What are the adenoids and tonsils?
The tonsils sit on both sides of the throat, while the adenoids are located behind the nose (in the nasopharynx). Both are lymphoid tissues that act as part of the immune system in childhood, and they naturally enlarge between the ages of about 3 and 7. Problems begin when these tissues grow excessively, narrowing the airway, or become a focus of recurrent infection.
Which symptoms matter?
Children with enlarged adenoids most commonly have constant nasal obstruction and mouth breathing during sleep, snoring, restless sleep, frequent upper respiratory infections and prolonged nasal discharge. Enlarged adenoids can also block the opening of the Eustachian tube, causing fluid to build up in the middle ear — which may present as reduced hearing and related speech or attention problems. Tonsil-related problems typically appear as several bouts of tonsillitis a year, difficulty swallowing and pauses in breathing during sleep.
How is the decision for surgery made?
Not every enlarged adenoid or tonsil requires surgery. The decision is based on the severity and duration of symptoms, examination findings, endoscopic evaluation where needed, and hearing tests. In general, surgery comes to the fore in children with observed pauses in breathing during sleep (apnea), frequent recurrent infections, long-standing middle-ear fluid, or early effects on facial and dental development. Where indicated, adenoidectomy, tonsillectomy or both are performed — combined with ear tube placement in the same session when necessary.
After the operation
These operations are performed under general anesthesia and most children go home the same day or the next morning. In the first days, plenty of fluids and soft, lukewarm foods are recommended; acidic, hard and very hot foods should be avoided. A sore throat is normal during the first week. If fever or bleeding occurs, contact your physician without delay. Most children can return to school within a week.
This article is for general information purposes only; please consult your physician for diagnosis and treatment.