What Does Grade 3 Adenoids Mean? Symptoms, Causes & Treatment Explained
-by ENT specialist doctor-Dr Sagar Rajkuwar, Nashik ,Maharashtra ,India -clinic website-
www.entspecialistinnashik.com
Table of contents-
- Introduction
- Implications for Grade 3
- Treatment
- The Surgical Procedure
- Medication
- What to Expect During and After Surgery
- Summary
- References-
Introduction
Children frequently have enlarged adenoids, which can cause snoring, nasal congestion, mouth breathing, and recurrent throat or ear infections. However, many parents are perplexed and alarmed when doctors use the phrase “Grade 3 adenoids” since they are unsure of what it truly implies. A considerable enlargement of the adenoids, which can obstruct the child’s airway and impair breathing, sleep, and general health, is referred to as Grade 3.
It is crucial to understand what grade 3 adenoids are, what their symptoms are, what causes them, and what treatment options are available in order to receive prompt medical attention and avoid potential long-term consequences. This article will provide parents with all the information they need about grade 3 adenoids in plain English, including when to seek advice from an ENT expert and the treatments that are currently available.
Adenoid hypertrophy, also known as Grade 3 adenoids, is a condition in which the adenoid tissue is enlarged and blocks the choanae (the openings between the nasal cavity). by 2/3 to almost all of the nasopharynx). As a result, the adenoid tissue occupies a large portion of the space and may lead to respiratory and other connected problems.
Adenoids:
Behind the roof of the mouth, above the tonsils, and in the rear of the nasal passage are the tiny pads of tissue known as the adenoids. They aid in warding off infections, particularly in the early years of life, and are a component of the immune system.
Hypertrophy of the adenoids:
The increase in the size of the adenoids is referred to by this phrase.
Grading:
The degree of adenoid hypertrophy is often assessed using a method that considers how much of the choanae is blocked by the adenoid tissue.
Grade 1: The choana is blocked by the adenoids for up to one-third.
Grade 2: The adenoids prevent one-third to two-thirds of the choana from closing.
Grade 3: The choana is blocked by the adenoids from two-thirds to almost its entirety.
The choana is totally blocked by the adenoids in fourth grade.
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Implications for Grade 3
Adenoids of Grade 3 indicate a severe blockage (50-75%) of the nasopharynx, which can result in symptoms such as frequent ear infections, sleep-disordered breathing, mouth breathing, snoring, and persistent nasal congestion. with fluid accumulation and hearing loss, and possibly impacting mood, concentration, and development. Although medical management with steroids is an option, surgical removal (adenoidectomy) is frequently advised if symptoms persist or if complications such as persistent ear fluid or sleep apnea arise.
Signs and Complications
Problems with the Nose and Breathing:
Adenoids of grade 3 result in severe nasal blockage, which manifests as persistent congestion, discharge, snoring, mouth breathing, and insomnia.
Issues with Sleep:
They raise the likelihood of sleep-disordered breathing, such as pediatric sleep apnea, which can have a detrimental impact on a child’s development.
Issues with the Ears:
The Eustachian tubes may get blocked by the massive adenoids, resulting in ongoing middle ear fluid (secretory otitis media), ear infections, and conductive hearing loss.
Effect on Progress:
A child’s attention, mood (resulting in irritation), growth, and general well-being can all be impacted by persistent sleep disruptions and inadequate oxygenation.
Medical care
Oral Steroids: Medical care with oral corticosteroids may occasionally be used in an effort to shrink the adenoid. Especially if initiated early, this might occasionally obviate the need for surgery.
Indications:
- Severe obstructive symptoms that cannot be treated with medication.
- Recurring ear infections or fluid accumulation, which can cause hearing loss.
- other severe sleep-disordered breathing or sleep apnea.
The Need for Medical Advice
An endoscopic examination, performed by a physician (ENT specialist), can precisely assess the size of the adenoids and their effects on the nasal airway and Eustachian tubes.
They may then provide advice on the best course of action, be it surveillance, medical care, or surgery.
Treatment
Because a Grade 3 adenoid enlargement often causes a substantial blockage in the nasal airway, surgery to remove the adenoids, known as an adenoidectomy, is frequently the advised course of treatment. Though treatments for underlying causes like allergies may include antihistamines or nasal steroid sprays, the severity of a Grade 3 blockage often calls for surgical removal. The procedure is an outpatient operation performed under general anesthesia, with a recovery time of one to two weeks.
The treatment of grade 3 adenoids may be necessary, particularly if the symptoms are severe. Alternatives include:
- Medical administration: Occasionally, anti-inflammatory medications such antihistamines or nasal steroids may be helpful.
- Adenoidectomy: If medical treatment is ineffective or the symptoms are severe, surgical removal of the adenoids (adenoidectomy) may be advised.
The Surgical Procedure
An adenoidectomy of grade 3 is an operation to remove enlarged adenoids that obstruct the nasal airway by 50–75%. The procedure entails putting the patient to sleep under general anesthesia before the surgeon uses an instrument to hold the mouth open. using tools like a curette, a microdebrider, or electrocaustery to open and remove the adenoid tissue. Following a recovery period, the patient is frequently able to return home on the same day.
