Etiology Adenoids are common, and they grow as the fetus develops in utero. The adenoids can help stop and fight infection by removing bacteria. Repeated, persistent infections can cause the adenoids to swell and remain enlarged even after recovery. Symptoms Because the enlarged adenoids block the back of the nasopharynx, children with adenoid hypertrophy often exhibit open-mouth breathing, which is especially noticeable at night when the child is sleeping, but sometimes persists. Open mouth breathing can lead to the following problems: 1) bad breath; 2) chapped lips; 3) dry mouth; 4) persistent nasal congestion and runny nose; adenoid hypertrophy can also lead to sleep problems, with children exhibiting 1) easy waking during sleep; 2) snoring during sleep; 3) sleep apnea; and frequent ear infections. Treatment Most patients with adenoid hypertrophy have no or mild symptoms and do not require any treatment. As children grow older, the enlarged adenoids will gradually shrink and become smaller. If infection is present, treatment with antibiotics and nasal spray hormones may be indicated. If symptoms persist or worsen, adenoidectomy may be performed.