Examination shows lymphoid hypoplasia (tonsils and adenoids, no splenomegaly or lymphadenopathy). Large tonsils and adenoids also contribute to tongue thrust swallowing. Mucosal injection and lymphoid hyperplasia involving tonsils, adenoids and base of tongue may be seen. He encountered severe breathing problems that required the removal of his adenoids and tonsils. Some authors speak of two pharyngeal tonsils/two adenoids. Nasotracheal intubation carries a risk of dislodgement of adenoids and nasal bleeding. Repeated adenoiditis may lead to enlarged adenoids. The adenoids, like all lymphoid tissue, enlarge when infected. Severe or recurring adenoiditis may require surgical removal of the adenoids (adenotonsillectomy). Surgical removal of the adenoids is a procedure called adenoidectomy. Splashes of excessive "drip" from infected adenoids may fall directly onto the vocal cords. He tells Debra that the doctor told him his adenoids have to come out. Just how big the adenoids become is quite variable between individual children. Adenoids and tonsils help prevent infection and are composed of lymph tissue. Their name derives from their initial isolation from human adenoids in 1953.