Adenoids
Adenoids are a deposit of lymph node-type tissue deep behind the nose. Our body has lymph tissue on all internal linings that contains immune cells to fight infections.
Are adenoids and tonsils the same?
Adenoids and tonsils are made up of the same type of tissue and carry out the same function, which is protecting the body from infections that enter through the mouth and nose by examining particles and proteins that are ingested through breathing, eating or nasal secretion. The difference is their location: adenoids are behind the nose, while tonsils are located either side of the throat at the back of the mouth.
What issues can occur in the adenoids?
Adenoids can become infected, often due to repeated exposure to viruses or bacteria, particularly in very young children whose immune systems are still developing. Infection causes adenoids to swell, which can also occur through allergies. While the swelling will sometimes go down by itself, on other occasions the adenoids will remain enlarged.
Enlarged adenoids can become a problem for children when the adenoids completely block the back of their nasal passages, and children cannot breathe or manage their nasal secretions or mucus.
What are the symptoms of enlarged adenoids?
Children with a chronic adenoid infection will have constant green snot dripping from the front of the nose, and a completely blocked nose. Children with large adenoids often snore and sleep with their mouth open, and sometimes the condition will also impact their ability to chew and swallow.
What is adenoids face?
Adenoidal facies, otherwise known as “adenoids face”, is a medical term that describes the appearance of an older child of around 10 who has a very flat midface and often dental crowding and jaw misalignment as a result of never having been able to close their mouth to breathe. This occurs when the adenoids completely block the nose, forcing the child to breathe through their mouth and sleep with their mouth open, which significantly affects the development of their midface.
How are enlarged or infected adenoids diagnosed?
Issues with adenoids are often apparent on clinical examination. Dr McKenzie can tell that adenoids are the problem because the nose is totally blocked, the child is mouth breathing and the front of the nose is clear, or there is excessive persistent nasal mucus discharge. Adenoids can also be diagnosed as being enlarged on X-ray or by nasal endoscopy, which is a camera that looks through the nose to determine if there is a blockage and how it is treated.
Surgery to remove adenoids
Adenoid hypertrophy (enlarged adenoids) and infection do not tend to respond to topical or antibiotic treatments. The only treatment that is effective is surgical removal of adenoids, known as an adenoidectomy.
Adenoids are removed during an operation under an anaesthetic. The adenoids are scooped out through the mouth so there are no cuts on the outside skin. The bleeding is healed with cautery, meaning heat will be applied with a special instrument.
When should an adenoidectomy (adenoids removal) be performed?
An adenoidectomy is recommended when the adenoids are repeatedly infected or enlarged enough to cause ongoing problems, such as mouth breathing, frequent ear infections, sinus infections or sleep issues.
Further information about adenoid surgery
Will adenoid removal result in more infections?
Adenoid removal dramatically decreases the frequency of ear infections and decreases the severity of symptoms of passing viruses, as the nasal secretions are able to drain freely down the back of the throat as they are supposed to.
Adenoidectomy recovery
Adenoid removal is performed as a day procedure and has a very straightforward recovery. Usually only simple pain relief like paracetamol and ibuprofen is required, and children can usually return to childcare or school after 48 hours.
Where does Dr McKenzie operate?
Dr McKenzie operates at Brisbane Private Hospital in Spring Hill, Mater Children's Private Hospital in South Brisbane, and Greenslopes Private Hospital in Greenslopes for paediatric patients.
These hospitals all offer excellent paediatric nursing care support, and Dr McKenzie only uses specialist paediatric anaesthetists for your child’s procedure. This means that you can be assured that your child is in the safest possible hands as it takes a dedicated and comprehensive team of specialist nurses and doctors to safely provide paediatric ear, nose and throat surgery. Dr McKenzie has chosen these hospitals based on their ability to provide the highest level of care to your child.
What are the risks of surgery versus the risk of not removing the adenoids?
While all surgeries carry some risks, these are well understood and carefully managed by specialist doctors and nurses. It’s important to remember that leaving a chronic condition untreated can lead to worsening health problems that may become more difficult to treat over time. Dr. McKenzie will only recommend surgery when the expected benefits clearly outweigh the potential risks.
Are there alternatives to surgery?
Doctors may try alternatives such as antibiotics to treat infection, or nasal steroid sprays to reduce swelling. However, the relief provided by these treatments is often temporary. If the adenoids remain enlarged or infections keep returning, surgery is the only effective option.
Tonsillectomy and adenoidectomy - adenoids and tonsils removal
In the care of children and the treatment of sleep-disordered breathing, adenoids and tonsils almost always need to be removed together. This procedure is called an adenotonsillectomy. Dr McKenzie will decide whether an adenotonsillectomy is required based on a child’s specific symptoms and needs.
Adults with adenoids
Adults do not tend to have prominent adenoids, although they are occasionally seen. In people who do not have any allergies, the adenoids will usually reduce in size and disappear by age 15. When adults have adenoids present, they usually also have other nasal inflammatory conditions, which requires nasendoscopy (a camera inserted through the nose) and assessment by an Ear, Nose and Throat specialist like Dr Mckenzie.
Adenoids and grommets
Adenoidectomy is often performed in conjunction with insertion of grommets, particularly if the child has needed a second set of grommets. This is because there is evidence that removal of adenoids reduces the number of ear infections and hence reduces the subsequent requirement for repeated insertion of grommets.
Can adenoids grow back?
Adenoids can regrow as they do not have a capsule – a thin layer of tissue that separates them from the surrounding tissue – to facilitate complete anatomical removal. The regrowth rate is about 10-15%. If a child has an adenoidectomy at a very young age or they have ongoing hayfever or other nasal conditions, then the adenoids can return and continue to be a cause of nasal obstruction. Dr McKenzie can advise on the best course of action should a child experience adenoid regrowth.