Enlarged adenoids


Last Updated December 20th, 2021

What is an adenoid?

Adenoid is also called as nasopharyngeal tonsil, which is a mass of lymphoid tissue found in the posterosuperior wall of the nasopharynx.  It is a pyramidal shaped structure composed of lymphoid tissue. The apex of this pyramid is extended towards the nasal septum, and the base sits on the posterior-most wall of the nasopharynx.  

adenoids tonsilsThe adenoidal surface is invaginated by the number of folds with some crypts.  There is a midline pharyngeal bursa, which is the bursa of Luschka that extends posteriorly and superiorly.  This represents the site of notochordal attachment to the endoderm.  Microscopically, the adenoid is covered by the same epithelium as the respiratory tract, which is called as pseudostratified ciliated columnar epithelium.  

Adenoids receive blood supply from six different arteries namely ascending pharyngeal artery, ascending Palatine artery, tonsillar branch, pharyngeal branch, pterygoid canal, basisphenoid artery.

Adenoids help keep the body healthy by trapping harmful bacteria and viruses which we breathe in or swallow.  They play an important role in fighting infection for babies and little kids. Since adenoids trap germs that enter the body, adenoid tissue sometimes temporarily swells as it tries to fight off an infection.  Some of the problems associated with swollen adenoids include ear infection, difficulty breathing from the nose, bad breath, sinusitis, and difficulty in sleeping.

What are the symptoms of enlarged adenoids

Symptoms of enlarged adenoids are quite common in children and the most common symptoms include:

  • Breathing through the mouth frequently.
  • The nose becomes stuffy or runny without any illness.
  • dry mouth and cracked lips.
  • Noisy breathing.
  • A nasal-sounding voice
  • Frequent or persistent ear infections.
  • Snoring
  • Low-quality sleep with intermittent pauses in breathing during sleep.

Health complications of enlarged adenoids

There are a few health concerns which arise due to enlarged adenoids, which are discussed in detail below:

Adenoiditis:  It is the inflammation of the adenoids, which is caused by an infection.  Bacteria or viruses cause adenoiditis. It mainly affects children below 15 years of age.  Adenoiditis is a very common disease, with approximately 10 million cases reported each year.  The disease spreads through airborne respiratory droplets and saliva.

adenoidsSymptoms of adenoiditis may vary depending on the cause of infection and severity.  Generally, the symptoms include sore throat, stuffy nose, swollen glands in the neck, obstruction of the airways resulting in oral breathing and nasal speech, ear pain, difficulty sleeping and sleep apnea.  Acute Adenoiditis has symptoms that include fever, runny nose, oral breathing, snoring, and pus secretion from the nose.

Breathing Problems:  Adenoids gets enlarged because of infection and enlarged adenoids can interfere with breathing or with the flow of mucus causing breathing problems.

Obstructive sleep apnea:  Obstructive sleep apnea is a type of apnea that occurs when the throat muscles intermittently relax and block the airway during sleep.  This can cause a person to stop breathing for a few seconds and can occur several times each night.  Signs and symptoms include loud snoring, observed episodes of breathing cessation during sleep, excessive daytime sleepiness, awakening with a dry mouth or sore throat, difficulty concentrating during the day, morning headache, experiencing mood changes, such as depression or irritability, nighttime sweating, as well as decreased libido.

Ear infections (otitis): Otitis is a term used for inflammation or infection of the ear.  Enlarged adenoids block the Eustachian tubes, which drain fluid from the ears into the throat.  Since the tubes are unable to drain fluid, they cause repeated ear infections.

Diagnosis of enlarged adenoids

  • Endoscopy:  A small, flexible tube with a lighted camera on the end is inserted into the nose or throat.  The doctor can view the nasal passages and adenoids on a video screen during endoscopy.
  • Magnetic resonance imaging (MRI):  An MRI scanner uses a high-powered magnet and a computer to create highly detailed images of the nasal passages, sinuses, and adenoids.
  • Computed tomography (CT):  A CT scanner takes multiple x-rays, and a computer constructs detailed images of the sinuses, nasal cavities, and adenoids.

Treatment for enlarged adenoids

Treatment of enlarged adenoids depends on how severe the condition is.  If the adenoids are not infected, the doctor may choose to simply wait and see if the adenoids shrink on their own.  Otherwise, doctors may recommend medication, such as a nasal steroid, to shrink enlarged adenoids. However, doctors may recommend removing the adenoids if they continue to cause problems despite treatment with medications called adenoidectomy.

