Enlarged Tonsils and Adenoids

Reviewed/Revised Jun 2024
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What are tonsils and adenoids?

Tonsils and adenoids are lumps of tissue in the back of your throat. They trap germs and help your body fight infection. You can see your tonsils in the back of your throat. But you can't see your adenoids because they're up behind the roof of your mouth.

Locating the Tonsils and Adenoids

The tonsils are two areas of lymphoid tissue located on either side of the throat. The adenoids, also lymphoid tissue, are located higher and further back, behind the palate, where the nasal passages connect with the throat. The adenoids are not visible through the mouth.

  • Tonsils and adenoids get bigger if you have an infection

  • Big tonsils or adenoids sometimes make it hard to breathe or swallow

  • Big adenoids can cause problems with breathing during sleep and increase the risk of ear infections

  • Doctors sometimes do surgery to remove adenoids that are too big

What causes tonsils and adenoids to enlarge?

Some children are born with tonsils and adenoids that are bigger than normal.

A child's tonsils and adenoids may grow too big because of repeated:

What are the symptoms of having enlarged tonsils and adenoids?

Big tonsils and adenoids often don't cause symptoms. When they do cause symptoms, children may:

  • Sound like they have a cold when they don't

  • Breathe through their mouth, instead of their nose

  • Have trouble breathing or swallowing

Enlarged tonsils and adenoids may cause more serious problems, such as:

How can doctors tell if my child’s tonsils or adenoids are too big?

The doctor will:

  • Look at your child's tonsils with a tongue depressor when your child sticks out his or her tongue and says "Ah"

  • Look at your child's adenoids using a tiny scope up your child’s nose (the scope doesn't hurt)

Doctors may also test for problems that result from big tonsils and adenoids, such as:

  • Ear or sinus infections, with blood tests and imaging studies

  • Ear fluid buildup, with hearing tests

  • Sleep apnea, with sleep studies

Your child may lose weight because of trouble breathing while eating. The doctor will compare your child's weight to standard growth charts to see if the weight loss is a concern.

How do doctors treat enlarged tonsils and adenoids?

Your child's doctor may give your child medicine to treat infections or allergies that are irritating the tonsils or adenoids.

Doctors may suggest removing the adenoids and tonsils if your child has:

  • Sleep apnea

  • A very hard time talking and breathing

  • Many throat infections

Doctors may suggest removing only your child’s adenoids if your child has:

  • A lot of ear infections and fluid behind the eardrum that won't drain

  • A stuffy nose that makes it hard to breathe and talk

  • Many sinus infections

Children can usually go home the same day as the surgery. If just the adenoids were removed, your child should feel better in 2 to 3 days. If the tonsils were also removed, recovery should take about 2 weeks.

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