Throat
Adenoid Enlargement
The adenoids are immune tissue located behind the nose, above the visible part of the throat. They are most prominent during childhood and usually shrink as children grow. When enlarged, they can interfere with nasal breathing, sleep and middle-ear function.
What Symptoms Can Occur?
Possible symptoms include:
- Persistent difficulty breathing through the nose.
- Frequent mouth breathing.
- Snoring or noisy breathing during sleep.
- Restless sleep or witnessed pauses in breathing.
- A voice that sounds blocked or congested.
- Recurrent ear problems or reduced hearing.
These symptoms can have other causes, including nasal allergies and enlarged tonsils. An examination helps establish which factors are contributing.
How Can Adenoids Affect the Ears?
The adenoids sit close to the openings of the Eustachian tubes, which help ventilate the middle ears. Enlargement or inflammation in this area can interfere with their function.
Fluid may collect behind the eardrum, a condition commonly called glue ear. This can cause fluctuating hearing difficulties even without an acute ear infection. Hearing concerns are particularly important in children whose speech and language are developing.
How Is Adenoid Enlargement Assessed?
Assessment includes reviewing nasal symptoms, sleep, infections and hearing concerns, together with an examination of the ears, nose and throat.
Unlike the tonsils, the adenoids cannot usually be seen by simply looking into the mouth. A small flexible nasal endoscope may help assess them when appropriate and tolerated.
Hearing tests and middle-ear pressure testing may be recommended if fluid or hearing loss is suspected. Some children with sleep-related breathing symptoms need a sleep study.
Non-Surgical Treatment
Mild symptoms may be monitored, particularly as adenoids often become smaller with age. Treatment may also address associated nasal inflammation or allergies.
A clinician may recommend a suitable nasal spray for selected children. Antibiotics are reserved for appropriate bacterial infections; they are not a routine treatment for enlarged adenoids alone.
The decision depends on symptom severity and their effect on breathing, sleep and hearing, rather than size alone.
When Is Surgery Considered?
Adenoidectomy, the removal of adenoid tissue, may be considered for persistent nasal obstruction, significant sleep-related breathing problems or selected cases of recurrent ear disease and middle-ear fluid.
Depending on the findings, it may be performed alone or alongside tonsil surgery or insertion of ear ventilation tubes. These additional procedures are not necessary for every child.
Surgery is performed through the mouth under general anaesthesia. Many children return home the same day, although some need additional monitoring.
Recovery and Possible Risks
Recovery after adenoidectomy alone commonly takes around one week. Temporary nasal blockage, throat discomfort, bad breath or a change in voice may occur. Recovery differs when other procedures are performed at the same time.
Risks include bleeding, infection and anaesthetic complications. Symptoms may persist, and adenoid tissue can occasionally regrow. Follow the surgical team’s advice about drinking, pain relief and activity.
Any bleeding from the nose or mouth after surgery requires immediate hospital assessment.
Discuss Your Child’s Symptoms
Contact the clinic to arrange an assessment for persistent mouth breathing, snoring, disturbed sleep or hearing concerns. Witnessed breathing pauses should be assessed promptly; severe breathing difficulty requires emergency care.
This information provides general guidance and does not replace an individual medical assessment.
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