 If the tonsils are also inflamed, the doctor may recommend removing the tonsils. After the adenoids are removed, people might experience a sore throat, may cause minor bleeding, earaches, and a blocked nose. The doctor will then prescribe an antibiotic to protect against any infection and are also prescribed with some mild pain relievers for the first few days.  

A diet is also advised to be followed which include to drink cold, icy drinks, like milkshakes and ice cream, and to avoid any warm foods for at least a week.

Adenoid removal

A detailed medical history of the patient is reviewed before recommending adenoid removal.  Adenoid removal may be beneficial if one or more of the following problems are faced by the patient:

  • Snoring or sleep apnea caused because of enlarged adenoids.
  • Recurring ear infections, which do not respond to antibiotics.
  • A buildup of fluid in the ear and earaches from adenoid swelling.
  • Repeated infection of the adenoids, which do not clear up with antibiotics.
  • Excessive daytime sleepiness because of adenoids.
  • Behavior or learning issues as a result of poor-quality sleep.

How are adenoids removed?

After thorough examination and consent, the patient is placed under general anesthesia during adenoid removal, which means the patient will be sleeping and is unable to feel any pain.  Patients are recommended to avoid all food and drink for several hours before surgery to prevent vomiting during the procedure. Adenoidectomy is begun by placing the patient in Roses position (the patient lies supine with the head falling down over the end of the table).  

The neck is extended by a sandbag under the shoulders and the head is supported on a ring.  Boyle-Davis mouth-gag is inserted. Next, the nasopharynx is examined by retracting the soft palate with the curved end of the tongue depressor and by digital palpation, to confirm the diagnosis.  This helps to assess the size of the adenoid mass and to push the lateral adenoid mass towards the midline.

Next, the adenoid curette is introduced into the nasopharynx till its free edge touches the posterior border of the nasal septum.  It is then pressed backward to engage the adenoids. With gentle sweeping movement, adenoids are shaved off. Generally, the surgery lasts less than an hour, and the patient can go home on the same day if there are no complications. Patients having complications such as trouble breathing may need to stay in the hospital overnight for observation.

Adenoid removal: What are the risks?

Adenoid removal surgery is generally safe and people will have minimal to no complications following the surgery.  However, the possible side effects and risks of adenoidectomy surgery include:

  • Swallowing problems.
  • Fever.
  • Nausea and vomiting.
  • Sore throat.
  • Ear pain.
  • Bad breath.

Adenoid removal surgery recovery

adenoids snoringRecovery from adenoid removal is a bit complicated as compared to undergoing the procedure.  Due to the lack of incision during the surgery, there are no stitches involved. The patient may feel pain or discomfort in the throat, nose, and ears for several days following surgery.  The doctor usually prescribes pain relievers or recommends over-the-counter (OTC) medications to help relieve any pain. In general, the patient recovers from adenoid removal within one to two weeks.

Following instructions can be followed for a safe and early recovery:

  • Prevent dehydration by drinking plenty of fluids.  Popsicles may be helpful if the patient is not drinking enough or feels sick.  Any signs of dehydration should be reported to the doctor immediately.
  • Eating soft foods can help with a sore throat, but drinking is preferably advised than eating.  The patient is likely to start eating normally again after a few days.
  • If the surgery is undergone by a child, keep the child home from school or daycare until they are eating and drinking normally, no longer need pain medicine, and are sleeping well.
  • Strictly avoid airplane travel for at least 2 weeks after surgery.  A mild fever is considered to be normal on the day of surgery, but it is essential to call a doctor if the fever is 102°F or higher or if the patient seems very unwell.  Symptoms of noisy breathing and snoring for up to 2 weeks after surgery is common after adenoid surgery and will usually stop once the swelling subsides.

Are there any side-effects of adenoid removal?

Tonsils and adenoids are part of the immune system and are generally removed in childhood to treat chronic ear infections and obstructed breathing.  Removal of adenoids and tonsils occurs at ages when immune system development is sensitive.

