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Adenoids
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Ear Nose Throat

Adenoids

Adenoids are immune-supporting tissues in the throat that can become enlarged, potentially causing breathing and sleep issues in children.

What are adenoids?

Adenoids are a patch of tissue that is high up in the throat, just behind the nose. They, along with the tonsils, are part of the lymphatic system. The lymphatic system clears away infection and keeps body fluids in balance. The adenoids and tonsils work by trapping germs coming in through the mouth and nose.

Adenoids usually start to shrink after about age 5. By the teenage years, they are almost completely gone. By then, the body has other ways to fight germs.

What are enlarged adenoids?

Enlarged adenoids are adenoids that are swollen. It is a common problem in children.

Causes

Your child's adenoids can be enlarged, or swollen, for different reasons. It may just be that your child had enlarged adenoids at birth. Adenoids can also become enlarged when they are trying to fight off an infection. They might stay enlarged even after the infection is gone.

Problems Caused by Enlarged Adenoids

Enlarged adenoids can make it hard to breathe through the nose. Your child might end up breathing only through the mouth. This may cause:

  • A dry mouth, which can also lead to bad breath
  • Cracked lips
  • A runny nose

Other problems that enlarged adenoids can cause include:

  • Loud breathing
  • Snoring
  • Restless sleep
  • Sleep apnea, a disorder that causes you to repeatedly stop breathing during sleep
  • Ear infections

Diagnosis

To find out if your child has enlarged adenoids, the health care provider will:

  • Ask about your child's medical history, including asking about your child's symptoms
  • Check your child's ears, throat, and mouth
  • Feel your child's neck

Since the adenoids are higher up than the throat, the provider cannot see them just by looking through your child's mouth. To check the size of your child's adenoids, your provider may use:

  • A special mirror in the mouth
  • A long, flexible tube with a light (an endoscope)
  • An x-ray

Treatment & Management

The treatment depends on what is causing the problem. If the symptoms are not too bad, your child may not need treatment. If treatment is needed, your child may get nasal spray to reduce the swelling or antibiotics if the provider thinks that there is a bacterial infection.

In some cases, your child may need an adenoidectomy.

What is an adenoidectomy?

An adenoidectomy is surgery to remove the adenoids. The provider may recommend this surgery if:

  • Your child has repeated infections of the adenoids. Sometimes the infections can also cause ear infections and fluid buildup in the middle ear.
  • Taking antibiotics doesn't get rid of a bacterial infection of the adenoids.
  • The enlarged adenoids block the airways.

If there is also a problem with the tonsils, your child will probably have a tonsillectomy (removal of the tonsils) at the same time that the adenoids are removed.

After having the surgery, your child usually goes home the same day. Your child will probably have some throat pain, bad breath, and a runny nose. It can take several days to feel all better.

Frequently Asked Questions

While saline sprays can help clear mucus and reduce temporary swelling, decongestant sprays should not be used for more than three days due to the risk of rebound congestion. They do not treat the underlying tissue enlargement. If your child has significant obstruction, a doctor may prescribe a steroid nasal spray, which can reduce inflammation over several weeks. Always consult a pediatrician before starting any new medication for a child under two years old.
Snoring due to a cold usually resolves within a week as the congestion clears. If your child snores consistently for more than two weeks, breathes through their mouth during the day, or has pauses in breathing during sleep, it is more likely related to enlarged adenoids. A persistent "adenoid facies," characterized by an open mouth and elongated face, is also a sign that chronic mouth breathing is affecting development.
Most children return to normal activities within 7 to 10 days. You can expect some sore throat pain, which is often worse than with a tonsillectomy, and a change in voice where the child sounds like they have a cold for a few weeks. It is common for the voice to sound nasal or "honky" as the throat heals. Watch for signs of bleeding, such as coughing up blood or vomiting blood, which requires immediate medical attention.
Yes, chronic mouth breathing and nasal obstruction can impact speech clarity and resonance. Children may develop a hypernasal voice or difficulty pronouncing certain consonants. Additionally, if enlarged adenoids lead to frequent ear infections and temporary hearing loss, the child may miss auditory cues essential for language acquisition. Early intervention with speech therapy or medical treatment for the adenoids can help mitigate these developmental delays.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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