What are Adenoid Vegetations?

13 November, 2020
Adenoids vegetations are a part of the human body's immune system. Although they're usually a cause of surgical operations, in reality, their primary function is, precisely, to prevent us from getting sick. In this article, we'll explain what they are and what their purpose is.

Adenoid vegetations are part of the human immune system. This means that their function is to defend the body against possible microorganisms or substances that may want to enter from the outside.

This immune tissue is located behind the nose, in what would be the roof of the respiratory tract, before starting its descent to the thorax through the neck. Along with the tonsils, they form a ring that divides the area of the oral and nasal cavities from the pharynx itself.

The main function of the adenoids is to filter and retain potentially harmful substances or exogenous microorganisms that may attempt to enter. Adenoids can retain bacteria, viruses, or even dust containing pathogens.

Adenoid vegetations are most active during childhood. Until the age of five, their function is recorded as being clearly active. From that age, they begin to diminish in size to tend to disappear during adolescence. That’s because, by then, the human body has other more efficient ways of defending itself.

Adenoid hypertrophy

As we said before, adenoid vegetations are “famous” because of the need to operate on them in certain cases. The condition that causes the need for surgery is known as adenoid hypertrophy.

Adenoid hypertrophy is an increase in the size of the immune tissue located there. This enlargement produces undesirable symptoms in individuals and prevents the tissue from fulfilling the very function for which it exists. The most frequent age at which adenoid hypertrophy appears is between three and six years old.

Children who suffer from it usually have some of the following symptoms:

  • Mouth breathing: When there’s an obstruction of the nasal passage, air enters through the mouth.
  • Dry mouth: Because air enters through the mouth, the cavity becomes dry. This is because the mouth isn’t prepared to carry out the act of breathing by itself.
  • Nasal voice: The obstruction generates changes in the sounding board that gives the voice its timbre. Therefore, children with hypertrophy tend to have a different voice, with a characteristic tone.
  • Snoring: Generally, these are children who snore at night. They may even breathe with an intense noise during wakefulness as well, sort of like daytime snoring.
  • Halitosis: Mouth breathing that dries out the mouth leads to bad breath, even with good hygiene. Certain bacteria thrive best in a dry environment.
  • Repeat infections: Perhaps the most common red flag for adenoid hypertrophy is when a child has repeat ear, nose, and throat infections. More than eight or nine episodes of pharyngitis, otitis, or sinusitis a year require that testing to rule out hypertrophy.
A child covering his mouth with both hands.
Oral health problems in children may be due to adenoid hypertrophy.

To learn more: Home Remedies for Bad Breath with 5 Plants

When to operate on adenoid vegetations?

Normally, the adenoids shouldn’t be removed. It’s a physiological tissue of the human being and it exists because it has a function, especially in children. In fact, not all professionals agree on the benefits of surgical therapy.

In general, when the removal of them is necessary, it takes place along with tonsillectomy – the removal of the tonsils. Until today, they are still the most frequent pediatric operations.

Common understanding indicates that children require surgery when:

  • The difficulty in breathing is constant and alters their physical performance, either in sports or in daily life activities.
  • During sleep, breathing difficulties appear, causing apneas – momentary stops in breathing.
  • The infections are more recurrent than normal in the pediatric age and can produce other complications. For example, delayed growth, hearing loss, or learning problems.

You may be interested: Obstructive Sleep Apnea in Children

Adenoid vegetation in adults

From the age of five, and through adolescence, adenoids begin a process of atrophy. In most cases, they progressively shrink and disappear. The body no longer needs them as much as it did during childhood, so it eliminates them naturally.

Their disappearance isn’t a significant loss. On the contrary, atrophy indicates that the body’s been able to evolve and develop other means of defense against external agents. However, the persistence of adenoid vegetations in adulthood does represent a problem.

A man snoring.
Adults with obstructive sleep apnea may benefit from an operation if their adenoids are inflamed.

Adults with inflamed adenoids may suffer from obstructive sleep apnea syndrome. This consists of nocturnal episodes of not being able to breathe for a few a second during sleep. This is a complicated situation that’s associated with high blood pressure and increased cardiac risk.

Like children who require surgery, adults with this inflammation may also need intervention to improve their airway and decreasing episodes of nocturnal apnea. It may not completely resolve the syndrome, but it helps reduce the possibility of a cardiac incident.

  • López, Maite. “Adenoides y amígdalas.” Revista chilena de pediatría 72.3 (2001): 251-255.
  • Escario, J. Cervera, et al. “Indicaciones de adenoidectomía y amigdalectomía: Documento de Consenso entre la Sociedad Española de Otorrinolaringología y Patología Cervicofacial y la Asociación Española de Pediatría.” Acta Otorrinolaringologica Espanola 57.2 (2006): 59-65.
  • Wilmott, Robert W., et al. Kendig. Enfermedades respiratorias en niños. Elsevier Health Sciences, 2019.