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. A doctor has to use a small mirror or a special scope to get a peek at your adenoids.
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 also called nasopharyngeal tonsils but are separate from the tonsils in the throat — filter out bacteria and viruses entering through the nose and produce antibodies to help the body fight infections.
Some doctors believe that adenoids may not be important at all after you reach your third birthday. In fact, adenoids usually shrink after about 5 years of age, and they often practically disappear by the time you're a teen.
What Are the 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
- stopping breathing for a few seconds while sleeping (called sleep apnea)
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
- listen to your breathing by using a stethoscope
- feel your neck near your jaw
To get a really close look at things, your doctor may even want to take one or more X-rays. If an infection is suspected, your doctor may prescribe oral antibiotics or maybe an injection of penicillin.
When Is Surgery Necessary?
A doctor may recommend surgical removal of enlarged or infected adenoids if they're bothersome and medicine doesn't prevent them from coming back (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
Having adenoids removed is especially important when repeated infections lead to sinus and ear infections. Badly swollen adenoids can interfere with ear pressure and fluid movement, which can sometimes lead to hearing loss. Therefore, people whose infected adenoids cause frequent earaches and fluid buildup may need to get an adenoidectomy as well as ear tube surgery.
And although adenoids can be taken out without the tonsils, if you are having tonsil problems, the tonsils may need to be removed at the same time.
What Happens During the Surgery?
During an adenoidectomy and/or tonsillectomy:
- The patient receives general anesthesia. This means the surgery will be performed in an operating room and monitored by an anesthesiologist, a doctor who specializes in administering drugs to patients during surgery.
- The patient will be asleep for about 20 minutes.
- The surgeon can get to the tonsils and/or the adenoids through the patient 's open mouth — there's no need to cut any skin.
- The surgeon removes the tonsils and/or the adenoids with a series of incisions and then cauterizes (or seals) the blood vessels.
After an adenoidectomy, the patient will wake up in the recovery area. In most cases, the total time in the hospital is 5 to 10 hours. However, patients who have trouble breathing or show signs of bleeding will return immediately to the operating room. And kids under 3 years of age and those with chronic disease, such as seizure disorders or cerebral palsy, will usually stay overnight for observation.
The typical recuperation after a tonsillectomy and/or an adenoidectomy often involves a week or more of pain and discomfort due to the exposure of the throat muscles. Because the throat will be sore for a little bit, the person will probably prefer eating a lot of soft foods, like ice cream, pudding, and soups.
About a week after surgery, everything should return to normal. The cut area will be left to heal naturally, which means there are no stitches to worry about. There's a small chance any tissue that's left behind can swell, but it rarely causes new problems.
After surgery, symptoms typically disappear immediately unless there's a lot of swelling that could temporarily cause some symptoms to recur.
Understanding Enlarged Adenoids
It's important to remember that enlarged adenoids are normal in some people. If the adenoids aren't infected, a doctor may choose to wait to operate because the adenoids may eventually shrink on their own.
Reviewed by: Aaron S. Chidekel, MD
Date reviewed: October 2007