When a baby feels breathless or snores in his sleep, the triage desk will often recommend that he first go to the ENT to have his adenoids checked. What are adenoids and what is adenoid hypertrophy? Adenoids, also known as pharyngeal tonsils, are located at the top of the nasopharynx and the back wall of the pharynx and are lymphatic tissue with an orange flap-like surface. The adenoids, like the tonsils, grow gradually with age after birth, with a period of vigorous proliferation between the ages of 2 and 6, reaching a maximum at the age of 8, and gradually shrinking after the age of 11. The adenoids can be said to be a necessary part of the growth of each child, but the adenoids can be pathologically hypertrophic due to repeated stimulation of inflammation, called adenoid hypertrophy. The symptoms are as follows: 1. Ventilation disorders The adenoids are located at the junction of the nasal cavity and the pharynx, and the enlarged adenoids can narrow the airway, thus affecting ventilation, open-mouth breathing, occlusive nasal sounds, sleep snoring and other symptoms, and the ventilation disorders will affect the children’s nighttime blood oxygen supply, resulting in delayed height development, decreased intelligence, and lack of mental concentration. Long-term open-mouth breathing will lead to “adenoid face”, resulting in impaired facial bone development, long jaws, high arched palate, uneven teeth, prominent upper incisors, thick lips, lack of expression, turning into an “ugly duckling”. 2, rhinitis, sinusitis Adenoid hypertrophy itself will release more inflammatory mediators, inducing nasal mucosa edema, long-term runny nose and even induced sinusitis, children with long-term nasal snot non-stop, some will lead to allergic rhinitis attacks, continuous sneezing, nasal itching and other symptoms, and rhinitis sinusitis produces a large number of secretions will further stimulate adenoid hypertrophy, forming a vicious circle. The opening of the middle ear ventilation tube – the eustachian tube – is located in the nasopharynx. The enlarged adenoids will squeeze the eustachian tube, causing obstruction of the eustachian tube and affecting the ventilation function of the middle ear, thus forming secretory otitis media, which will not heal. In the case of upper respiratory tract infection, the inflammation will reach the middle ear through the eustachian tube, resulting in acute otitis media, causing severe ear pain and, in severe cases, ear perforation, pus flow and hearing loss. Some children with adenoid hypertrophy may have a long-term cough, and there are two causes of coughing, one is “upper airway cough syndrome”, which means that secretions from the nasal cavity and nasopharynx flow backward, stimulating the throat and trachea, resulting in a long-term chronic cough. Another type of chronic cough is the long-term stimulation of the body by inflammatory mediators in the upper respiratory tract, which leads to long-term airway sensitivity and “airway hyperreactivity”, resulting in an irritating dry cough and, in severe cases, wheezing or even asthma attacks. To what extent do adenoids need surgery? 1.Adenoid hypertrophy affects breathing, and children with adenoid hypertrophy have symptoms of oxygen deprivation, such as snoring during sleep, physical or mental retardation, and adenoid facial features. 2. Recurrent episodes of upper respiratory tract infection, such as prolonged runny nose, fever, cough, etc. If any of the above two points occur, surgery should be considered. Regarding surgical pain: Children’s surgeries are performed under general anesthesia, which is painless and does not create fear in children. Nowadays, the technology of general anesthesia is very advanced, and the child will wake up soon after the surgery, the drug metabolism is very fast, and there is basically no after-effects, and the pain of the child after the surgery is also very light. Pain as a perception generally intensifies with age, which means that the younger the child, the less painful it is, and the older the child, the more pronounced the pain. Therefore, for children with indications for surgery, the earlier the surgery, not only will the respiratory problems be relieved as early as possible to help physical and intellectual development, but the less painful the child will be.