Merck Manual

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Adenoid Disorders


Alan G. Cheng

, MD, Stanford University

Reviewed/Revised May 2022 | Modified Sep 2022
Topic Resources

Enlarged and inflamed adenoids, common among children, can make breathing difficult and lead to sleep disturbances and recurring ear infections.

  • Enlarged adenoids in children may result from infections.

  • Enlargement usually causes no symptoms but can occasionally cause difficulty breathing or swallowing and sometimes recurring ear or sinus infections or obstructive sleep apnea.

  • The diagnosis is based on nasopharyngoscopy.

  • Antibiotics may be used if a bacterial infection is present, and sometimes, if infections are recurring, the adenoids are removed.

Adenoids are collections of lymphoid tissue Lymphoid organs The immune system is designed to defend the body against foreign or dangerous invaders. Such invaders include Microorganisms (commonly called germs, such as bacteria, viruses, and fungi) Parasites... read more where the nasal passages connect with the throat. They help defend the body against infection by trapping bacteria and viruses entering through the throat and by producing antibodies. The adenoids are largest in children who are 2 to 6 years of age.

Locating the Adenoids

The adenoids are lymphoid tissue located behind the palate, where the nasal passages connect with the throat. The adenoids are not visible through the mouth.

Locating the Tonsils and Adenoids

Causes of Adenoid Disorders

Some preschool and adolescent children have relatively large adenoids that are not due to any problem. However, adenoids can become enlarged because they become infected with a virus or bacteria that cause throat infections (sore throat Sore Throat Sore throat is pain in the back of the throat. A sore throat can be very painful and is usually worsened by swallowing. Many people with a sore throat refuse to eat or drink. Sometimes pain... read more Sore Throat ). Ongoing exposure to children who have bacterial or viral infections, such as children at child care centers, increases the risk of infection. In addition, allergies (such as seasonal allergies or year-round allergies), irritants, and, possibly, gastroesophageal reflux also can cause the adenoids to enlarge. Although extremely rare, cancer sometimes causes enlarged adenoids.

When enlarged, adenoids may block the nose or the eustachian tubes that connect the back of the throat to the ears. Usually, adenoids return to normal size once the cause of the problem is resolved. Sometimes they remain enlarged, particularly in children who have had frequent or chronic infections.

Symptoms of Adenoid Disorders

Diagnosis of Adenoid Disorders

Treatment of Adenoid Disorders

  • Treatment of the cause

  • Sometimes adenoidectomy

If doctors think adenoids are enlarged because of allergies, they may give a nasal corticosteroid spray or other drugs, such as antihistamines, by mouth. If the cause appears to be a bacterial infection, doctors may give antibiotics. If these drugs are not effective or if doctors think they will not be useful, doctors may recommend surgical removal of the adenoids (called adenoidectomy).

Doctors may recommend adenoidectomy for children who have the following:

Adenoidectomy does not seem to decrease the frequency or severity of colds or cough.

Although it requires general anesthesia, adenoidectomy usually can be done on an outpatient basis. Children typically recover from adenoidectomy in 2 to 3 days.

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