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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tonometry
Tonometry Tonometry uses a device called tonometer to measure the pressure inside the eye. This pressure is depends upon…
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…
complement c4 test
Anemia Profile Anemia Profile test (Basic) is a blood screening test that measures the levels of important components of the…
Thyroid disorders
Thyroid Profile Thyroid profile is a panel of blood tests performed to check if an individual is suffering from any…
colposcopy
Colposcopy Colposcopy is a simple, quick and non- invasive diagnostic tool to look closely inside the vulva, vagina, and…
cancer-389921_1280
Radiation Therapy Radiation therapy or radiotherapy is used to treat cancer. The treatment includes high doses of radiation to destroy…
Jack in the box fast food
Jack In the Box : The perils of surging fast food culture in the USA Jack in the Box - How a culture of fast-food can clog your arteries, weaken your heart, fatten…
iron deficiency profile
Iron Deficiency Profile An iron deficiency profile is a battery of blood tests which are performed in order to determine the…
Love tea, hate tannins? Rooibos tea is just what you need The market is brimming with a multitude of herbal teas. But what makes rooibos tea (or red bush)…
CLA: A breakthrough weight loss supplement with minimal side effects Tried every weight loss supplement in the market with no substantial gain? Why not try CLA supplements, derived…
Barium-enema
Barium Enema Barium enema is also known as colon x-ray. Here, the patient is asked to consume small amount of…
common mental disorders
Common mental health disorders :The silent stigma surrounding millions More than 300 million sufferers and yet a silent and agonizing stigma; why are people still hush-hush about…
amylase test
Amylase Test Amylase test is done by checking the level of this protein in the blood sample and also in…
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…
eating disorder anorexia
Eating Disorders: Lifestyle choice or a psychological condition? Is eating disorder just a harmless bad habit? Or does it represent grim psychological disorders? Do you want…
rosacea-treatment--before-_-after
The best and safest ways to treat rosacea Rosacea is a skin disease that is characterized by reddish hives and rashes on the face. Read more…
Hydroquinone: Is it the best topical treatment for hyperpigmentation? Darkening of the skin due to high melanin levels is called hyperpigmentation.  Hydroquinone interferes with melanin production thus treating…
What is the right way to take a pregnancy test? A pregnancy test is undertaken to determine if you have conceived. A home pregnancy test is the most…
Milk Thistle skin
Milk Thistle: Find possible cures for fatal diseases in these purple blooms Milk thistle is well-known for treating liver conditions. However, did you know that it comes with a plethora…
Cottage cheese: What can you find in this healthy chunk of fresh milk cheese? Love cheese but scared of putting on extra pounds? With cottage cheese, you can get the best of…
Heart diseases patient
Heart Valve Surgery A heart valve surgery is a procedure to replace or repair the diseased heart valves. The most commonly…
Sputum test Sputum test is a commonly used diagnostic tool that is used to examine the presence of pathogens in…
Miracle extract from the root of maca: 10 ways it can help you! Maca root has been used for years in herbal medicine. Today scientific research is unearthing fresh evidence in…
Quinine: How gin and tonic came to be known as a potent health elixir The discovery of quinine-containing tree bark is sometimes considered the most serendipitous medical discovery of the 17th century.
