If your child is a mouth breather, he may need immediate medical health. The most common cause of mouth breathing in children is enlarged adenoids. If left unattended for long, mouth breathing can cause a dull facial expression with pinched nose, thin upper lip, open mouth, bunny teeth aptly referred to as adenoid facies. Enlarged adenoids obstruct free flow of nasal and sinus secretions leading to frequent colds.
Involvement of the ears is crucial. The Eustachian tube which connects the ear and the back of the nose gets involved by enlargement and infection of the adenoids. This causes multiple ear infections and glue ear. This can affect hearing in children. At times the hearing loss can be permanent, if symptoms are ignored.
Nose block can cause snoring, disturbed sleep and obstructive sleep apnea. The child becomes restless, irritable and inattentive due to lack of sound sleep and low levels of oxygenation. The circulatory and nervous systems also get secondarily affected.
Conservative management is tried initially for adenoid hypertrophy and adenoiditis. If symptoms subside or are reasonably controlled one can wait for natural regression.
Surgical removal of adenoids is recommended for obstructive sleep apnoea, affections of the ears, involvement of teeth changing facial features and repeated infections affecting the child’s quality of life adversely.
Along with the tonsils and a few other lymphatic structures the adenoids form a protective ring at the entrance of the food and air passages. Unlike the tonsils, the adenoids are not visible easily since they are located at the back of the nose. Probably this is why few are aware of this structure.
The adenoids are present at birth and grow in size till about six years of age after which the size regresses.
By this age the rest of the body immune system takes over protective function and the significance of the adenoids reduces. Being aware of some of the affections of the adenoids is worthwile. Infections of the adenoids is common especially in the play school going age. Simple enlargement of the structure also is of concern.
Awareness of this structure and the symptoms caused by diseases of the adenoids especially among young parents will help tackling the problems at an early stage so that irreversible sequelae like hearing loss , change in facial features, cardiac and neurological complications can be avoided.
Dr Bathi Reddy, ENT Head, Manipal Hospital