What are adenoids?
Adenoids are similar to the tonsils. The adenoids are made up of lymph tissue and are located in the space above the soft roof of the mouth (nasopharynx) and cannot be seen by looking in your child's nose or throat. Adenoids also help to fight infections. Adenoids may cause problems if they become enlarged or infected.
Adenoiditis is when the adenoids become inflamed from infection.
What are the symptoms of adenoiditis, or enlarged adenoids?
The symptoms of adenoiditis vary greatly depending on the cause of the infection, and can occur either suddenly or gradually. The following are the most common symptoms of adenoiditis. However, each child may experience symptoms differently.
Symptoms may include:
- Breathing through the mouth
- Noisy breathing
- Nasal speech
- Periods at night when breathing stops for a few seconds
The symptoms of adenoiditis may resemble other conditions or medical problems. Always consult your child's physician for a diagnosis.
Treatment for adenoiditis
Specific treatment for adenoiditis will be determined by your child's physician based on:
- Your child's age, overall health, and medical history
- Extent of the infection
- Type of infection
- Your child's tolerance for specific medications, procedures, or therapies
- Expectations for the course of the infection
- Your opinion or preference
Your child's physician will decide the best treatment for your child. Treatment depends on the cause of the infection, the severity of the infection, and the number of times the child has developed infections. Your child's physician may order antibiotics to help with the infection.
Some children may be referred to an ear, nose, and throat surgeon to have the adenoids removed. This surgery is called a adenoidectomy. Often, the tonsils and adenoids are removed at the same time, but, sometimes, only one is removed. Your child's physician will discuss this with you.
What are the reasons to have a adenoidectomy?
The reasons for this surgery are not well defined, and many surgeons differ in their views. The following are some of the more widely accepted reasons for having a adenoidectomy:
- Sleep apnea, or periods at night when your child stops breathing
- Trouble swallowing
- Tumor in the throat or nasal passage
- Bleeding from the tonsils that cannot be stopped
- Significant blockage of the nasal passage and uncomfortable breathing
The following are adenoidectomy Guidelines from the American Academy of Otolaryngology:
- Seven sore throats in one year
- Five sore throats in each of two years
- Three sore throats in each of three years
The sore throats may be associated with the following:
- Fever above 101º F
- Discharge on the tonsils
- Positive strep throat culture
The following are additional reasons that are more controversial regarding the removal of the adenoids and tonsils:
- Bad snoring
- Recurrent infections or abscesses in the throat
- Recurrent ear infections
- Hearing loss
- Chronic sinusitis, or infection in the sinuses
- Constant mouth breathing
- Frequent colds
- Bad breath
What happens during adenoidectomy?
The need for adenoidectomy surgery will be determined by your child's ear, nose, and throat surgeon and discussed with you. Most adenoidectomy surgeries are done on an outpatient basis. This means that your child will have surgery and then go home the same day. Some children may be required to stay overnight, such as, but not limited to, children who:
- Are not drinking well after surgery.
- Have other chronic diseases or problems with seizures.
- Have complications after surgery, such as bleeding.
- Are younger than three years of age.
Before the surgery, you will meet with different members of the healthcare team who are going to be involved with your child's care. These may include:
- Day surgery nurses--Nurses who prepares your child for surgery. Operating room nurses assist the physicians during surgery. Recovery room (also called the Post Anesthesia Care Unit) nurses care for your child as he/she emerges from general anesthesia.
- Surgeon--A physician who specializes in surgery of the ear, nose, and throat.
- Anesthesiologist--A physician with specialized training in anesthesia. He/she will complete a medical history and physical examination and formulate a plan of anesthesia for your child. The plan will be discussed with you and your questions will be answered. This surgery requires a general anesthesia.
During the surgery, your child will be anesthetized in the operating room. The surgeon will remove your child's adenoids through the mouth. There will be no cut on the skin.
In most cases, after the surgery your child will go to a recovery room where he/she can be monitored closely. After the child is fully awake and doing well, the recovery room nurse will bring the child back to the day surgery area.
At this point, if everything is going well, you and your child will be able to go home. If your child is going to stay the night in the hospital, the child will be brought from the recovery room to his/her room. Usually, the parents are in the room to meet the child.
Bleeding is a complication of this surgery and should be addressed immediately by the surgeon. If the bleeding is severe, the child may return to the operating room.