Does a child sleeping with their mouth open indicate enlarged adenoids?

Written by Lian Wen Xi
Pediatrics
Updated on March 06, 2025
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The mouth and nose are two organs of the human body used for breathing. Normally, breathing is done through the nose, but when the nose is blocked, mouth breathing occurs. Therefore, mouth breathing is a sign of respiratory discomfort and nasal congestion. Common causes like acute and chronic rhinitis, upper respiratory infections, enlarged tonsils, enlarged adenoids, and nasal foreign bodies can all lead to children sleeping with their mouths open. Thus, a child sleeping with an open mouth does not necessarily indicate enlarged adenoids. If a child experiences nasal congestion, snoring, or mouth breathing for more than a month, it is advisable to consult an otolaryngologist (ENT specialist) for a timely examination.

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Written by Xu Qing Tian
Otolaryngology
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Does adenoid hypertrophy have a strange smell?

Adenoid hypertrophy is a common ENT disease, mostly seen in infants and young children aged 5 to 7 years. Before surgery for adenoid hypertrophy, the blockage of the posterior nasal aperture can cause edema, inflammation, and purulent secretions in the sinus and nasal mucosa, leading to an unpleasant odor in the nasal cavity. Patients with adenoid hypertrophy usually need to undergo adenoidectomy using a plasma knife. After the surgery, local burns can cause necrosis of the mucosa, resulting in bad odors in both the nasal and oral cavities. Therefore, for patients with adenoid hypertrophy, the main approach is to maintain oral hygiene, which can help reduce the unpleasant nasal odors.

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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 Deng Bang Yu
Otolaryngology
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Can adenoid hypertrophy heal itself?

The adenoids are normal lymphoepithelial tissue located in our nasopharynx. In young children, especially around the ages of 5-6, the adenoids become enlarged or hyperplastic. This can then easily lead to the obstruction of surrounding structures causing issues such as snoring, sinusitis, and otitis media. Generally, adenoid hypertrophy is self-resolving because, after the age of around ten, the adenoids gradually atrophy. However, there are a minority of patients in whom the adenoids do not atrophy. Although the adenoids of the vast majority of patients will atrophy around the age of ten, it is important to recognize that from hypertrophy to atrophy, there is a long duration during which if deformities or conditions that affect body development occur, they cannot be reversed to normal. Therefore, it is essential to treat and intervene timely in patients with adenoid hypertrophy.

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Written by Deng Bang Yu
Otolaryngology
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Adenoid hypertrophy is what?

The adenoid is a lymphoepithelial tissue located in our nasopharynx, and it has certain immune functions. Under the stimulation of various factors such as infectious or immune factors, the immune tissue and glands of the adenoid hypertrophy, leading to enlarged adenoids. Once the adenoids are enlarged, they can block our posterior nasal apertures and the pharyngeal opening of the Eustachian tube. This, in turn, can cause us to snore, breathe through the mouth, and lead to secretory otitis media. The progression of the condition can affect our hearing, impact physical development, affect the development of the facial and jaw regions, and result in an adenoid facies. Therefore, when clinical symptoms of adenoid enlargement appear, active management is generally required, mainly surgical treatment.

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Written by Li Mao Cai
Otolaryngology
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Can adenoid hypertrophy cause otitis media?

Adenoid hypertrophy is commonly seen in children. The adenoids are located at the back of the nasal cavity, more precisely, at the nasopharyngeal region of the posterior nasal cavity. The nasal cavity is connected to the ears via the Eustachian tube, whose internal opening is situated in the nasopharynx. If the adenoids are enlarged, they can block the internal opening of the Eustachian tube. Therefore, adenoid hypertrophy can cause secretory otitis media. The common symptoms of secretory otitis media in children include a decrease in hearing, turning up the volume of the TV intentionally, and a sluggish response when called. This explains the mechanism and clinical presentation of how adenoid hypertrophy can lead to otitis media.