Snoring and mouth-breathing in children may be a sign of enlarged adenoids

During the summer months, changes in children's sleep schedules, increased screen time, and hot weather can cause symptoms such as snoring or mouth-breathing to be overlooked. According to experts, these complaints can be among the early signs of enlarged adenoids in some children.

Acıbadem Altunizade Hospital Ear, Nose, and Throat Specialist Prof. Dr. Haluk Özkarakaş stated that if left untreated, enlarged adenoids can negatively affect a child's sleep quality, hearing, school performance, and growth and development. He emphasized that while the problem is most common in the 3-6 age range in Turkey, it can also lead to significant health problems in school-aged children.

SURGERY IS NOT THE FIRST OPTION FOR EVERY CHILD

One of the most common concerns in society regarding adenoids is the belief that removing them will weaken the immune system. Prof. Dr. Özkarakaş stated that while adenoids are part of the immune system, there are numerous lymphoid tissues in the body that perform similar functions, and that surgery performed on appropriate patients does not lead to permanent immune deficiency.

Another misconception is the belief that every child with enlarged adenoids will necessarily snore. However, the clinical picture is not limited to snoring alone. Symptoms such as mouth-breathing due to nasal congestion, frequent waking at night, tossing and turning in bed, sweating in the forehead-neck-collar area, sleep apnea, fatigue, difficulty concentrating, behavioral changes, and a decline in school performance may be observed. Fluid accumulation in the middle ear and recurrent ear infections can also accompany enlarged adenoids.

According to Özkarakaş, the appearance of enlarged adenoids alone is not a reason for surgery. The surgical decision is made by evaluating the child's breathing, sleep patterns, whether they experience snoring or sleep apnea, whether they have frequent ear infections, their hearing, and their quality of life together. While follow-up and, if necessary, allergy-focused treatment are sufficient for some children, surgery may become the most appropriate option in some cases.

Families should also be cautious about the approach of "Let them grow a little, the adenoids will shrink on their own." Although adenoids tend to shrink naturally toward adolescence, this process does not progress the same way in every child. Waiting for years is not considered correct in cases that make breathing difficult, cause sleep-disordered breathing, frequent ear infections, or hearing loss.

One of the expert's warnings concerns the uncontrolled use of nasal sprays and compounded medications prepared in pharmacies. Although steroid nasal sprays can be used with a physician's recommendation in the presence of allergic rhinitis, it is noted that these treatments do not shrink the adenoids. Özkarakaş pointed out that some compounded medications may contain antibiotics or silver solutions, and said that such applications should not be used without scientific basis.

Prof. Dr. Özkarakaş emphasized that if symptoms such as mouth-breathing, sweating, and frequent tossing and turning in bed persist together for at least three months in a child, a physician's evaluation for adenoids and accompanying tonsillar hypertrophy is essential.