Q. My son just turned 5. He has enlarged adenoids and is having continuous nasal infections and sinusitis. He has had six courses of antibiotics in the past year. The doctor is recommending that they come out. I am not sure if this is a good idea. Why would it be his adenoids instead of his tonsils?

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 at night can be impaired, and norrmal sinus function compromised as you describe.

The most common reasons for adenoid removal is to address problems of mouth breathing (nasal passage blockage), or recurrent ear or sinus infection. 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.

http://www.fda.gov/fdac/features/1998/498_sleep.html

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

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

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