Adenoids in a child: when treatment is enough and when surgery is needed

What adenoids are and why they grow

Adenoids are lymphoid tissue at the back of the nose, part of a child’s immune system. Between the ages of 3 and 7 they naturally enlarge, especially with frequent colds and allergies. The problem is not their size but the consequences: obstructed nasal breathing, snoring, reduced hearing and recurring ear infections.

When conservative treatment is enough

In most cases the first step is observation and treatment: rinsing the nose with saline, topical medication prescribed by the doctor, removing allergens. The evaluation period is 2–3 months; in most children breathing improves during that time.

• Daily nasal rinsing and humidified air at home
• Treat colds fully rather than “pushing through”
• Endoscopic check-ups with an ENT doctor every 3 months

When to consider surgery

Adenoidectomy is considered when there are pauses in breathing during sleep (apnoea), hearing loss lasting longer than 3 months despite treatment, and more than 4 ear infections a year. Modern techniques are performed under endoscopic control and general anaesthesia; the child goes home the same day.