Adenoidectomy
Definition
Adenoidectomy is the surgical removal of the adenoids. Adenoids are made of tissue located in the back of the nose near the throat. Adenoids are thought to be involved in developing immunity against infections in children.
Anatomy of the Adenoids
© 2008 Nucleus Medical Art, Inc.
Reasons for Procedure
Adenoidectomy is usually performed for the following reasons:
- To remove swollen adenoids that cause problems with breathing through the nose, particularly when sleeping, and to relieve snoring
- To relieve chronic earaches or problems hearing or swallowing
- To treat chronic ear infections or fluid in the ear which occurs when the Eustachian tube connecting the middle part of the ear and throat is blocked by swollen adenoids
- To treat sinusitis or other chronic sinus infections
Risk Factors for Complications During the Procedure
- Previous adverse reaction to anesthesia
- Bleeding disorders
- Hypernasal speech
- Submucous cleft of the palate
What to Expect
Prior to Procedure
Your doctor will likely do the following:
- Physical exam of the tonsils, throat, and neck, at minimum
- Blood test
- Review your medications, some may need to be stopped or adjusted for the procedure
In the days leading up to your procedure:
- Do not take aspirin, aspirin-containing medications, or other nonsteroidal anti-inflammatory medications (NSAIDs).
- Do not eat or drink anything six hours prior to surgery time, including mouthwash, toothpaste, lozenges, chewing gum, and water.
X-ray films will be taken to assess the size of the adenoids.
Anesthesia
General anesthesia is used.
Description of the Procedure
After the anesthetic takes effect, the adenoids are surgically removed through the mouth or they are cauterized (scarred with an electrical current). Occasionally, the adenoids are removed or cauterized through the nose. Gauze packs are placed at the site of surgery to prevent bleeding. Radiofrequency ablation has been used as a way to atraumatically reduce the volume and size of adenoids. This technique affords less bleeding, and seems to cause less pain.
After Procedure
Recovery will take 7-14 days. Postoperative symptoms include, but are not limited to:
- Light bleeding
- Nasal stuffiness or drainage
- Sore throat
- Bad breath
- Difficulty swallowing
- Ear or throat pain
- Occasionally, stiff or sore neck
- “Nasal” speech
How Long Will It Take?
The process takes less than 45 minutes.
Will It Hurt?
Anesthesia prevents pain during the procedure, but pain after the procedure is not uncommon. Your doctor may prescribe pain medication or recommend over-the-counter pain drugs. Some reports suggest that radiofrequency ablation causes less pain.
Possible Complications
Complications following adenoidectomy are rare but may include:
- Failure to cure the ear or sinus infections, or relieve nasal blockage or drainage
- A permanent change in voice (rarely)
- Infection
- Failure to treat snoring, disturbed sleep, or mouth breathing
- Adenoid tissue can sometimes re-grow
- Postoperative bleeding (rarely)
Average Hospital Stay
Adenoidectomy is usually done on an outpatient basis.
Postoperative Care
- Eat light meals of soft foods for the first several days.
- Avoid hot liquids.
- Take prescribed antibiotics to prevent infection after surgery.
- Take pain medications as needed.
- Avoid swimming and rough or vigorous exercise or play, as recommended by your doctor.
- Avoid forceful nose blowing.
Outcome
A complete and quick recovery is usual following a healing period of 7-14 days. Outcomes vary depending on the reason for the adenoidectomy. They include:
- Improved breathing through the nose
- Fewer ear infections
Call Your Doctor If Any of the Following Occurs
- A sudden increase in the amount of bright red bleeding from the nose for more than two minutes.
- A persistent fever greater than 101.5 degrees Fahrenheit.
- Persistent sharp pain or headache that is not relieved by prescribed pain medication.
- Increased swelling or redness of the nose or eyes.
RESOURCES:
The American Academy of Otolaryngology—Head and Neck Surgery (AAO-HNS)
http://www.entnet.org
American Society of Pediatric Otolaryngology
http://www.aspo.us/index.php
CANADIAN RESOURCES:
BC Health Guide, British Columbia Ministry of Health
http://www.bchealthguide.org
Canadian Society of Otolaryngology
http://www.entcanada.org
References:
Adenoid removal . Medline Plus, US National Library of Medicine website. Available at: http://www.nlm.nih.gov/medlineplus . Accessed September 2, 2005
Gigante J. Tonsillectomy and adenoidectomy. Pediatr Rev . 2005;26(6):199-203.
Paradise JL, Bernard BS, Colborn DK, Janosky JE. Assessment of adenoidal obstruction in children: clinical signs versus roentgenographic findings. Pediatrics . 1998 Jun;101(6):979-86.
Shehata EM, Ragab SM, Behiry ABS, Erfan FA, Gamea AM. Telescopic-assisted radiofrequency adenoidectomy: a prospective randomized controlled trial. Laryngoscope . 2005 Jan;115(1):162-166.
Tonsillectomy and adenoidectomy. Medline Plus Interactive Tutorial, US National Library of Medicine website. Available at: http://www.nlm.nih.gov/medlineplus/tutorials/tonsillectomyadenoidectomy/htm/index.htm. Accessed September 2, 2005.
Tonsils and adenoids. American Academy of Otolaryngology website. Available at: http://www.entnet.org/healthinfo/throat/tonsils.cfm . Accessed September 2, 2005.
Last reviewed March 2008 by Elie Rebeiz, MD, FACS
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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