In the throat and back of the nose lies a considerable amount of tissue which doctors call lymphoid tissue. Lymphoid tissue picks up infectious germs and helps the body to get rid of them. Occasionally, however, this tissue itself becomes infected and inflamed. The lymphoid tissue enlarges. Then it becomes more dangerous than helpful to the body and requires removal.
The adenoids, which lie back of the nose and which may be reached through the throat, are lymphoid tissue. When a doctor wants to see whether or not a child has enlarged adenoids, he passes a throat mirror down into the throat. This enables him to look up into the back of the nose and to see the size and character of the adenoid tissue. In the case of a small child the doctor may reach into the throat and pass his fingers up and back of the nose; then he can actually feel the size of the adenoic tissue.
Usually, if the adenoids are infectec or inflamed, the tonsils and the other lymphoid tissue in the throat will be inflamed and vice versa. A child with infected and inflamed adenoids may be quite sick with a fever, have difficulty in breathing, and sometimes also a chronic cough. When the adenoids have been repeatedly infected, they may remain permanently enlarged; in fact so large as actually to interfere with breathing. Moreover, the child with chronically infected adenoids catches frequent colds. Usually the child will breathe through its mouth because of the trouble in breathing through its nose.
The presence of inflamed and enlarged adenoids leads to frequent disturbances of the Eustachian tubes and trouble with hearing. Children with enlarged adenoids were once considered stupid; probably such children seldom heard and were, therefore, slower in their reactions. This made them seem stupid. The enlargement of adenoids tends to give the child an expression which is known as an “adenoid face.” The mouth is open all the time, the eyes staring and a little dull. The lines leading from the sides of the nose to the mouth are smooth, exaggerating the narrowness of the face and thinness of the nose, and thus tending to enhance the stupid appearance. Moreover, the constant breathing through the mouth tends to make the palate high and pointed, and this interferes with proper growth of the teeth.
The adenoids are a mass of tissue, very much like the tonsils, located in the back of the pharynx below the entrance to the Eustachian tube. When the adenoids become infected and swollen they may close this entrance, thereby interfering with the equilibrium of air pressure in the middle ear cavity. The swelling may also close off the air passage between the nose and the pharynx, forcing the person to breath through the mouth and giving the voice a nasal quality. If the tonsils and adenoids become inflamed, the doctor will usually recommend that they be removed, but not while they are infected.
Since this condition is usually associated with enlarged and inflamed tonsils as well, the tonsils and adenoids are removed at one operation. 1 he removal of the adenoids is not a difficult operation in a child. It involves a simple cutting procedure with a special apparatus and is carried out under an anesthetic. It does not require a long time.
Parents frequently ask whether or not it is possible to treat the adenoids with various drugs which might be applied directly, or with vapors which can be inhaled, or by the X ray, or by some other method which would not involve an operative procedure. Unfortunately none of these methods has any certainty in its application.
The operation is not a serious or difficult procedure and results in complete removal of the adenoid tissue, with a wide opening for breathing space through the nose. Occasionally, however, even a small portion of the adenoid tissue which is left may again become infected and enlarged.