How big should the adenoids be to consider surgery?

Written by Yao Jun
Otolaryngology - Head and Neck Surgery
Updated on June 04, 2025
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Enlarged glands are generally more common in infants and preschool children. They can block the posterior nasal passages, causing the child to breathe through the mouth, snore, and hold their breath. If the child is over one year old, surgical treatment can be considered. Because the anesthesia risk is higher with very young children, but as they get older, chronic mouth breathing and breath-holding can lead to abnormal facial development and brain oxygen deficiency, affecting the child's development. Theoretically, the earlier the adenoid hypertrophy is discovered and treated, the better the treatment effect. However, due to the young age of the child and the risks of anesthesia, surgery is generally best scheduled around the age of two years, after the child has turned one.

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Written by Dong Xian Yan
Pediatrics
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Does a baby snoring mean that the adenoids are enlarged?

Baby snoring cannot necessarily be attributed to enlarged adenoids; it might also be due to a cold, nasal congestion, enlarged tonsils, or the position of the tongue falling back while sleeping. Therefore, the specific cause of a baby's snoring needs to be determined by a professional physician's examination, and appropriate treatment should be given based on the specific cause. If the snoring is due to enlarged adenoids or tonsils, a professional evaluation may be required to decide whether surgery is necessary to alleviate the symptoms of snoring. If the cause is nasal congestion, oral antihistamines or local nasal sprays can be used to relieve the symptoms of snoring. (If medication is required, please proceed under the guidance of a doctor.)

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Written by Zhang Jun
Otolaryngology
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Is adenoid hypertrophy more severe in winter?

Adenoid hypertrophy tends to be more severe in the winter due to the weather changes which can lead to significant adenoid hyperplasia. Adenoid hypertrophy is generally more common in children aged three to eight. It is caused by repeated stimulation from acute inflammation, leading to congestion, edema, and growth of the adenoids. This condition can cause patients to experience persistent bilateral nasal congestion, snoring during sleep, and episodes of breath-holding. Additionally, patients may also experience tinnitus, hearing loss, and other related symptoms. Diagnosis can be confirmed through an electronic nasopharyngoscope and adenoid CT scans. For treatment, patients can initially opt for conservative treatments such as oral antibiotics. Additionally, localized nebulizer inhalation can be used to reduce congestion and swelling of the adenoids. If conservative treatments are ineffective, adenoidectomy may be necessary for recovery. (Medication should be taken under the guidance of a doctor.)

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Written by Xu Qing Tian
Otolaryngology
1min 6sec home-news-image

Do adenoids cause coughing?

Children with adenoid hypertrophy may exhibit symptoms of coughing. The reason for the aforementioned symptoms primarily stems from excessive growth and enlargement of adenoid tissues, resulting in obstruction of the posterior nasal aperture. This causes chronic sinusitis in children and postnasal drip, leading to reflex cough. Therefore, for patients with adenoid hypertrophy, it is crucial to first conduct thorough examinations such as paranasal sinus CT and electronic nasopharyngoscopy to definitively diagnose the patient's condition, enabling early detection and timely surgical treatment. This involves removing the enlarged adenoid tissues to restore normal nasal ventilation and overall physical condition. Additionally, relevant examinations should be promptly completed before and during surgery to rule out surgical contraindications. After surgery, it is advisable to avoid hot baths, foot baths, and strenuous exercise to prevent postoperative bleeding from the surgical site.

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Written by Zhang Peng
General Surgery
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Does adenoid hypertrophy always require surgery?

Is surgery necessary for adenoid hypertrophy? The answer is not necessarily. Adenoid hypertrophy is generally caused by acute rhinitis, tonsillitis, or acute epidemic influenza, among other factors. These factors can lead to the rapid proliferation and enlargement of the adenoids, which may compress the tissues of the nasal cavity, causing nasal obstruction or sinusitis. In such cases, it depends on the symptoms triggered and how significant the impact is on the patient. If the symptoms are not particularly severe, some non-surgical treatments can be adopted, such as enhancing the body's own disease resistance. Oral medications for clearing heat and detoxifying, and if necessary, traditional Chinese medicine for promoting blood circulation and removing blood stasis can be used to adjust the condition. If the enlargement of the adenoids is significantly alleviated with these medicinal treatments, surgery may not be necessary. However, if the disease is not well-controlled and severely affects breathing or swallowing, surgical treatment may be considered.

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Written by Li Rui
Otolaryngology
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What should I do about adenoid hypertrophy?

Adenoid hypertrophy is a relatively common disease among children, and it also occurs in a small portion of adolescents and adults. Generally, it is necessary to first perform a nasopharyngoscopy to assess the specific extent of hypertrophy. If the hypertrophy is very mild and there are no subjective symptoms, the situation is usually managed with regular check-ups without special treatment. If the hypertrophy is more significant and accompanied by nasal congestion, sleep disturbances, snoring, or a feeling of ear blockage, treatment typically involves the use of oral medications and nasal sprays. Generally, a standard treatment lasts about two weeks, after which the effectiveness should be reassessed. If there is no effectiveness, adenoidectomy, a relatively routine surgery, may need to be considered. However, most patients are very effectively treated with conservative management.