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Adenoids

 

Adenoids are similar to tonsils. They are lymph gland type tissue designed to help fight infections. They sit at the back of the nose, above the tonsils. Because they are at the back of the nose, they usually can't easily be seen, unlike tonsils that are visible through the mouth.

It is therefore often difficult for doctors to be certain about how big the adenoids are, or whether they are causing a problem. In older children, the ENT doctor may be able to have a look at the back of the nose with a camera. Younger children are usually too distressed for this procedure, and the doctor therefore makes decisions about treatment based on the problems that the child is experiencing, rather than through knowing exactly what the adenoids look like.

Adenoid enlargement is a problems in younger children, but by the age of 8 years or so the adenoids shrink down, and problems usually resolve.

Adenoids can contribute to the following problems:

-Snotty noses in toddlers: these usually resolve with age, and adenoid removal would not normally be appropriate. See blocked nose

-Obstructive sleep apnoea: This is treated with surgery to remove tonsils and adenoids

-Glue Ear: See Glue Ear

-Blocked nose without sleep apnoea in older children

Adenoidectomy

To remove the adenoids, the surgeon operates through the mouth and through the nose. The risks of surgery include bleeding, infection, a chipped or loose tooth, lip bruising, regurgitation of liquids through the nose when drinking, or voice changes. 

Adenoids at the back of the nose shown in red

The issue of blocked nose and adenoid removal deserves special attention, particularly in relation to what is funded by the NHS. In the past, ENT surgeons would offer adenoid removal if adenoids were the cause of blocked nose in a child aged 8 years or older (or thereabouts). This was on the basis that adenoids should have shrunk down, and if they haven't and are causing problems then surgery was one of the options for parents to consider. We would not usually have offered surgery at a younger age, on the basis that the problem adenoids are likely to just shrink down of their own accord. At present, adenoidectomy is no longer funded by the NHS in most parts of the country, unless obstructed sleep apnoea is present. Therefore, ENT surgeons are no longer able to offer adenoidectomy for blocked nose in children aged 8 years or older.