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Adenoidectomy

By

Megan Freedman

What is an adenoidectomy?

An adenoidectomy is the surgical removal of the adenoids. The adenoids are glands located in the throat behind the nose. They are not visible through the mouth.

The adenoids fight infection, but they can become infected and enlarged themselves. This can cause persistent breathing difficulty, sleep apnea (pauses in breathing during sleep), sinus infections, ear infections, and hearing loss. Your doctor may recommend an adenoidectomy for your child to treat these conditions.

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The adenoids are largest in infants and younger children. Large adenoids are more likely to become infected. This is why doctors perform most adenoidectomies on younger children. Adenoids begin to shrink around age five and may disappear in time. It is rare for adults to have an adenoidectomy.

Your child may have less invasive treatment options. Consider getting a second opinion about all the treatment choices before your child has an adenoidectomy.

Other procedures that may be performed

Doctors often remove the tonsils (tonsillectomy) during the same procedure. The tonsils are also infection-fighting glands located in the throat. Tonsils can become infected and enlarged along with the adenoids and cause similar problems. 

Why is an adenoidectomy performed?

Your doctor may recommend an adenoidectomy when the adenoids become infected or enlarged and cause persistent: 

  • Excessive and loud snoring due to enlarged adenoids that block the breathing passages

  • Difficulty breathing through the nose due to enlarged adenoids

  • Recurrent ear infections, possibly leading to hearing loss

  • Sinus infections, also known as sinusitis

  • Sleep apnea, or pauses in breathing during sleep

Doctors also remove the adenoids to treat cancer or a tumor affecting the adenoids.

Your doctor may only consider adenoidectomy if other treatment options that involve less risk of complications have been ineffective. Ask your doctor about all of your child’s treatment options and consider getting a second opinion before deciding on an adenoidectomy.

Who performs an adenoidectomy?

The following surgeons perform adenoidectomy: 

  • General surgeons specialize in the surgical treatment of a wide variety of diseases, disorders and conditions.

  • Otolaryngologists (ENTs) specialize in the treatment of diseases and conditions of the ears, nose and throat.

  • Pediatric otolaryngologists (pediatric ENTs) specialize in the treatment of diseases and conditions of the ears, nose and throat in infants, children and adolescents.

  • Pediatric surgeons specialize in surgery for infants, children and adolescents.

How is an adenoidectomy performed?

An adenoidectomy is usually an outpatient procedure done in a hospital or surgical clinic setting. Some children may need to stay overnight in the hospital for observation. 

Your surgeon will prop open your child’s mouth and remove or cauterizing the adenoids through the mouth. Cauterizing is sealing blood vessels or tissues with heat. Your surgeon will cauterize the remaining blood vessels to reduce bleeding.

Types of anesthesia that may be used

Your surgeon will perform an adenoidectomy using general anesthesia. General anesthesia is a combination of intravenous (IV) medications and gases that put your child in a deep sleep. Your child will be unaware of the procedure and not feel pain. 

What to expect the day of your child’s adenoidectomy

The day of surgery, you can expect to:

  • Talk with a preoperative nurse. The nurse will perform an exam of your child and ensure that all needed tests are in order. The nurse can also answer questions and make sure you understand and sign the surgical consent form.

  • Remove all of your child’s clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home. Your care team will give your child blankets for modesty and warmth.

  • Talk with the anesthesiologist or nurse anesthetist about your child’s medical history and the type of anesthesia used

  • A surgical team member will start an IV.

  • The anesthesiologist or nurse anesthetist will start your child’s anesthesia.

  • The surgical team will monitor your child’s vital signs and critical body functions. This occurs throughout the procedure and recovery until your child is alert, breathing effectively, and all vital signs are stable.

What to expect the day of your child’s adenoidectomy

The day of surgery, you can expect to:

  • Talk with a preoperative nurse. The nurse will perform an exam of your child and ensure that all needed tests are in order. The nurse can also answer questions and make sure you understand and sign the surgical consent form.

  • Remove all of your child’s clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home. Your care team will give your child blankets for modesty and warmth.

  • Talk with the anesthesiologist or nurse anesthetist about your child’s medical history and the type of anesthesia used

  • A surgical team member will start an IV.

  • The anesthesiologist or nurse anesthetist will start your child’s anesthesia.

  • The surgical team will monitor your child’s vital signs and critical body functions. This occurs throughout the procedure and recovery until your child is alert, breathing effectively, and all vital signs are stable.

What are the risks and potential complications of adenoidectomy? 

As with all surgeries, an adenoidectomy involves risks and potential complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.

General risks of surgery 

The general risks of surgery include: 

  • Anesthesia reaction, such as an allergic reaction or breathing problems

  • Bleeding, which can lead to shock

  • Infection

Potential complications of adenoidectomy

Complications of adenoidectomy include:

  • Ear pain

  • Pain or difficulty when swallowing, which typically goes away after a few days

  • Re-growth of the adenoids, although this is very rare

  • Throat pain, which usually goes away after a few days

Reducing your risk of complications

You can reduce the risk of some complications by making sure your child follows the treatment plan and:

  • Following activity, dietary and lifestyle restrictions and recommendations before surgery and during recovery

  • Notifying your child’s doctor immediately of any concerns, such as bleeding, fever, or increase in pain

  • Taking medications exactly as directed

  • Telling all members of the care team if your child has any allergies

How do I prepare for my child's adenoidectomy? 

You are an important member of your child’s healthcare team. The steps you take before surgery can improve your child’s comfort and outcome. 

You prepare your child for surgery by: 

  • Answering all questions about your child’s medical history and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your child’s medical conditions, medications, and allergies at all times.

  • Getting preoperative testing as directed. Testing varies depending on your child’s age, health, and specific surgery. Preoperative testing may include blood tests, radiologic imaging of the adenoids, and other tests as needed.

  • Ensuring that your child does not eat or drink before surgery as directed. Surgery may be cancelled if your child eats or drinks too close to the start of surgery because your child can choke on stomach contents during anesthesia.

  • Ensuring that your child stops taking medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners.

  • Helping your child to lose excess weight before the surgery by providing a healthy diet and exercise plan, as directed by the doctor

  • Talking with your child about what to expect during and after the surgery. Allow your child to express feelings. Tell your child that he or she will have a sore throat for a few days after the surgery. Reassure your child that medications will make him or her comfortable.

  • Tell your child that the surgery will improve comfort and health, such as improving breathing or reducing earaches or infections.