Adenoidectomy is the surgical removal of the adenoids for reasons which include impaired breathing through the nose, chronic infections, or recurrent earaches. The surgery is less commonly performed in adults in whom adenoids are considered vestigial and purposeless. It is most often done on an outpatient basis under general anesthesia. Post-operative pain is generally minimal and reduced by icy or cold foods. The procedure can be combined with tonsillectomy if indicated and recovery time can range from several hours to two or three days (though as age increases so does recovery time).
Adenoidectomy is not often performed under one year of age as adenoid function is part of the body’s immune system but its contribution to this decreases progressively beyond this age.
What Is an Adenoidectomy (Adenoid Removal)?
Adenoid removal, also called adenoidectomy, is a common surgery to remove the adenoids. The adenoids are glands located in the roof of the mouth, behind the soft palate where the nose connects to the throat.
The adenoids produce antibodies (white blood cells) that help fight infections. Typically, the adenoids shrink during adolescence and may disappear by adulthood.
Doctors often perform adenoid removals and tonsillectomies (removal of the tonsils) together. Chronic throat and respiratory infections often cause inflammation and infection in both glands.
Why the Adenoids Are Removed
Frequent throat infections can cause the adenoids to enlarge. Enlarged adenoids can obstruct breathing and block the Eustachian tubes, which connect your middle ear to the back of your nose. Clogged Eustachian tubes cause ear infections that can jeopardize your child’s hearing and respiratory health.
Symptoms of Enlarged Adenoids
Swollen adenoids block the airways and can cause the following symptoms:
frequent ear infections
difficulty breathing through the nose
habitual mouth breathing
obstructive sleep apnea, which involves periodic lapses in breathing during sleep
Repeated middle ear infections due to swollen adenoids and clogged Eustachian tubes have serious implications, such as hearing loss, which can also lead to speech problems.
Your child’s doctor may recommend an adenoid removal if your child has chronic ear or throat infections that:
don’t respond to antibiotic treatments
occur more than 5 or 6 times per year
impede your child’s education due to frequent absences
Part 4 of 8: Preparation
Preparing for an Adenoidectomy
The mouth and throat bleed more readily than other areas of the body, so your doctor may request a blood test to find out whether your child’s blood clots correctly and if their white and red blood count is normal. Preoperative blood tests can help your child’s doctor ensure that there won’t be excessive bleeding during and after the procedure.
In the week before surgery, don’t give your child any medicine that can affect blood clotting, such as ibuprofen or aspirin. You may use acetaminophen (Tylenol) for pain. If you’re in doubt about which medicines are appropriate, talk with your doctor.
The day before surgery, your child should have nothing to eat or drink after midnight. This includes water. If the doctor prescribes medicine to be taken before the surgery, give it to your child with a small sip of water.
How an Adenoidectomy Is Performed
A surgeon will perform an adenoidectomy under general anesthesia (a drug-induced deep sleep). This is usually done in an outpatient setting, which means that your child can go home on the day of the surgery.
The adenoids are usually removed through the mouth. The surgeon will insert a small instrument into your child’s mouth to prop it open. They’ll then remove the adenoids by making a small incision or by cauterizing, which involves sealing the area with a heated device.
Cauterizing and packing the area with absorbent material, such as gauze, will control bleeding during and after the procedure. Stitches aren’t usually necessary.
After the procedure, your child will stay in a recovery room until they wake up. You’ll receive medication to reduce pain and swelling. Patients will typically go home from the hospital on the same day as the surgery. Complete recovery from an adenoidectomy usually takes one to two weeks.
After an Adenoidectomy
A sore throat for two to three weeks after surgery is normal. It’s important to drink lots of fluids to avoid dehydration. Good hydration actually helps to alleviate pain. Don’t feed your child spicy or hot foods or foods that are hard and crunchy for the first couple of weeks. Cold liquids and desserts are soothing for your child’s throat.
While your child’s throat is sore, good diet and drink options include:
warm chicken or beef broth
soft-cooked meats and vegetables
An ice collar can help with pain and reduce swelling. You can make an ice collar by placing ice cubes in a zip-lock bag and wrapping the bag in a towel. Place the collar on the front of your child’s neck.
Your child should avoid strenuous activity for up to one week after surgery. Your child may return to school in three to five days if they feel up to it and have the surgeon’s approval.
Risks of an Adenoidectomy
Adenoid removal is usually a well-tolerated operation. Risks from any surgery include bleeding and infection at the surgery site. There are also risks associated with anesthesia, such as allergic reactions and breathing problems.
Be sure to tell the doctor if your child is allergic to any medication.
Adenoidectomies have a long history of excellent results. After surgery, most children:
have fewer and milder throat infections
have fewer ear infections
breathe easier through the nose