The adenoids are a mass of lymphatic tissue located at the top of the nasopharynx at the back of the nasal cavity, and are also called pharyngeal tonsils or proliferators. Like the tonsils, the adenoids grow gradually after birth due to the body’s immune needs, becoming largest at the age of 6-7 years and gradually shrinking after the age of 10. Therefore, enlargement of the tonsils and adenoids in childhood is a common physiological phenomenon. If the enlarged adenoids exceed the physiological limit and cause narrowing of the upper airway, the symptoms of airway obstruction may include nasal congestion, nasal congestion, snoring (snoring) at night, open-mouth breathing and sleep disturbance, and in severe cases, apnea (breath-holding), which significantly reduces the quality of sleep. As a result of breath-holding, the whole body is deprived of oxygen, and the brain is deprived of oxygen, the child will be drowsy during the day, poor mental health, memory loss, and decreased academic performance. Long-term nasal blockage and open-mouth breathing can affect the cranial development of the jaws, manifested as the upper lip upward, uneven teeth, protruding upper incisors, high arched palate, widened eye spacing, dull expression and other so-called “adenoid face”. In addition, the heart and lungs are also affected, which can cause pulmonary heart disease and heart failure in severe cases. In addition, because the adenoids are located in the side wall of the nasopharynx, there is the eustachian tube leading to the middle ear, abnormally enlarged adenoids can compress the outlet of the eustachian tube and lead to otitis media, resulting in hearing loss. Adenoid enlargement is not necessarily a disease. The key is whether the enlargement blocks the airway and compresses the eustachian tube. How can we tell if the adenoids are sick? Parents need to carefully observe their child’s symptoms (snoring, breath-holding, drowsiness, memory loss, hearing loss, etc.) and the doctor needs to check the actual size of the adenoids and the percentage of the airway they occupy. Nasal endoscopy is easy to perform, visualizes the adenoids, and provides a clear picture of the presence or absence of pharyngeal tube compression and airway obstruction, making it the preferred tool for viewing the adenoids. In fact, surgical treatment of adenoid hypertrophy is not required for most children, and a significant number of children can be treated with appropriate Chinese medicine.