Adenoids

The adenoids are lymph nodes located in the back of the throat behind the nose. Lymph nodes make up part of the lymphatic system, which helps the immune system to fight infection. Other lymph nodes are located in many places, including the neck, armpits, chest, abdomen and groin. Along with the tonsils, they form part of the 'first line of defence', which protects the body from infections. Airborne germs entering the body via the nose are filtered and trapped by hairs and mucous in the nose and then most are destroyed by antibodies and white cells made by the adenoids.

In adults, both tonsils and adenoids shrink. However, they can all swell up again with infections.

Swollen adenoids can block the nose

Since adenoids are constantly in the path of germs (micro-organisms), infections are common. Infected adenoids swell, which can reduce the airflow through the nose. Symptoms of infected adenoids include:

• breathing through the mouth
• snoring when asleep
• talking with a 'blocked nose' sound
• the inability to pronounce certain consonants, including 'm' and 'n'
• dry and sore throat because of breathing through the mouth (this is often a problem in the morning after sleeping with the mouth open)
• yellow or green mucous coming from the nose.

Complications of infected adenoids

Infections of the adenoids can cause a variety of complications, including:

• Middle ear infections - the adenoids are right at the end of the tubes from the middle ear to the throat (the Eustachian tubes). Infections can spread up to the ears from the adenoids and cause middle ear infections, which can affect hearing.
• Glue ear - the swollen adenoids block the Eustachian tubes and prevent the normal mucous, which is made each day in the middle ear, from draining away. A build-up of sticky mucous interferes with the movements of the tiny bones in the middle ear, affecting hearing.
• Sinusitis - the air-filled cavities of the skull may also become infected.
• Chest infections - bacteria or viruses can infect other sites, such as the bronchi (bronchitis) or lungs (pneumonia).
• Vomiting - the child may swallow a great deal of pus, generally at night while sleeping, which may be vomited in the morning.

Treatment for infected adenoids

What is done to treat infected adenoids depends on whether the child is ill or not, and what other effects the infected adenoids are causing. For example, if a child has a middle ear infection or sinusitis, and the adenoids are swollen, treatment will be aimed at reducing the pain in the ears. Antibiotics will often be used. If these treatments improve the health of the ear or the sinuses, they will usually help get rid of the infection in the adenoids as well. It is rare for 'infected adenoids' to be the main reason for treatment.

Your doctor may recommend having the adenoids removed (adenoidectomy) if:

• your child has recurrent ear infections, which are interfering with language development
• your child is often unwell
• your child, or an older person, has large adenoids that are interfering with breathing, especially at night.

Adenoidectomy

Surgery to remove the adenoids is done under general anaesthetic. Often, the tonsils are removed at the same time, since recurring infections tend to affect both the adenoids and tonsils. Post-operative complications may include vomiting, difficulties with swallowing, pain and bleeding.

Where to get help

• Your doctor
• Pharmacist
• Ear, nose and throat specialist

Things to remember

• The adenoids are lymph nodes located in the throat behind the nose.
• Infected adenoids can cause other health problems, including middle ear infections, sinusitis and difficulty with breathing, especially at night.
• Infected adenoids are rarely treated by themselves. Treatment is determined by the other health problems caused by the infected adenoids.