Enlarged adenoids are commonly a disease of children. Adenoids are small tissues located at the back of the throat. They are similar to the tonsils, and located right above them, but they are not visualised through mouth. Adenoids are present at birth, and they grow until a child is between the ages of 3 and 5. Normally, they begin to shrink after around age 7. They shrink considerably at the age of 12.
Usually adenoids are supposed to get enlarged in childhood. Certain children have a tendency to suffer from enlarged adenoids enlarged more due to repeated nasal allergy and infection in throat. If it is growing too large then it causes nasal obstruction and or breathing and sleeping problems.
Symptoms of enlarged adenoids
Symptoms related to nose:
Stuffy nose is the common symptom, this leads to mouth breathing. Nasal blockage also interferes with feeding and sucking in a child. Chronic runny nose is usually seen due to obstruction of the inner openings of the nose by enlarged adenoids, as the normal nasal secretion cannot drain through the inner openings of the nose to the throat. Speaking with a nasal sound due to nasal obstruction If adenoids get infected, bleeding from nose can occur with nose blowing. Because of blocked nose, child cannot smell properly and loses appetite. Enlarged adenoids narrows the airway and make the breathing difficult, resulting in snoring, restlessness during sleep, pauses in breathing for a few seconds at night may indicate sleep apnea.Symptoms related to ear:
Blocked feeling of either or both ears, as hugely enlarged adenoids can block the openings of a tube situated in nasopharynx (An area above the uvula and behind the nose) which connects middle ear to nasopharynx. The tube called Eustachian tube. The openings of these tubes in the nasopharynx are to maintain the balance of middle ear air pressure with atmospheric air pressure. Pain in either or both ears is another symptoms due spread of infection to middle ear via Eustachian tube. Deafness is a late symptom of enlarged adenoid. It is caused by blocked Eustachian tube opening which in turn causes collection of fluid in the middle ear, as through a patent Eustachian tube fluid in the middle ear is supposed to be drained out. Due to deafness, a child becomes inattentive in the class and gradually it hampers the performance in school.Longstanding cases:
Chronic nasal obstruction and mouth breathing lead to a characteristic facial appearance called adenoid facies. This child has an elongated face with dull expression, open mouth; prominent and crowded upper teeth, hitched up upper lip and pinched nostrils.
Adenoids can affect
Adenoid enlargement also affects throat. Infected nose results secondary throat infection which may involves tonsils, pharynx and larynx. Enlarged Adenoid with symptoms increase energy expenditure for breathing and reduces food intake which in turn may cause physical growth retardation. The child becomes small size and thin. Due to obstruction of airways, Children with enlarged adenoids usually snore and have sleep apnea. This leads to a poor quality sleep or deprivation of sleep and thus hampers the growth hormone production which only occurs during sleep. Enlarged adenoids will cause Eustachian tube obstruction. This causes fluid to build up in middle ear. This fluid acts as good cultural medium for bacterial growth and acute infection with pus formation occurs. Accumulation of pus in the middle ear can cause perforation of tympanic membrane. If pus in the middle ear is treated with antibiotic, the pus becomes sterile and remains in the middle ear which resulting a disease called glue ear. Adenoid enlargement with snoring, sleep deprivation and sleep apnea causes reduced oxygen and increased carbon dioxide level in the blood which can cause cognitive, academic, intellectual and behavioral problems. Long-standing nasal obstruction due to enlarged adenoids can cause pulmonary hypertension.How are enlarged adenoids diagnosed?
A child with enlarged adenoids can be assessed by taking history and proper clinical examination. Finally an x-ray easily reveals the size and extent to which air way has been compromised.
What about treatment?
When symptoms and signs are marked, affects ears or causing facial deformity then removal of adenoids is advised.
Otherwise child can take medication for symptomatic relieve.