Enlarged nasopharyngeal tonsils, or “adenoids,” as they are often popularly called, can overlap or block the nasal cavity, as well as the nearby entrance to the middle ear, the Eustachian tube. Adenoids can cause a painless accumulation of fluid in the middle ear (otitis exudative), which in turn affects hearing or can lead to inflammation of the middle ear. Adenoids are mainly diagnosed in preschool children. Long-term consequences of this condition are rare, as in most cases the adenoids go away on their own. But if exudative otitis media remains undetected for more than one month, and the child has poor hearing in both ears, then speech may develop incorrectly (especially in children of kindergarten age), and there may also be a negative impact on the formation of the bite due to constant mouth breathing. If the adenoids are the cause of restless sleep, recurring ear infections, or you notice that the child is breathing heavily during sleep with long pauses (sleep apnea), the adenoids must be removed.
Course of the disease
The typical course of the disease includes prolonged nasal congestion, mucopurulent runny nose, constant breathing through the mouth and cough. At night, you may notice your child wheezing or snoring loudly; hearing problems are common. There may also be loss of appetite and daytime fatigue due to restless nights. If the problem persists for a long time, a typical “adenoid face” develops: puffy, pale with a half-open mouth.
When to call a doctor
- If you have been observing the symptoms described above in your child for more than a month, then schedule a visit to the doctor in the coming days;
- If fever, ear pain (symptoms of inflammation of the middle ear), purulent runny nose are added to the described symptoms, consult a doctor within the next few hours.
Doctor’s help
If the effusion remains in the eardrum for a long time (from 4 to 6 weeks), the disease can lead to hearing loss in both ears, so the doctor may prescribe tympanocentesis (a puncture in the tympanic membrane) to remove the effusion. In case of suffocation, persistent nasal congestion, sleep apnea or persistent exudative otitis media, adenoid removal under general anesthesia is necessary. Surgery to remove the adenoids is also necessary for children with repeated inflammation of the middle ear.
Your help to the child
Try to strengthen the child’s immunity and ensure good ventilation of the middle ear. Give your child inhalations and warming over a saline or chamomile solution, as well as foot baths. Protect your child from cigarette smoke, try to play with your child in the fresh air more often, start tempering the child with a contrast shower and monitor the temperature in the child’s room (the room should not be hot, too dry or stuffy).
To get advice on the problems of enlarged lymphoid tissue of the nasopharynx, you need to make an appointment with a pediatric ENT doctor.