What are adenoids and tonsils?
The adenoids and tonsils lie at the back of the throat in the place where the nostrils join the airway. Along with the tonsils, they form part of the defense mechanism designed to fight infection in the upper respiratory tract. Most of the time they do their job with no problems.
However, sometime both the adenoids and tonsils become enlarged and can cause breathing problems by obstructing the throat 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 if they became troublesome and caused such difficulties. Today doctors feel that this tissue should be left alone and it is rare for children to have their adenoids or tonsils removed.
When should adenoids and tonsils be removed?
Removal of adenoids or tonsils 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 apnea) 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 apnea have been reported, so the operation is justified in certain circumstances.
Alternatives to surgery
Surgery is always risky and doctors are always reluctant to put children through general anesthetic. Some people routinely breathe through their mouths, so this alone is not an indication that surgery is the best approach. There are many alternative treatments to surgery for adenoids and tonsil enlargement and your doctor will normally try a course of antibiotics and monitor your child carefully before recommending surgery.