Steps for Surgery
1. Anesthesia:
The patient is given general anesthesia to keep them unconscious and pain-free throughout the procedure.
2. Gaining Access to the Adenoids:
In order for the surgeon to see the adenoid glands, which are found at the back of the nose, a little instrument is inserted into the patient’s mouth to maintain it open.
3. Adenoid Removal:
The surgeon uses tools to excise the hypertrophied adenoid tissue.
Cold Dissection: The adenoids are removed from the underlying muscle by peeling or cutting them using a steel instrument.
Cautery: This technique uses heat (electrocaustery) or radiofrequency energy (coblation) to ablate the tissue and halt bleeding.
Microdebrider: The adenoid tissue is also removed with this cutting instrument.
4. Hemorrhage Management:
To stop bleeding during and after the treatment, the surgeon may employ an absorbent substance or electrical heat.
5. Recovery:
Following the procedure, the patient stays in a recovery room until the effects of the anesthesia wear off.
Essential Information
Duration: The treatment often lasts between 30 and 45 minutes.
Adenoidectomy is often performed as an outpatient surgery, which means that the patient may return home on the same day.
Recovery: It typically takes one to two weeks for a full recovery, during which time you might take pain relievers and get plenty of rest.
Medication
To treat a Grade 3 adenoid enlargement (which obstructs 50–75% of the nasal passage), nasal steroid sprays such mometasone furoate or fluticasone propionate can be used. minimize swelling and size, particularly if allergies are the culprit. Systemic corticosteroids can be used for a quick, short-term decrease, but they come with hazards. Surgery to remove the adenoids (adenoidectomy) may be necessary in some instances, particularly when medical management is ineffective.

Possible Drugs:
Topical Corticosteroids (Nasal Steroids):
These sprays, such as fluticasone propionate or mometasone furoate, are frequently prescribed for long-term therapy to alleviate inflammation and shrink the size of enlarged adenoids.
Systemic Corticosteroids:
Systemic (oral) steroids may be used for a fast, short-term reduction, but they are typically not appropriate for children’s long-term usage because of potential side effects.
Medications for Allergies:
A physician may also advise saline sprays and over-the-counter allergy treatments to help minimize nasal and adenoid tissue inflammation if the adenoid enlargement is caused by allergies.
Antibiotics:
If the inflammation is brought on by a bacterial infection (such as group A Streptococcus), these are often prescribed for a course of 10 to 14 days and administered orally.
What to Expect During and After Surgery
Expect temporary throat pain, earaches, foul breath, and nasal congestion for up to two weeks following an adenoidectomy (adenoidectomy) at Grade 3. Prescribed medication should be used to control pain, and you should get enough sleep, consume soft meals, and drink lots of fluids. For “red flags” such as severe bleeding, high temperature, or dehydration symptoms, get in touch with your physician right away.
Throughout the procedure
- Your youngster will receive general anesthesia.
- The adenoids will be removed by the surgeon through the mouth.
- It’s possible that you’ll be kept at the hospital for a couple of hours or for the entire night.
What to Expect in the 1–2 Weeks Following Surgery
Pain: Ear, neck, and throat discomfort are frequent and may worsen before improving.
Nasal Symptoms: Bloody discharge and a blocked or stuffy nose are possible symptoms.
Bad Breath: Bad breath can result from healing tissues, but it usually goes away in a week or two.
Changes in Voice: Your voice can sometimes sound nasal or muffled.
Eat meals that are mild, cool, and simple to swallow, such as applesauce, ice cream, and yogurt. Stay away from foods that are acidic, harsh, and hot.
Activity: Getting enough rest is essential. For a week or two, rigorous activities should be restricted.
When to Call Your Physician
Bleeding: Notify if you see any new, bright red blood coming from your mouth or nose.
Fever: Any temperature above 102°F (38.9°C) that does not react to medication should be reported.
Dehydration: Look for signs of dehydration, such as decreased urine, lethargy, and a dry mouth.
Tips for recovery
Keep hydrated by drinking lots of clear fluids.
Take pain medication as directed to control pain and keep the discomfort at bay.
Rest: Don’t rush back into school or other activities too soon; instead, promote rest for the first few days.
✅ Summary: What Parents Should Know About Grade 3 Adenoids
Grade 3 adenoids indicate that the adenoid tissue is significantly enlarged, obstructing 50–75% of the nasal airway. This may result in snoring, mouth breathing, recurrent ear infections, nasal congestion, and sleep issues like pediatric sleep apnea.
An adenoidectomy (surgical removal of adenoids) is frequently necessary for ongoing or severe symptoms, whereas moderate cases may be treated with antihistamines or nasal sprays. The treatment is often performed as an outpatient treatment since it is safe and improves respiratory, sleep, hearing, and general health.
If a youngster has persistent snoring, mouth breathing, sleep problems, or frequent ear/throat infections, parents should speak with an ENT professional. Early diagnosis and treatment can help promote good growth and development as well as avoid potential long-term consequences.
References-
This article is written as per the clinical experience of ENT Specialist doctor –Dr Sagar Rajkuwar(MS-ENT) ,Nashik Maharashtra -Clinic website-www.entspecialistinnashik.com
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