The adenoids grow from the roof of the nasopharynx, which is the space behind the nasal cavity and above the soft palate. When the adenoids enlarge the nose may become completely obstructed resulting in mouth breathing, snoring, drooling, and oftentimes difficulty eating, as with the nose obstructed it can become difficult to eat and breathe at the same time. The nasal obstruction often leads to chronic rhinorrhea and sinus infections as well. Because they are far in the back of the nose the adenoids usually can not be seen on routine physical exam. They often enlarge in conjunction with the tonsils which can clearly be seen in the mouth on the lateral aspects of the posterior oropharynx. Thus, if tonsil surgery is recommended the adenoids will routinely be evaluated and likely removed at the time of tonsillectomy. However, there are some cases where the tonsils are small and not causing problems and the adenoids are suspected to be enlarged and causing symptons. If a suspicion of isolated adenoid enlargement is suspected it is necessary to visualize and confirm this in order to make a determination if surgery will be beneficial. This will usually require a quick in office endoscopic evaluation.