Researchers have found that after tonsil or adenoid removal, there is two to three times increase in diseases of the upper respiratory tract and also a small increase in risks for infectious and allergic diseases.  The study urges caution before scheduling surgery, as it is not always feasible to avoid the operations. Researchers have pointed out that surgery cannot be avoided to treat chronic or recurring conditions.

Physicians should be aware of the possible health consequences of tonsil and adenoid surgery and continue to follow the protocol such as avoid operating on children unless there is a clear need.  Children who are considering having their tonsils out for frequent throat infections are recommended to discuss with their doctor so that watchful waiting can be considered because many children get better over time on their own.


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Labiaplasty Labiaplasty is a surgical procedure to modify the labia minora and the labia majora. Learn about who can…
cytomegalovirus igm test
Cytomegalo Virus (CMV) – IgM Test The CMV antibodies include both IgM and IgG antibodies which are the immune system's response to a CMV…
tonometry
Tonometry Tonometry uses a device called tonometer to measure the pressure inside the eye. This pressure is depends upon…
Coconut sugar: What is it and is it healthier than table sugar? In the long list of things that the wonderful coconut gives us, coconut sugar is another remarkable addition.…
black seed oil benefits
Black Seed Oil: What secret benefits could it bestow on your health? Black seeds or nigella seeds are tiny packets of health brimming with amazing benefits. Find out why should…
Aphasia brain scans
Neuroendoscopy Neuroendoscopy is a minimally-invasive surgery used to treat disorders of brain, spine, head, etc.
shiitake mushrooms healthy
What are Shiitake Mushrooms and why should you eat them? Shiitake Mushrooms are well known for their smoky and robust taste. However, did you know they are replete…
Gynecomastia or male breast enlargement
Gynecomastia Gynecomastia is the enlargement of the male breasts. Learn about the treatment options, surgeries, and post-op care for…
Ear pain model
Easy and safe tips for ear wax removal you can do at home Cerumen impaction generally occurs when an external object like cotton swabs are used to remove the ear wax.…
The science behind daith piercing: Can it really cure migraine? Since the ear has several pressure points, it is believed that daith piercing activates the vagus nerve and…
breast-surgery-2
Breast Augmentation Breast augmentation is a surgical procedure done to alter the shape and size of the breast. It uses…
Low carb diet
8 appetizing and mouth-watering recipes that every low-carb dieter should try Looking for delicious recipes that will fix your hunger pang without adding those pesky carbs? Look no further…
Threatened abortion
A few facts about threatened abortion A threatened miscarriage indicates an early pregnancy loss. Look out for symptoms like bleeding, vaginal discharge, and pain.
social media adddiction
Your health in the age of Social Media: Why is digital detox a necessity? Did you know that more than 400 million people are dangerously addicted to social media? Are you one…
Sputum test Sputum test is a commonly used diagnostic tool that is used to examine the presence of pathogens in…
Urologist: When should you visit one and why? A urologist can treat not only genitourinary problems of both men and women but also can treat various…
stress depressed anxiety
Are you depressed or just stressed? Know when to see a doctor Why are some people more anxious than others? Is being depressed the same as feeling sad? Have you…
CBC blood test
CBC (Hemogram 6-part diff) blood test CBC (Hemogram 6-part diff) blood test refers to the test that measures the number of RBCs, WBCs, etc…
stain blood
Blood in your stool Know the reason for blood in your stool, toilet bowl or tissue and the important steps to take…
post circumcision
Circumcision Check to know everything about open , laser, stapler circumcision, and about preparation, procedure, risks, benefits , and…
Is bronchitis contagious? And how to prevent this infection? It is acute bronchitis that is contagious which means you can contract it from another person or you…
hYdroxycut pills
Hydroxycut: How safe are these so-called weight loss supplements? Hydroxycut is a blend of several different ingredients formulated to promote weight loss; powered by a key weight…
Grass-fed meat
Facts about grass-fed meat Grass-fed meat has a rich source of vitamins, minerals, and are low in fat and cholesterol. They are…
blood elements analysis
Blood Element Analysis Test A blood element analysis is a blood test performed to measure the level of toxic elements such as…
gallbladder diet tomato
