What are the adenoids?

Adenoids are composed of immune tissue that lies behind the nose, and are not directly visible from the mouth. Together with the tonsils they form a ring of tissue that encircles the back of the throat. In children, they are large, but as time progresses they decrease in size, so that by the time they are teenagers they are mere remnants. Once again, removing them does not seem to compromise the body’s ability to fight infections.

Figure 1. The adenoids are purple in this slice through the head showing the nose and tongue.

What trouble do adenoids cause?

The adenoids can be so large in children, that it obstructs their breathing through the nose. As a result, they have to breath continuously through the mouth. Children with large adenoids tend to snore. When the adenoids get inflamed they can also cause a runny nose. They can also block the Eustachian tube, which is the tube which helps drain secretions from the middle ear into the back of the nose. This means that children may get glue ear which reduces their hearing.

How do we remove the adenoids?

We often remove the adenoids at the same sitting as doing a tonsillectomy or putting in grommets. When you are asleep, we open the mouth with a metal retractor, and feel for adenoids behind the nose with a finger. If they are large we can remove them by scraping them out using a metal instrument or using a special electric current device (diathermy) to burn whilst using a mirror to visualize behind the nose.

Recovery and complications

The recovery is the same as that for tonsillectomy, with the exception that it may be less painful to eat if the tonsils are kept. You may expect the nose to be more runny initially in the first six weeks following the operation and then things tend to settle down. Once again, it is possible to get bleeding from the area of the operation. Just occasionally, we will have to insert some gauze behind the nose to stop bleeding for 24 hours, if you come back to hospital with bleeding.

Follow up

We don’t generally tend to follow up children that have this operation done, unless pre-operatively they had trouble with stopping breathing when asleep.