your child is dealing with recurring ear infections, chronic congestion, snoring, sleep apnea, or hearing problems, their adenoids may be the culprit.
Most parents have never heard of adenoids, even if they’re familiar with tonsils or tonsillitis, and that’s completely normal. These small but mighty structures rarely come up in conversation until there’s a reason to pay attention to them.
If your child is showing any of these symptoms discussed here, it may be time to visit your local ENT specialist to get some answers.
Below, we review the common problems associated with adenoids in children, including adenoiditis and adenoid hypertrophy.
But first, let’s review what the adenoids are, where they are located, and why their healthy function is important for children.
What are Adenoids?
The adenoids are a mass of lymphatic tissue located at the back of the nasal cavity, right where the nose meets the throat.
The adenoids aren’t an organ, but instead operate as part of the immune system and are a type of lymphatic tissue or lymphoid organ. As they are part of the immune system, they help protect the body by trapping bacteria and viruses that enter through the nose and mouth.
Adenoid function is most active and relevant during early childhood, typically growing between birth and age 6, as this is a period of time when children are exposed to more bacteria and viruses and need extra help defending against them.
As children age into the teenage years, the size of the adenoids gradually shrinks until they largely disappear in adulthood.
Where are the Adenoids Located?
The adenoids sit at the back of the nasal cavity, where the nose meets the throat (the nasopharynx). They are part of Waldeyer’s ring, a ring of lymphoid tissue that also includes the tonsils, and form a key part of the body’s first line of immune defense.
Because of where they sit, in the back of the nasal cavity, it is hard to see them just by opening your mouth, unlike the tonsils, which are visible at the back of the throat.
To see them, a physician can look with a flexible camera through the nose to this area, or may use an x-ray.
Adenoids are not the same as tonsils. Adenoids and tonsils are both made of the same type of tissue (lymphatic tissue) and both are part of Waldeyer’s ring. So they’re in the same family, but they are separate structures in different locations.
Why Adenoid Function Matters in Children
Adenoids are extremely important in children because they support immune function and breathing. However, similar to the tonsils, they can become infected and inflamed.
Immune Function
Adenoids trap and filter bacteria, viruses, and other pathogens entering the nose and mouth. In particular, they produce antibodies and activate immune cells (lymphocytes) to fight infection.
They are most active and important in early childhood (ages 2–6), when the immune system is still developing.
Respiratory Role
Healthy adenoids allow for normal nasal breathing. To do this, they filter, warm, and humidify air before it reaches the lungs. They also help with proper facial and jaw development.
Adenoiditis
Adenoiditis is a common problem that regularly affects the adenoids and young children.
What is Adenoiditis?
Adenoiditis occurs when the adenoids become infected or inflamed. Typically, this is triggered by bacteria or a virus and can act like a bad cold including runny nose, sore throat, fever, and swollen neck glands.
Adenoiditis lingers longer than a common cold and can last for weeks or months.
How is Adenoiditis treated?
Adenoiditis typically responds to antibiotics taken orally. If antibiotics fail to get rid of the infection, the adenoid tissue may have to be removed through adenoid surgery.
Adenoid Hypertrophy
Adenoid hypertrophy is another major issue that impacts the adenoids and can cause health problems in young children.
What is Adenoid Hypertrophy?
Adenoid hypertrophy is when the adenoids become chronically enlarged, often after repeated infections. It typically occurs when the adenoids are enlarged because of infection, meaning that if your child has adenoid hypertrophy, they are also likely to have an infection.
Adenoids appear larger in children, shrinking as they age. However, if the adenoids become infected, they can enlarge too much and block the passage behind the nose, leading to snoring, mouth breathing, and hyponasal sound to speech.
This may also result in otitis media, or middle ear infections, because the size of the enlarged adenoid can block the eustachian tube (the tube that connects the ear to the throat).
Sometimes the adenoids also act as a reservoir where bacteria remains, giving rise to sinusitis and ear infections.
If you suspect that your child has enlarged adenoids, your pediatric ENT will also rule out tonsil hypertrophy.
Signs a Child’s Adenoids May Be Problematic
Parents typically notice an issue with adenoids when their child develops symptoms.
If a child has a nasal obstruction, causing mouth breathing, and foreign bodies have been ruled out, it could mean that the adenoids are enlarged and blocking the nasal airway.
Chronic mouth breathing can affect facial and jaw development over time if left untreated.
In addition, enlarged adenoids are the leading cause of obstructive sleep apnea in children, which causes breathing difficulties during sleep.
Adenoid issues can also lead to ear infections and hearing loss because they sit close to the Eustacian tubes that drain the middle ear. Enlarged adenoids can block drainage and lead to fluid buildup and ear infections, which can cause temporary hearing loss and pain.
Enlarged or infected adenoids can also be a frequent underlying cause of pediatric sinus infections in children.
Common symptoms of adenoid problems include:
- snoring
- noisy breathing during sleep
- mouth breathing during the day
- frequent ear infections
- hearing difficulties
- recurring sinus infections
- nasal voice
- blocked-sounding speech
- restless sleep/ frequent waking
- behavioral changes
Because of these issues, children with adenoid problems typically have poor sleep, which can contribute to behavioral and learning problems.
Hyperactivity, inattentiveness, and difficulty concentration might actually be symptoms of adenoid problems and not ADHD.
Conservative Treatment Options for Adenoiditis and Adenoid Hypertrophy
The first line of treatment for adenoiditis or adenoid hypertrophy is medicine.
Nasal corticosteroids sprays are conservative, first-line options that reduce inflammation and adenoid size. Antibiotics can be used for acute adenoiditis as well.
If allergies are contributing to the adenoid infections, some pediatricians will recommend management for common allergies or chronic allergic rhinitis, too.
Surgery Options for Adenoiditis and Adenoid Hypertrophy
If your child has been referred to an ENT specialist, adenoid removal may be on the table.
An adenoidectomy is typically considered when a child is experiencing chronic adenoid infections with sinus-like symptoms that haven’t responded to treatment, enlargement of the adenoids causing mouth breathing, nasal blockage, snoring or restless sleep, recurrent ear infections, or persistent sinus infections.
Before any surgery is scheduled, every patient is screened to ensure they are not at an increased risk of developing hypernasal speech, a nasal quality to the voice, following the procedure.
The surgery itself is performed through the mouth under general anesthetic and typically takes around 10 minutes. In many cases, cautery is used to remove the tissue with suction and heat, which results in very little to no blood loss. It is an outpatient procedure, meaning your child will go home the same day.
Adenoidectomy is one of the most common pediatric surgeries performed and has a strong safety record with a quick recovery time.
It is frequently performed alongside tonsil removal or ear tube placement depending on the child’s individual needs.
Research consistently shows meaningful improvements in sleep quality, behaviour, and overall quality of life following surgery.
Treating Adenoiditis and Adenoid Hypertrophy in Michigan
Adenoid health in childhood has a ripple effect on breathing, sleep, hearing, speech, behavior, and development.
What can seem like simple snoring or frequent colds may actually point to an underlying adenoid issue worth investigating, early assessment by your local Michigan pediatrician or ENT at MPENTA can make a meaningful difference in a child’s overall wellbeing.
This information is not intended as a substitute for professional medical care. Always follow your healthcare professional’s instructions. This information was reviewed by ENT professionals.
