What in the world are adenoids? As these objects of mystery usually disappear by the time the teenage years hit, you can be forgiven for asking. They’re often talked about in the same breath as tonsils, but they’re actually different things – the adenoids are lymphoid tissue (like tonsils) at the back of the nose, where the nose turns down into the throat airway. Unlike tonsils they can’t be seen by looking in the mirror, but they perform a similar role, fighting off harmful bacteria and viruses by trapping them (nice one, adenoids!). That’s why, if an adenoid issue is suspected in kids, it’s a good idea to investigate. Dr Lynne Lim told us what to look for and what steps to take if you think your little person’s adenoids need attention.
My child is a loud snorer – should I be worried about adenoid issues? What are the telltale signs of a problem?
Children with significantly enlarged adenoids will show symptoms of a blocked airway, such as open mouth breathing or snoring (fun for all the family!). There may be constant throat clearing or mucus trapping in the nose, as the nose secretions that are produced daily are trapped by the adenoid and can’t clear. Some kids are also more predisposed to sinus infections, again because of trapped secretions that also encourage bacterial growth and prevent normal ventilation of the nose.
Some children may have increased middle ear infections because the adenoid compresses or blocks the opening of the Eustachian tube (which connects the middle ear space to the back of the nose), or is a source of retrograde infection to the middle ear. With middle ear infections, the child may exhibit mild hearing loss, inattention to verbal communication, or pain in the ears.
I’m told my child has enlarged adenoids – what should I do?
If adenoid hypertrophy is suspected, the ENT (Ear Nose Throat) doctor will suggest a flexible nasoendoscopy of the nose in the clinic. This is easily done, with no pain, in less than 3-5 minutes, if the child is able to cooperate with the procedure. No special preparation is needed. For children who cannot cooperate with the scope, an x-ray can be done to see if the adenoid is enlarged. If the doctor diagnoses the cause as infection, medication will be prescribed. If it’s a chronic adenoid block, surgery may be needed when medical therapy fails.
If the adenoids have to be removed, what’s involved in surgery? And what’s recovery like?
It’s not as scary as it may sound! Adenoids can be removed under a 15-minute general anaesthetic, via the mouth, without external incisions. Kids can be discharged after three hours, and then eat and drink normally. There’s usually no significant pain, and paracetamol syrup is enough to ease any discomfort. They can get back into their normal activities on the third day after the procedure, but swimming is best avoided for 10 days.
If you’d like to find out more about adenoids, Dr Lim and her team will be happy to help! And, stay tuned for her insights into chronic ear infections and what to do when you want to avoid antibiotics.
Adj Assoc Prof Lynne Lim is Senior ENT Consultant at Mount Elizabeth Medical Centre, Orchard. Her clinic provides a one-stop service for treatment of ear, nose, allergy, snoring, throat and hearing problems for children and adults through a culture of listening, expertise and excellent outcomes. Dr Lim graduated with degrees from NUS (MBBS) in 1992, Edinburgh (FRCS, ENT) in 1996, and Harvard (MPH) in 2005. Her further sub-specialisation Healthcare Manpower Development Program awards were in paediatric ENT, hearing and ears in America and Japan.
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This post is sponsored by Dr Lynne Lim Ear Nose Throat & Hearing Centre (Child & Adult).