A mass of lymphoid tissue above and behind the soft palate where the nose and mouth meet, on the back wall of the air passage from the nose to the throat and windpipe. Present in children, the adenoids start to shrink as the child grows older; usually they are absent in adults. With the tonsils, the adenoids form part of the barrier ring of lymph tissue—a protective system around the throat whose cells attack and devour germs entering the body through the nose and mouth. The lymphatic system is very active in young children but its usefulness decreases as they grow older and develop natural immunity to many infections.
In battling bacteria, the adenoids themselves may become infected and form a reservoir for recurrent infection instead of acting as a protective device. Furthermore, persistent adenoid swelling may block the nose-and-throat air passage and hinder breathing; it also may block the opening to the eustachian tube that connects the nose and throat to the middle ear and serves to adjust air pressure in the cavity to external pressure.
The blockage also may lead to recurrent ear infections or accumulation of fluid in the middle ear. Both of these conditions interfere with hearing, which often is restored by removing the adenoids.
Adenoid infection rarely occurs without a similar tonsillitis, but when the adenoids alone are enlarged and infected, and the cause of nose and ear complications, they may be removed without removing the tonsils. Adenoid swelling may also be associated with an allergy in the absence of tonsil infection.
The physician generally will observe the child for a period to determine whether the condition will improve spontaneously without any intervention. After deciding to operate, the doctor usually takes a few precautions. He will wait until the child is in good health and check his previous immunization against various other diseases. Parents can prepare the child for hospitalization and surgery by ex-plaining that removing the adenoids will ease a condition that has been causing him some discomfort. They should describe the short hospital stay and acquaint the patient with the hospital beforehand. The young child may be hospitalized only for a day or two and probably will be
able to play and return to school within a week.