Q. My grandson is 8 years old and has had a plugged nose for at least 4 years. He can barely breathe through his nose. You can even see his nostrils move back and forth when he tries to breathe in. He has never been able to blow his nose and has frequent headaches. He has been prescribed allergy medications for 2 years and they just don't help.

My daughter is thinking about getting his adenoids removed. Two years ago the doctor said they were slightly enlarged and suggested trying the allergy medications first. I would appreciate any opinion you have on this. Can these symptoms be caused by enlarged adenoids?

A. The tonsils and adenoids are lymphoid tissue, part of the immune system located in the back of the mouth and throat. While the tonsils can be seen by shining a light in the mouth, the adenoids are not visible as they are in the air passage between the nose and throat. Children have small airways to begin with, so if the tonsils or adenoids are enlarged, breathing can be impaired as you describe.

The removal of tonsils and adenoids has been done for over 50 years, and indeed many studies have been conducted as to any long-term consequences. No such consequences have been seen when these young patients are followed into adulthood. Before preparing for a surgical procedure, the diagnosis must be clear that the adenoids are the problem. A pediatric ENT specialist and an allergy specialist can advise you on this.

http://www.pedisurg.com/PtEducENT/adenoids.htm

http://www.kids-ent.com/tonsil.html

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