Enlarged Adenoids

What are enlarged adenoids?

Adenoids are lumps of tissue on the back wall of the nasal cavity. They are found above the tonsils and behind the nose. Adenoids cannot be seen when looking in the mouth.

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The adenoids are located behind the nose.

Adenoids are made of lymphatic tissue. This tissue helps fight infection. After a recurrent infection, the adenoids can become swollen. This is common and normal. They usually shrink to normal after an infection.

Swollen adenoids that don’t shrink back down after a cold may lead to chronic symptoms. They may block the child’s air passage. They may prevent the middle ears from draining normally.

Adenoids start to get smaller overall around the age of 7 years. They are very small or non-existent by adolescence.

Signs and symptoms of enlarged adenoids

The symptoms may include:

  • severe snoring
  • trouble sleeping
  • sleep apnea: when a child stops breathing for a few seconds while sleeping
  • mouth breathing
  • speech problems
  • nasal voice
  • problems swallowing
  • frequent ear infections


After the first year of life, the adenoids tend to grow as they are part of the body’s immune system. The adenoids filter and fight germs that enter the body through the mouth and nose. The adenoids may become so enlarged that they disturb the child’s quality of life.


The eustachian tubes lead from the ears to the throat. If the adenoids block these tubes, your child may have many ear infections. These may cause middle ear problems and hearing loss.

Sleep apnea is a complication of enlarged adenoids. Some children snore so strongly that it disrupts their breathing. This can cause trouble sleeping. A poor nights sleep may need to poor attention at school, difficulty learning, hyperactivity, or impulsivity.

What you can do to help your child with enlarged adenoids

To prevent a dry mouth, place a humidifier in your child’s room. This will help keep the air more moist. Also, snoring and disrupted sleep can sometimes be avoided when the child sleeps on his side or front.

What your child’s doctor can do to help

The doctor will physically examine your child. She will listen to your child’s breathing. She will feel your child’s neck near the jaw.

Currently, adenoids and tonsils are no longer removed with surgery simply for recurrent infections. If a child has sleep apnea, certain medications may be given. These include decongestants and anti-inflammatories. Antibiotics are not given for this problem. Surgery may be an option if drugs do not work.

The operation is called an adenoidectomy (say: ADD-uh-noy-DECK-toe-mee). Surgery usually helps the child breathe and sleep more easily. The tonsils are sometimes taken out at the same time.

For more information on the surgery, please read this article Adenoid Surgery: Caring For Your Child After the Operation.

Key Points

  • Adenoids are lumps of lymphatic tissue. They are found on the back wall of the nasal cavity. They cannot be seen when looking in the mouth.
  • In some children, adenoids become more enlarged after repeated infections. This is common and normal.
  • Severely enlarged adenoids can lead to fluid in the ear. This can cause mild, temporary hearing loss if left untreated.
  • Surgery to remove the adenoids may be recommended if they are disrupting breathing or sleep.

Mark Feldman, MD, FRCPC


AboutKidsHealth. Health A-Z: Adenoid Surgery: Caring For Your Child After the Operation (updated 2008). http://www.aboutkidshealth.ca/HealthAZ/Adenoid-Surgery-Caring-For-Your-Child-After-the-Operation.aspx?articleID=8461&categoryID=AZ1q Accessed February 22, 2010.

Zhang L, Mendoza-Sassi RA, César JA, Chadha NK. Intranasal corticosteroids for nasal airway obstruction in children with moderate to severe adenoidal hypertrophy. Cochrane Database of Systematic Reviews 2008, Issue 3. Art. No.: CD006286. DOI: 10.1002/14651858.CD006286.pub2. http://www.cochrane.org/reviews/en/ab006286.html Accessed February 22, 2010.