Enlarged Adenoids and Adenoidectomy
What are Adenoids?
Adenoids and tonsils are often discussed together because they have similar functions as part of the immune system, namely to help fight infection. Adenoid tissue is composed of lymphatic tissue that traps and destroys pathogens in the air that enter the nasopharynx. Adenoid tissue is completely separate from tonsil tissue. Adenoids are located behind the nose and roof of the mouth and therefore not visible on exam without using special instrumentation such as an endoscope or mirror. Enlarged adenoids can be seen on X-ray, but usually the patient's history and symptoms are sufficient to diagnose enlarged adenoids without undergoing diagnostic procedures or tests. Generally, the adenoids shrink with age, disappearing by the teenage years.
Symptoms Associated with Enlarged Adenoids
The adenoid tissue may become swollen and enlarged due to recurrent infections. When the adenoids no longer respond to antibiotics, and remain enlarged, the hypertrophic tissue may continually obstruct the back of the nose. This nasal obstruction causes problems with breathing through the nose, sleeping, and ear infections.
Breathing problems due to adenoid hypertrophy may include breathing through the mouth, noisy breathing, difficulty breathing through the nose, and a hyponasal voice (talking as if the nostrils are pinched). Recurrent nasal infections with drainage can also be a symptom of enlarged adenoids.
Sleep-related symptoms include loud snoring and sleep apnea. The restless and fragmented sleep may result in daytime sleepiness and poor concentration, behavior changes, and sometimes persistent bed-wetting.
Frequent ear infections may also be associated with hypertrophic adenoids. The adenoid tissue is located at the opening of the eustachian tubes in the back of the nose. The eustachian tubes need to remain open and draining to have proper ear function. When the eustachian tubes are blocked by chronically enlarged adenoids, the child may present with middle ear infections or retained fluid in the middle ear. Often, the adenoids will be removed in children who experience recurrent middle ear infections.
Removal of the adenoid tissue (adenoidectomy) is a surgical procedure done under general anesthesia in an operating room. This is a common outpatient procedure, which takes approximately 20 minutes. The tissue is removed through the nose, so there is no need to cut any skin and the area heals naturally so there are no stitches. An adenoidectomy is often done in conjunction with removal of enlarged tonsils or ear tube surgery. Recovery varies depending upon whether additional procedures are included, but generally discomfort from the adenoidectomy resolves after several days. Talk with Dr. Bryan or Dr. Mettman about travel restrictions immediately following an adenoidectomy.