Adenoids in the Nose and Nasopharynx: Symptoms and Causes

At night in the children's room you can hear someone sniffling, and in the morning the mouth is open. Sound familiar? Then we'll be talking about adenoids: what this tissue is, what happens inside the nasopharynx, why the child breathes through the mouth, and what this has to do with constant ear infections.

What adenoids are, where they are located, and why they are needed

Adenoids are the pharyngeal tonsil — a cluster of lymphoid tissue in the vault of the nasopharynx, that is, high in the throat, just behind the nose. Together with the lingual, tubal, and palatine tonsils, it is part of the lymphoid pharyngeal ring and the lymphatic system. The task is simple and useful: to catch microbes that enter the body through the mouth and nose.

Strictly speaking, an "adenoid" is already a pathologically enlarged pharyngeal tonsil. Parents say "adenoids in the nose," although anatomically they are higher and deeper, in the nasopharynx. You cannot see them by looking into the mouth: on a routine throat examination this tonsil is not visible, and special instruments are needed.

Why adenoids enlarge and become inflamed

There are several causes, and infection is not always to blame. Sometimes a child is born with already enlarged adenoids. More often the tissue grows when the tonsil tries to cope with an infection — and it may remain enlarged after the infection has gone.

The development of adenoids is promoted by diseases that cause inflammation of the nasal mucosa and tonsils: measles, scarlet fever, influenza, and acute and chronic inflammatory diseases of the upper respiratory tract. If inflammation is added to the enlargement, this is called adenoiditis — it can be acute, subacute, or chronic and manifests with fever and a sharp impairment of nasal breathing.

Main signs of adenoids: nasal congestion and other symptoms

What happens inside: the nasopharynx is blocked, air does not pass through the nose, and the child switches to mouth breathing. At first this is noticeable only at night — sniffling, snoring, then during the day as well. Mouth breathing causes dry mouth, bad breath, cracked lips, and a runny nose.

• congestion and mouth breathing, especially during sleep;
• snoring, sniffling, restless sleep;
• morning cough — sometimes the only symptom;
• mucous or purulent nasal discharge, dry cough;
• gradual hearing loss.

Nasal discharge is possible but is not named as an obligatory sign; the main symptom is difficulty with nasal breathing. The degrees are described by how much the tonsil closes the nasal passages: the first — the upper part, the second — about two-thirds, the third — almost the entire space.

Adenoids, allergy, runny nose, and sinusitis: how they are connected

The connection is two-way. Inflammation of the nasal mucosa and tonsils promotes the growth of adenoids, and enlarged adenoids can cause nasal congestion and a runny nose.

Typical complications of adenoids are related to the patency of the nasopharynx: these are various forms of sinusitis, including maxillary sinusitis and frontal sinusitis. Hearing loss and ear infections occur due to impaired patency of the Eustachian tubes. The connection between adenoids and allergy is not described in the reference material; why the nose is blocked — because of adenoids, inflammation, or other causes — is determined by a doctor.

Until what age adenoids grow and when they shrink

Usually adenoids begin to shrink at about after 5 years of age, and by the teenage years they almost completely disappear: by that time the body has other ways to fight microbes. Most often, enlarged adenoids are found in children aged 3–7 years.

How adenoids are diagnosed and when a doctor is needed

The doctor asks about symptoms, examines the ears, throat, and mouth, and palpates the neck. Adenoids sit higher than can be seen on examination of the mouth, so their size is assessed with a special mirror, a flexible tube with a light (endoscope), or an X-ray. Endoscopy is considered the "gold standard"; there are other methods as well — digital examination, computed tomography, posterior rhinoscopy.

It makes sense to see an otorhinolaryngologist if the child snores and breathes through the mouth, coughs in the mornings, hears poorly, frequently catches ear infections, or has prolonged congestion. Next, the doctor decides whether observation is sufficient or removal of the adenoids is discussed.

Enlarged adenoids alone are not a reason to call an ambulance; 103/112 — if the child has difficulty breathing, cannot swallow or speak, and swelling in the mouth and throat is increasing.

This material is for reference and does not replace a doctor's consultation.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer