Enlarged adenoids in children

LIKE the tonsils in the throat, the adenoids are responsible for protecting the body against the invasion of harmful viruses and bacteria which may enter our bodies when we breathe or swallow. However, according to Dr Anona Griffith, paediatrician at Gateway Plaza, Old Harbour, sometimes in their effort to trap germs and fight off infections, the adenoids themselves can get infected and become inflamed.

“The adenoids in children serve a very important purpose. They are a part of the lymphoid system that helps to fight infection. They form part of the body’s guardhouse and may become enlarged in response to infection, and when this happens it can cause parents much concern. Fortunately, they return to normal once the infection clears,” Dr Griffith said.

She pointed out that the adenoids are a mass of tissue located above the tonsils at the back of the throat behind the nasal passage, and which, unlike the tonsils, are not visible. They serve a most important purpose in small children whose immune systems are still underdeveloped, which makes them vulnerable to infections. As children grow older, however, the adenoids decrease in size as children become less dependent on them for protection.

She noted that when the adenoids become infected the body presents with symptoms such as:

•Snoring (severe).

•Nasal stuffiness and blockage of the nose and ears.

•Mouth breathing.

•Pauses in breathing during sleep (obstructive sleep apnoea).

•Sore throat.

•Ear pain and other ear problems.

•Swollen glands in the neck.

These symptoms are accompanied by other challenges for the children, who may complain about being tired because their sleep is disrupted, not only because of the snoring but the sleep apnoea as well. They often have to breathe through their mouths and as such may suffer from dry mouth. They may also speak with a nasal tone, and may have difficulty eating/swallowing in instances where there are swollen glands in the neck or a sore throat.

To identify enlarged adenoids, Dr Griffith said that after a thorough history is taken of the child’s complaints, the physician will use special tools to identify swelling of the tissue which can be confirmed by having X-rays done if deemed necessary.

“Once it is confirmed that the child is suffering from adenitis, the underlying infection will have to be treated. This is to rid the body of the virus and prevent any further complication. Nasal sprays may also be prescribed and may assist in maintaining good air flow through the nostrils. The adenoids generally return to their normal size with treatment; however, in cases where the condition persists, surgical intervention may be required,” Dr Griffith advised.

A decision to remove the mass of tissue, Dr Griffith shares, is recommended if there is a history of frequent throat and ear infections along with difficulty breathing and/or pauses during breathing. The procedure is generally done at the same time the tonsils are being removed.

“The procedure which is performed by an ear, nose and throat specialist is among the most popular procedures that they perform. Following the procedure, they will have to monitor the child closely since it is possible for the adenoids to grow back. If they do, the specialist will have to determine if further intervention is required,” Dr Griffith advised.