Adenoids are small lumps of lymphatic tissue located high up in the throat, just behind the nose. They are part of the immune system, similar to tonsils, and help trap germs (bacteria and viruses) that enter the body through the nose and mouth, especially in children.

Function and Development

Immune Defense: Adenoids act as a first line of defense, filtering inhaled air and producing antibodies to fight infections.

Childhood Role: They are most prominent in young children (typically reaching their largest size between ages 3 and 5) because their immune system is still developing and learning to fight off various pathogens.

Shrinking with Age: Adenoids usually begin to shrink naturally after about age 5 and are often almost completely gone by the teenage years. By adulthood, they are rarely present or active, as the body develops other ways to fight germs.

Problems Associated with Adenoids

While adenoids are important for immune function in early life, they can cause problems if they become enlarged or repeatedly infected.

Enlarged Adenoids (Adenoid Hypertrophy):

Causes: Can be naturally large from birth, or swell due to frequent infections (viral or bacterial), allergies, or irritation. Even after an infection clears, they might remain enlarged.

Symptoms:

Difficulty breathing through the nose: Leading to chronic mouth breathing, especially at night.

Snoring and restless sleep: Due to blocked nasal passages.

Sleep apnea: In severe cases, where breathing repeatedly stops during sleep.

Nasal voice: The voice may sound "stuffy" or like the child has a permanent cold.

Chronic runny nose.

Recurrent ear infections (Otitis Media): Enlarged adenoids can block the Eustachian tubes (connecting the middle ear to the back of the throat), leading to fluid buildup and infections in the middle ear, sometimes causing temporary hearing loss.

Recurrent sinus infections (Sinusitis).

Bad breath.

"Adenoid facies": A characteristic facial appearance in children who consistently breathe through their mouth, including a constantly open mouth, prominent upper teeth, and a flattened mid-face.

Infected Adenoids (Adenoiditis):

Causes: Bacterial or viral infections of the adenoid tissue itself.

Symptoms: Similar to enlarged adenoids, but often with fever, sore throat, and thick nasal discharge.

Diagnosis

A doctor will usually:

Ask about the child's symptoms and medical history.

Examine the child's ears, throat, and mouth.

Since adenoids are high up behind the nose and cannot be seen by just looking into the mouth, the doctor may use:

A small mirror in the mouth to view them indirectly.

A flexible endoscope (a thin, lighted tube) inserted through the nose to get a direct view.

An X-ray of the side of the face to assess the size of the adenoids.