What Are Adenoids? What Is Adenoidectomy?

Adenoids, also known as pharyngeal tonsil, or nasopharyngeal tonsil are located at the back of the throat, above the tonsils – they are small lumps of tissue. They form part of the immune system of babies and young children; they protect the body from harmful bacteria and viruses, they fight off infection.

Adenoids start growing from birth and reach their peak size when the child is between about 3 and 5 years of age. After the age of 7 they shrink, and are barely detectable during adolescence. They will have disappeared completely by the time a person has become an adult.

Babies and very young children have undeveloped immune systems. At that age the adenoids are a useful back up for fighting off infections. Later on in life, when the immune system is better developed and can cope with infections more effectively, they are not needed.

Unlike the tonsils, which can be seen if you open your mouth and look into the mirror, adenoids can only be seen when the doctor uses a light and a small mirror, or a flexible telescope.

Why do adenoids swell up?

Adenoids trap germs when they enter the body. In doing so they can sometimes puff up temporarily as they try to fight off an infection. On most occasions the swelling resolves on its own. However, sometimes medical treatment is required.

If the bacterial invasion is aggressive enough, the adenoids themselves can become infected.

Swollen or enlarged adenoids are common in children. Often the tonsils will swell up at the same time. Swollen adenoids may cause the following signs and symptoms:

Blocked or stuffy nose, the child may breath just through his/her mouth

Ear problems

Sleeping difficulties


Sore throat

Swallowing difficulties

he glands in the neck seem swollen

Even after the infection has cleared up, the adenoids may continue to be enlarged. In some children, an allergic reaction can irritate the adenoids, making them swell up. Some children may be born with enlarged adenoids.

What is an adenoidectomy?

The surgical removal of the adenoids. This is a quick and straightforward procedure with very few risks. Experts say that an adenoidectomy will not increase the risk of subsequent infections for the child. His/her immune system will be able to cope with viruses and bacteria without the adenoids. Most doctors will not perform an adenoidectomy on very young children.

Sometimes the doctor will surgically remove the tonsils at the same time – this is called a tonsillectomy.

There is a possibility of regrowth after the adenoids are removed.

Adenoidectomy does not reduce frequency of respiratory tract infections

Some lay people and doctors believe that removing the adenoids helps reduce the incidence of respiratory tract infections, such as sinusitis and colds. However, researchers from the University Medical Centre, Utrecht, the Netherlands, reported in the BMJ (British Medical Journal) (September 2011 issue) that adenoidectomy makes no difference to the frequency of respiratory tract infections.

Study leader, Professor Anne Schilder, said “One of the main reasons adenoidectomy is performed is to reduce the incidence of upper respiratory tract infections. However, the clinical effectiveness of the procedure in children with recurrent upper respiratory tract infections is lacking.”

The ideal approach for children with recurrent upper respiratory tract infections is a strategy of initial watchful waiting.