Adenoids

Adenoids are lymphoid tissue at the back of the nose, above the roof of the mouth. Like the tonsils, they are part of the immune system in early childhood and usually shrink from about age 5-7. In some children, they become enlarged enough to cause symptoms and may need treatment.

Symptoms of enlarged adenoids

• Mouth breathing — open mouth all day, snoring at night.
• Nasal speech, constant blocked nose.
• Sleep disturbance, restless sleep, bedwetting.
• Obstructive sleep apnoea — pauses in breathing, gasping during sleep, daytime drowsiness.
• Recurrent ear infections, glue ear, hearing problems.
• "Adenoid facies" in severe long-standing cases — elongated face, high palate, dental crowding.

When to see a Health Expert

• Chronic mouth breathing and loud snoring.
• Witnessed pauses in breathing during sleep.
• Recurrent ear infections, persistent hearing loss.
• Poor growth, learning/behaviour problems suspected to be from poor sleep.

Evaluation and treatment

• ENT examination; nasal endoscopy; sometimes lateral neck X-ray or sleep study.
• Trial of nasal steroid spray for 6-12 weeks — helps many children.
• Treat allergies (allergic rhinitis is commonly associated).
• Adenoidectomy — day-care surgery; often combined with grommets if ear fluid, or tonsillectomy if tonsils also enlarged.
• Recovery is fast — most children return to school within a week.
• Regrowth is occasional — sometimes needs re-surgery.

India-specific note

Poor air quality and high allergy rates in Indian cities keep adenoid-related symptoms common. A child with persistent mouth breathing deserves evaluation — it's not "just a phase" and affects growth, teeth, sleep, and learning.