What are the signs and management of enlarged adenoids?

Adenoids are situated at the back of the nose and cannot be seen without special instruments. They enlarge up to the age of about 7 years and then spontaneously become smaller. Enlarged adenoids may obstruct the nasal airway. This causes snoring, frequent waking at night, mouth breathing, nasal speech, and chronic secretory otitis media. Poor sleep may affect schooling. Mild enlargement of the adenoids requires no treatment but adenoidectomy (removing the adenoids) is indicated for signs of severe upper airway obstruction, especially snoring and sleep apnoea (stopping breathing during sleep).

Large adenoids can be diagnosed on a lateral X-ray of the neck. Sleep apnoea due to enlarged adenoids is an important condition, as it causes nocturnal hypoxia, and must be urgently treated by adenoidectomy.

Snoring and sleep apnoea are important reasons for adenoidectomy.

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