They lie behind the roof of our mouth cavity (the
palate) where the back of our nostrils joins the back of our
throat. Ordinarily, they seem to do their job quietly by keeping
in check the germs in our upper respiratory tract. The
tonsils act likewise.
At times, however, these adenoids get enlarged and block the breathing passages, causing varying
degrees of obstruction of breathing. In most cases, the enlarged
adenoids shrink in size as the child grows older. In the past, it
was considered routine to remove the adenoids along with the tonsils. But it is now being increasingly
recognised
that often, both these tissues should be kept intact, and only
removed if definite indications for removal exist.
Removal of adenoids thus should only be considered if
the child gets recurrent ear infections, has difficulty breathing normally, breathes mostly through the mouth, or snores
heavily at night with temporary stoppage of breathing (obstructive sleep apnoea) for a few seconds; his speech
is disturbed and his voice sounds nasal, as if his nose is
blocked.
Increased gain in weight and height, and improved grades
in school after removal of tonsils and/or adenoids in children with obstructive sleep apnoea have been reported.
Even in the above conditions, the removal of adenoids
need not necessarily be resorted to. Breathing through the mouth alone is not an adequate indication; some people do so
out of habit. At the same time, if the child does not have
mouth breathing or nasal speech, the diagnosis of enlarged
adenoids is likely to be wrong. Before undertaking surgery, your
doctor may also like to treat the child with antibiotics if
he/she suspects persistent infection, or he/she may like to
treat the child for allergies.
