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 Zhang Jun
Otolaryngology
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Can adenoid hypertrophy be felt by touch?

Adenoid hypertrophy is palpable, as the adenoids are a cluster of lymphoid tissue located at the top of the nasopharynx. If there is localized hypertrophy, it can be directly felt through the mouth. Adenoid hypertrophy most commonly occurs in children, especially those between the ages of three and six, and often follows acute colds, rhinitis, and adenoid hypertrophy, eventually leading to persistent bilateral nasal obstruction. Additionally, it may be accompanied by symptoms such as snoring during sleep, decreased hearing, tinnitus, and a feeling of ear fullness. In severe cases, it may lead to a facial appearance characteristic of adenoid hypertrophy. It is necessary to first visit a hospital for a thorough examination, which can include an electronic nasopharyngoscopy, nasopharyngeal CT, and nasopharyngeal palpation to confirm the diagnosis. In terms of treatment, acute adenoid hypertrophy requires symptomatic anti-inflammatory treatment, along with nebulized inhalation. If conservative treatment is ineffective, adenoidectomy may be necessary for cure.

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Written by Xu Qing Tian
Otolaryngology
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Postoperative care for adenoid hypertrophy removal surgery

Adenoid hypertrophy is currently treated primarily via surgical removal using a plasma scalpel to ablate the hypertrophied adenoid tissue, effectively treating the condition. The advantages of using a plasma scalpel include minimal bleeding during and after the surgery, less pain, smaller wounds, and faster healing and recovery, achieving significant therapeutic results. Post-surgery, it is advised that patients avoid hot baths and foot baths for two to three weeks, refraining from strenuous activities, heavy lifting, and excessive exercise, which could lead to bleeding. Diet-wise, it is recommended to avoid overly hot foods to prevent delayed postoperative bleeding of the adenoids.

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Written by Deng Bang Yu
Otolaryngology
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When is a good age to have surgery for adenoid hypertrophy?

The reason adenoid hypertrophy requires surgical treatment is because it blocks the passage of our nasopharynx, leading to nasal congestion and snoring, affecting body and jawbone development, and even causing otitis media which can impair hearing. There is no absolute age requirement for adenoidectomy; surgery is an option if these complications are present. Clinically, we generally consider the size of the adenoid and whether it causes complications, along with the patient's actual age. Typically in our clinical practice, surgery is usually considered after the child is two and a half years old, as long as the symptoms and hypertrophy are present. It is important to understand that adenoid hypertrophy is quite common around the ages of 6 to 7 years, when the enlargement peaks, making adenoidectomy a common procedure for children of this age group.

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Written by Xu Qing Tian
Otolaryngology
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Can adenoid hypertrophy be treated with massage?

Patients with adenoid hypertrophy generally do not see significant therapeutic effects from massage therapy. Adenoid hypertrophy is due to the proliferation of lymphoid tissue at the posterior nasopharyngeal wall, which leads to nasal congestion and sleep apnea at night. When sleep apnea occurs, it is first necessary to complete sleep monitoring and blood oxygen saturation monitoring and other relevant tests to make a clear diagnosis of the patient's condition. For patients with adenoid hypertrophy occupying more than two-thirds of the posterior nasal aperture, plasma surgery is usually required to ablate the hypertrophied adenoid tissue and restore normal nasal ventilation function, thereby alleviating the patient’s sleep apnea and hypoventilation syndrome.

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Written by Huang Kun Mei
Pediatrics
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What are the symptoms of adenoid hypertrophy in children?

Children with adenoid hypertrophy mainly have the following symptoms: The first is that children are prone to nasal congestion, and they may snore and breathe through their mouths while sleeping at night. The second is that their facial appearance might change. The third is that children may experience a decrease in memory and lack of concentration. It is recommended to visit the otolaryngology department for diagnosis. If diagnosed with adenoid hypertrophy in children, treatment should be targeted, based on the specific condition and severity of the child.