While most of us have heard of tonsils, a related body part, adenoids, are also part of the ears, nose and throat functions. Like tonsils, adenoids are part of the body’s immune system. Adenoids are located behind the nasal passage and help trap germs that enter the body through the nose and mouth.

Unlike tonsils, adenoids usually disappear by adulthood as they begin to shrink when a child is seven to eight years of age. Their function is to trap germs in babies and young children until their bodies develop other ways to fight bacteria, infections and viruses.

Adenoids can become enlarged when they are trying to fight off something. Inflamed adenoids cannot be seen by looking in the child’s throat, but symptoms include:

• Mouth breathing
• Nasal congestion
• Plugged ears/feeling pressure in the ears
• Sleep issues such as:
  • Obstructive sleep apnea (OSA)
  • Snoring
  • Trouble sleeping
• Sore throat

What causes enlarged adenoids?

Inflamed adenoids are caused by:

• Frequent ear infections
• Repeated nosebleeds
• Seasonal allergies
• Upper respiratory infections (the common cold, nose and throat infections)

If your child’s primary care provider (PCP) suspects your child has enlarged adenoids, they may recommend one or more of the following tests depending on your child’s symptoms:

• Bacteria culture test, to determine if the inflamed adenoids are being caused by an infection
• Imaging tests (X-rays, CT scan or MRI)
• Nasal endoscopy, during which a flexible tube with a light and camera is inserted into the nose to see the adenoids
• Sleep study if your child’s symptoms include snoring or OSA

How are enlarged adenoids treated?

Once the cause of the inflamed adenoids is known, it will be treated. For example, if your child’s enlarged adenoids are being caused by an infection, your child’s PCP will likely prescribe an antibiotic. If the cause is seasonal allergies, antihistamines or nasal spray may be recommended. Depending on the cause, your child’s PCP may also refer your child to a pediatric specialist, like an ears, nose and throat physician (an otolaryngologist), pulmonologist or sleep medicine specialist.

When do adenoids need to be removed?

Your child’s adenoids may need to be removed surgically if other treatments are not successful, and your child continues to have inflamed adenoids. Called an adenoidectomy, this surgery is performed by an ears, nose and throat specialist in the hospital under general anesthesia.

An adenoidectomy is done as an outpatient procedure, in most cases, so your child can go home the same day. Most children recover from this common surgery in two to three days.

Will my child get more colds and illnesses if their adenoids are removed?

Similar to tonsils, adenoids are part of the immune system but are not required. In fact, children who have recurrent inflamed adenoids generally have fewer colds and related symptoms once their adenoids are removed. When adenoids are regularly enlarged, they are not able to do their job, resulting in more sore throats, nasal congestion and sleep problems.

Once the problemed adenoids are removed, your child’s immune system finds other ways to find off bacteria to help your child stay healthy. Without the inflamed adenoids causing problems, your child’s immune system can work more effectively.