Adenoids and adenoidectomy - Why is it necessary? 

Why adenoids need to be removed 

Sometimes a child's adenoids can become swollen or enlarged. For most children, this will only cause mild discomfort and will not require any specific treatment.

But, for some children, swollen or enlarged adenoids can cause severe discomfort and start to interfere with their daily life.

For example, a GP may suggest the child has their adenoids removed (an adenoidectomy) if they're experiencing:

  • breathing problems – such as shortness of breath or constantly breathing through their mouth
  • difficulty sleeping – particularly if breathing problems lead to heavy snoring and sleep apnoea
  • recurrent or persistent problems with the ears – such as glue ear or middle ear infections (otitis media)
  • recurrent or chronic sinusitis – leading to symptoms such as a constantly runny nose, facial pain and nasal-sounding speech

These symptoms are discussed in more detail below.

Breathing problems

Swollen adenoids can make it difficult for your child to breathe through their nose. Their nasal breathing may sound noisy or make a rattling sound causing them to breathe through their mouth instead.

However, this can cause cracked lips and a dry mouth, which your child may find uncomfortable. Occasionally, your child may have difficulty eating as they need to breathe through their mouth at the same time.

Difficulty sleeping

Swollen or enlarged adenoids can also make it harder for your child to sleep, and as breathing through their nose is difficult, they may snore.

In severe cases of swollen or enlarged adenoids, some children may also experience sleep apnoea.

Sleep apnoea is a condition that causes irregular breathing and holding your breath during sleep at night and excessive sleepiness during the day. It occurs when the upper airway obstructs during sleep, temporarily cutting off the air supply.

Enlarged adenoids can make the throat narrower than normal, increasing the chance of the upper airway obstructing.

Glue ear

Swollen or enlarged adenoids can also lead to problems with the ears and hearing. This is because the adenoids can press on the entrance of the Eustachian tubes. Bacteria on the adenoids can also spread up the Eustachian tubes, causing middle ear problems.

The Eustachian tubes connect the middle ear to the back of the nose and help drain away any fluid that builds up in the middle ear, as well as maintaining air pressure within the ear.

When the Eustachian tubes are blocked, fluid can build up in the middle ear, leading to glue ear or a middle ear infection.

If your child cannot hear clearly, it may affect learning, development and social interaction so it is important that ear conditions are diagnosed and treated.

If your child's ear condition is still causing hearing loss after three months, an adenoidectomy may be considered to help the Eustachian tube function normally.

Ear and sinus infections

If the adenoids are infected (adenoiditis), this can lead to other infections in connected areas, such as the middle ear or sinuses.


Page last reviewed: 28/07/2014

Next review due: 28/07/2016

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Child health 6-15

Information on child health, including healthy diet, fitness, sex education and exam stress