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A nose for trouble: Addressing adenoiditis

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For almost a year now, my son has complained that he always has a stuffy nose and a sore throat. More recently, he has developed trouble swallowing and has had frequent ear infections as well. A friend suggested that my son may have adenoiditis, as her son did earlier this year. Her son required surgery. Can you tell me more about this condition, and what the next step is? Is surgery always necessary?

Issues with the adenoids, or adenoid glands, are most common in children around your son’s age, so your friend’s suspicion is understandable. The adenoid glands are a collection of tissue that is located in the space behind the nose. From birth through the age of 3, the adenoids typically remain very small, and then start to grow rapidly until they reach their maximum size around the age of 6. After that, the adenoids usually start to shrink, and generally disappear altogether by a child’s teenage years. However, if the adenoid glands become enlarged, either due to infection (adenoiditis) or excessive growth (adenoid hypertrophy), this can indeed lead to the symptoms you are describing — congestion, ear infections due to fluid not draining from the ear canal, sore throat, and trouble swallowing. Other symptoms may include trouble breathing, bad breath, dry mouth, and snoring. Persistent adenoiditis can also result in more serious complications such as bronchitis, pneumonia, and lung asthma.

A surgical procedure to remove the adenoid glands (adenoidectomy) can sometimes be necessary to treat adenoiditis. However, there are many steps that should come first. A doctor usually confirms a diagnosis of adenoiditis by viewing the adenoids directly, either with a specialized mirror inserted into the mouth or by carefully threading a device called an endoscope through the nose.

Antibiotics and steroidal nasal sprays are the most common treatment for adenoiditis. However, should they prove ineffective, or if the symptoms of adenoiditis recur, adenoidectomy may ultimately be required. Adenoidectomy is a safe, non-invasive procedure that takes 45 minutes, and is performed under general anesthesia by an otolaryngologist — a surgeon who specializes in the study and treatment of diseases of the ear, nose, and throat.

If you are concerned that your son may have adenoiditis, consult your pediatrician. He can evaluate your child, recommend the proper treatment, and, if necessary, refer you to a specialist. Adenoiditis can be a serious condition, but the array of options available to effectively address it means that your child can be breathing easily before you know it.

Updated 4:54 pm, July 9, 2018
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