Gallbladder surgery :Tips on post-operative care and diet What to eat post a gallbladder surgery? What are the key things to avoid if you had a…
Vitamin b12
Vitamin B12 Test Vitamin b12 is an essential nutrient required for healthy functioning of the nervous system and also development of…
Gatorade: Top things you need to know about this staple energy drink Gatorade is a popular (in fact the most popular) energy drink worldwide. But this power-packed drinks comes with…
blood ketone test
Blood Ketone (D3HB) Test The Blood Ketone Test measures and monitors the levels of ketone in the blood which is usually performed…
liver detox facts
7 liver detox facts and why ignoring these could kill you! Are you taking care of this organ that handles over 500 different vital functions in your body? Your…
Astaxanthin: Why experts believe it could be 550x more potent than vitamin E! What is astaxanthin and why is this new supplement on the block touted as the most powerful antioxidant…
amylase test
Amylase Test Amylase test is done by checking the level of this protein in the blood sample and also in…
complement c4 test
Complement 4 (C4) Test The Complement 4 or C4 test measures the level of the protein in the bloodstream, and is primarily…
ureteroscopy
Ureteroscopy Ureteroscopy is the diagnostic procedure which is used for the detection of the kidney stones in addition to…
Barium-enema
Barium Enema Barium enema is also known as colon x-ray. Here, the patient is asked to consume small amount of…
Ca 19.9 test
CA19.9 Test CA 19.9 is a cancer antigen that exists on the surface of cancer-causing cells. The levels of CA…
piles
Best treatment for piles in Bangalore All you need to know about piles and piles treatment in Bangalore - the types of treatment available,…
Shilajit: A miracle Himalayan herb for an active and happy life The Himalayas contain more wonders than you thought. Shilajit is a miracle herb that is widely used in…
Tamarind: The top health benefits of this staple Asian ingredient Did you know this sweet and sour pulpy fruit does more than just add a tangy flavor to…
Cordyceps: How the Caterpillar fungus works as a proven cancer-shield Strange as it may sound, but cordyceps or "caterpillar fungus", a fungus variety native to the Himalayas may…
Paleo snack
Paleo snacks Paleo snacks are healthy diet options that emphasize fresh foods and eliminate processed foods, dairy products, and sugar.
edamame
Edamame: How healthy are these green baby beans? Edamame or "immature" soybeans are soft and easily digestable forms of soybeans that are great as an eveyday…
Low fat diets
A complete list of low-fat diets and how to follow them Low-fat diets help you lose weight in a healthy way, but it works only with regular exercise and…
CEA_test
Carcinoembryonic antigen (CEA) test CEA or carcinoembryonic test detects the presence of CEA antigen in your blood mainly & determines the effectiveness…
vdrl test syphilis
VDRL Test The VDRL test is a blood test that is used to diagnose sexually transmitted or venereal diseases, primarily…
Pelvic_ultrasound
Pelvic Ultrasound Pelvic ultrasound is a process where sound waves are used to create image of your pelvic region organs…
about mediterranean diet
Why you should be adopting a Mediterranean style of diet today Ever wondered why the Mediterranean diet is so healthy? One simple solution to lowering risk of several deadliest…
How can Kegels help you overcome weak pelvic muscles & incontinence? Kegel exercises are pelvic floor strengthening exercises that can help you overcome incontinence issues that rise out of…
avocado benefits
Avocado: 15 reasons why this fruit should be a staple in your diet Did you know that the word avocado literally means "testicles". Don't get grossed out as this power-packed fruit…
malarial antigen test
Malaria Antigen Test A malaria antigen test is a rapid diagnostic test (RDT) that can detect malarial antigens (proteins) in your…
Is it possible to achieve full body detox with Master Cleanse? Master cleanse is a diet consisting of a lemonade based beverage, a salt water drink and a herbal…
Sushi: health benefits and recipes Sushi is a traditional Japanese dish prepared with vinegared rice served with fish (often raw), vegetables, and other…
botox injection
Botox: Top things you should know before undergoing the procedure Botox is technically a toxic compound that is widely used in cosmetic procedure. But in addition to wrinkle-reduction,…
antiHEV IgM test
Anti hepatitis E virus (Anti HEV) IgM Test Anti HEV IgM test determines the level of the IgM antibodies in the blood, The disease is often…
free thyroxine ft4
Free thyroxine test (FT4) The FT4 or free thyroxine test is used to detect the level of free thyroxine of FT4 thyroid…
How to scrub away stress and fatigue with an Epsom salt bath? Epsom salt is a popular home remedy for many skin ailments. Though there is a lack of scientific…

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