Adenoids are a part of the immune system, like the tonsils, and are found at the upper part of the throat, right behind the nose, in the post-nasal space. They are in close relationship with the Eustachian tubes, which ventilate the ears (image). Their contribution to the immune defense is significant during the first few years of life. After the age of 12 they shrink or disappear. Chronic inflammation of the adenoids is a common problem of childhood. It causes nasal obstruction, snoring and frequent ear infections. Often it leads to accumulation of fluid behind the ear drum, a condition known as Glue Ear. Sometimes this can be more significant than the typical otitis, because it affects the hearing without troublesome symptoms. So it can go undetected for long, exposing the child to the effects of hearing loss, which include impact on the development of speech or even psychological defects. If the adenoids are enlarged, with or without ear problems, surgical removal may be indicated (adenoidectomy). Adenoid enlargement in adults is approached with suspicion, as it can incorporate malignant disease. This is why all adult patients with swelling in the postnasal space undergo imaging studies with MRI or CT. In selected cases, biopsy under local or general anaesthesia may be indicated.