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Common Infections

Enlarged Adenoids

Often, tonsils and adenoids are surgically removed at the same time. Although you can see your tonsils by taking a mirror and looking in your throat, adenoids aren’t directly visible. Doctors use a special scope to get a peek at the adenoids, and sometimes will order a head X-ray for a better idea of their size.

So, what are adenoids exactly? They’re a mass of tissue, located in the passage that connects the back of the nasal cavity to the throat. Adenoids — which are different from the tonsils — filter out bacteria and viruses entering through the nose and produce antibodies to help the body fight infections.

Adenoids begin to shrink after about 5 years of age. They often practically disappear by the time you’re a teen.

Symptoms of Enlarged Adenoids

Because adenoids trap germs that enter the body, adenoid tissue sometimes temporarily swells as it tries to fight off an infection.

Symptoms associated with enlarged adenoids include:

  • difficulty breathing through the nose
  • breathing through the mouth
  • talking as if the nostrils are pinched
  • breathing noisily
  • snoring
  • stopping breathing for a few seconds while sleeping (called sleep apnea)
  • ear infections or middle ear fluid that might make ear tube surgery necessary

If your doctor thinks you have enlarged adenoids, he or she might:

  • ask you how things feel in your ears, nose, and throat, and then examine these areas
  • feel your neck near your jaw

If an infection is suspected, your doctor may prescribe oral antibiotics.

When Is Surgery Necessary?

A doctor may recommend surgical removal of enlarged or infected adenoids if they’re bothersome and medicine is not controlling the problem (this procedure is called an adenoidectomy).

Surgery may be recommended if a person experiences one or more of the following:

  • difficulty breathing
  • sleep apnea
  • recurrent infections
  • the need for ear tubes

Having adenoids removed is especially important when repeated infections lead to sinus and ear infections. Badly swollen adenoids can interfere with the ability of the body to ventilate the middle ears. This can sometimes lead to infections or temporary hearing loss. Therefore, people whose infected adenoids cause frequent earaches and fluid buildup may need to get an adenoidectomy at the same time as ear tube surgery.

And although adenoids can be taken out without the tonsils, if someone has tonsil problems, the tonsils may need to be removed at the same time.

What Happens During the Surgery?

During an adenoidectomy:

  • The surgery will be performed in an operating room.
  • The patient receives general anesthesia. This means the patient is unconscious (or “asleep”) during the operation, with no sensations, feeling of pain, awareness, movement, or memory of the surgery. Heart rate, breathing, and other body functions are monitored to be sure the person stays safe and healthy during the operation.
  • The surgery usually takes less than 20 minutes.
  • The surgeon can get to the adenoids (and tonsils if needed) through the patient ‘s open mouth — there’s no need to cut any skin.

After an adenoidectomy, the patient will wake up in the recovery area. In most cases, a person can go home the same day of the surgery.

After Surgery

The typical recuperation after an adenoidectomy often involves several days of pain and discomfort.

In less than a week after surgery, everything should return to normal. The area where the adenoids were will be left to heal naturally, which means there are no stitches to worry about.

Reviewed by: Steven P. Cook, MD
Date reviewed: May 2013