Signs Your Child’s Adenoids May Need to be Removed

What is Adenoid Hypertrophy in Children?

Adenoid hypertrophy in children refers to the abnormal enlargement of the adenoids, which are tissues located behind the nasal cavity and at the top of the throat. The adenoids are part of the immune system and help fight infections and germs. Typically, adenoids are larger in children and shrink as they age. However, in some children, the adenoids may become abnormally enlarged due to frequent infections or allergies, causing airway obstruction and other health problems.

When is Adenoidectomy Necessary?

In the United States, adenoidectomy and tonsillectomy are among the most common surgeries performed on children. Each year, approximately 300,000 children under the age of 15 undergo these procedures【5,6】. A survey of U.S. otolaryngologists (ENT doctors) indicated that the primary reasons for these surgeries include various obstructive breathing issues (59%), recurrent infections (42%), and obstructive sleep apnea (OSA) (39%).

Generally, when the adenoids are obstructing more than 50% to 75% of the airway, doctors may recommend surgical treatment, particularly if the child exhibits significant symptoms. The specific recommendation for surgery also depends on the following factors:

Obstructive Sleep Apnea (OSA): OSA is a common pediatric condition that, if left untreated, can lead to cardiovascular diseases and cognitive problems. The American Academy of Pediatrics (AAP) and the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) recommend adenoidectomy and tonsillectomy as a first-line treatment for children over the age of 2 with adenoid and tonsil hypertrophy and without other serious conditions. If a child experiences pauses in breathing or significant breathing difficulty during sleep, surgery may be necessary even if the degree of obstruction is less than 75%.

Recurrent Infections: If a child experiences frequent tonsillitis or upper respiratory infections, surgery might be recommended even if the obstruction is not severe.

Reduced Quality of Life: If adenoid hypertrophy is affecting the child's daily life, such as persistent nasal congestion, nasal-sounding speech, and difficulty breathing, surgery might be an effective solution.

The decision for surgery is ultimately based on the child’s symptoms, the severity of the adenoid obstruction, and the professional judgment of the doctor.