Where are the Adenoids?
The adenoids sit right at the back of the nose between the openings of the eustachian tubes. These tubes connect the nose to the middle ear.
What are the Adenoids?
Adenoids are made of lymphoid tissue, just like the tonsils. Lymphoid tissue does form part of the body’s immune system but there are lots of other bits of lymphoid tissue in the body and so adenoids can be taken out without any effect on the body’s ability to fight infections.
Why should the adenoids be removed?
Adenoids only need to be removed if they are causing problems. If the adenoids are large they cause nasal blockage and mouth breathing. This can be a particular issue at night, causing a child to have disrupted sleep and even episodes of breath holding (apnoea). Infection is the main reason for large adenoids and these children can also have persistent unpleasant nasal discharge and cough. Infected adenoids can lead to middle ear problems such as infection and glue ear.
What are tonsils?
The tonsils are the two swellings at the back of the mouth which can be clearly seen when opening wide to say ‘aaah’. They are made of something called lymphoid tissue, which is the same thing as the appendix is made of.
What do the tonsils do?
Lymphoid tissue (the tonsils) is part of the immune system. However, tonsils can be removed without worry, as there are lots of other bits of lymphoid tissue in the body that can do their job. In fact, tonsils that are constantly infected lose their ability to contribute to the immune system.
Why do we remove tonsils?
A lot of work has been done over the years to make sure that tonsils are only removed if they really need to be.
Recurrent infection
When infections in the tonsils are a problem (tonsillitis), a decision to remove the tonsils is made because the impact of these repeated infections (febrile painful illness, time off school, repeated courses of antibiotics etc) is thought to be worse than the undertaking of tonsillectomy (admission to hospital, anaesthetic etc).
Problems with breathing
If the tonsils are very large, they can cause problems with a child’s ability to breathe properly at night. Snoring is quite common but there are some children who actually hold their breath repeatedly for short periods of time while asleep. This is called obstructive sleep apnoea. If sleep apnoea persists, it can have quite an impact on the way children function. They can be tired in the day and their ability to concentrate can be affected. It can cause changes in behaviour and affect the ability of the child to grow properly. In rare cases, when the situation is very bad, there have been issues with the way in which the heart and lungs work.
Other reasons
There are other reasons for which we remove tonsils, including abnormal growth in them. These are very rare though and will be discussed with you by your doctor, if necessary.
Nasendoscopy
A small telescope is used to get a beautiful view inside the airway and look at the adenoids, tonsils, back of the tongue and voice box. This is especially useful for children with breathing/voice/swallowing problems.
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