Oxidative Stress: Understanding the most lethal phenomenon happening in your body right now Free radicals cause damage to the body, which is known as oxidation.  The amount of oxidation caused by…
Vitamin K2: 8 reasons why you need this bone-building & cancer-fighting nutrient Vitamin K2 is claimed to be essential for your bone health, for reducing the risk of cancer, and…
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…
Vagus nerve: 7 health benefits of stimulating the “gut-brain” connection As a matter of fact, there are two vagus nerves namely the left and the right but is…
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…
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…
myelogram
Myelography Myelography is an important diagnostic tool that is used to investigate and identify abnormalities in the spine and…
Kava: Is it the healthy substitute for alcohol you have been waiting for? Native to the beautiful South Pacific islands, Kava is a famous beverage rooted in the local culture. It…
GGt test
GGT – Gamma-Glutamyl Transferase Test GGT or gammaglutamyl transferase test is a liver function test that is used to detect the extent of…
angiography
Angiography Angiography is a diagnostic tool used to determine the narrowing or blockage in the arteries and veins supplying…
How can berberine supplements help you live longer and healthier? Berberine is a turmeric look-alike herbal extract that is credited with numerous health benefits ranging from diabetes cure…
nutritional yeast bread
Nutritional Yeast : How can a fungi culture be good for your body? Nutritional yeast: How a simple culture of fungi can transform your skin, digestion, immunity , and much more.…
hidden benefits walking
9 benefits of walking we bet you didn’t know! Did you know walking can be the miracle pill for eternal youth? Everyone knows walking is good for…
Greek Yogurt: Discover the secret ingredient to the real Spartan strength Greek yogurt is probably the tastiest way you can enhance your gut microflora. Read more to find out…
alcohol toxic
7 startling facts that will make you quit alcohol today Does drinking really make you friendly and happy? How many calories does a can of cold beer add…
Potassium healthy
Potassium: How only 100 mg a day can dramatically increase your lifespan! The word potassium comes from the process where wood ashes were stored in pots for extraction. What else…
Blood Disorders cancer
Immunotherapy immunotherapy is a treatment that boosts the body's immune system to identify the cancer cells and fight cancer.
Lung cancer xray
Lobectomy Lobectomy is a surgery where a lobe of the diseased lung is removed. It is mainly done to…
heartfail_2
Open Heart Surgery An open heart surgery is a major procedure performed to treat heart diseases like congenital heart problem, heart…
Tart Cherry: The healthiest excuse for taking that second serving of pie Tart cherry has been traditionally used in delectable desserts such as pies. Recent studies have revealed that its…
These are the top foods to increase your hemoglobin count It is important to add iron-rich foods into your diet in order to increase hemoglobin. Deficiency of hemoglobin could…
biopsy procedure
Biopsy Biopsy is a procedure of studying a live tissue sample collected from a specific organ for diagnosing a…
chloride test
Chloride Test A chloride test of the blood checks the level of chloride in body, an important factor governing the…
Mood swings
The real reasons for your mood swings and how to overcome them Are you prone to heated moods frequently? Do you also feel bouts of depressive feeling creeping up on…
L-theanine attention
L-Theanine: Better sleep, higher focus, and many other benefits Did you know that L-theanine found in green tea can make you sleep better and be focused at…
vdrl test syphilis
VDRL Test The VDRL test is a blood test that is used to diagnose sexually transmitted or venereal diseases, primarily…
What is Qigong and how can it help you channelize you inner “Qi”? Qigong is an integrated way of performing a traditional exercise regimen that can help in promoting health, mental…
Tissue Transglutaminase Antibody (tTG) Test Transglutaminase is an enzyme present in our body and is involved in protein metabolism. A tTg test is…
xylitol gum
Xylitol : Is this the right sugar substitute for you? Discovered during World War 2 owing to sugar shortage, xylitol has become a common name in pharamaceutical industry.…
fructosamine test
Fructosamine Test A fructosamine test measures blood sugar glucose content. Fructosamine level can indicate blood sugar level in past 2-3…
Period sanitary napkin-menstruaion-blood-colors
Period blood – what it says about your health Your period blood color and consistency indicate what is happening in your body. Is your blood bright red…
acne removal tips
Anatomy of acne: 7 instant steps to kiss those zits goodbye Blackheads, whiteheads, or pimples-call them what you may. Acne is never good news.Did you know some of the…
reflexology massage
Top reasons why you should go for a reflexology massage today Reflexology involves the application of pressure to your feet and hands to encourage self-healing. Could this be beneficial…
Bronchoscopy procedure
Bronchoscopy Bronchoscopy is a procedure where in a scope is inserted into the lung pathway to observe any growth…
APL IgM Test
Antiphospholipid Antibody(APL)-IgM test The antiphospholipid antibodies are specific protein in the body directed against the phospholipids. It is used to detect…

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