Enlarged Tonsils and Adenoids


My journey from a patient to a scientist

Hypertrophy means enlargement. Hypertrophy of the tonsils and the adenoids means this tissue is enlarged.

Tonsils and adenoids have a role in helping the body fight infection. They trap bacteria and viruses entering through the throat.

The tonsils are located on both sides of the back of the throat. The adenoids are located higher and further back, where the nasal passages connect with the throat. Tonsils are visible through the mouth, but the adenoids are not.

Having enlarged tonsils or adenoids may signal infection. However, in some children, the adenoids and tonsils may be naturally enlarged and present no problem.

Patients can be seen by Texas Children's experts in Ear Nose and Throat (Otolaryngology).

Causes & Risk Factors


  • Infection by a virus or bacteria
  • Allergies
  • Cancer (rare)

Risk Factors:

  • Being exposed to smoking  
  • Allergy

Symptoms & Types

Symptoms Include:

  • A voice that has a stuffy-nose quality
  • An abnormally shaped palate and position of the teeth
  • Breathing through the mouth
  • Sore throat
  • Snoring, gasping and pauses when sleeping

Diagnosis & Tests

Your child's doctor will perform a physical examination and ask questions.

These questions may include:

  • How many episodes of sore throat in the last year?
  • Has your child been having trouble sleeping?
  • Does your child snore? Does she gasp for air? Does she stop breathing?
  • Does your child breathe through the mouth instead of the nose most of the time?
  • Has your child had a runny nose?

Tests May Include:

  • Throat culture
  • X-rays
  • Nasopharyngoscopy, a camera put in the nose to examine adenoids
  • Blood tests
  • Sleep study (called a Polysomnogram)

Treatment & Care

Treatment and care depend on why the tonsils and adenoids are enlarged.

Bacterial infection:

  • Antibiotics are used.

Recurrent infections:

  • Surgery may be recommended if antibiotics do not work or if enlarged tonsils and adenoids cause problems with breathing and sleeping.

Watch a video explaining how to care for your child after surgery

Living & Managing

If your child has recurring infections, the doctor will most likely recommend having the tissue removed through surgery. This is a common surgery for children.