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Adenoidectomy by Alice A. McCarthy, MBA

Definition | Reasons for Procedure | Possible Complications | What to Expect | Call Your Doctor

Definition

Adenoidectomy is the surgical removal of the adenoids. Adenoids are made of tissue located in the back of the nose near the throat. They are thought to be involved in developing immunity against infections in children.

Anatomy of the Adenoids

Reasons for Procedure

Adenoidectomy is usually done to remove enlarged adenoids that are causing a blockage in the nasal passage. It may also be used to treat long-term sinus infections.

Possible Complications

Complications are rare but no procedure is completely free of risk. If you are planning to have an adenoidectomy, your doctor will review a list of possible complications which may include:

Infection
Adenoid tissue can sometimes re-grow
Bleeding
A permanent change in voice
Reaction to anesthesia

Factors that may increase the risk of complications include:

Previous adverse reaction to anesthesia
Bleeding disorders
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
Blood test
Review your medications; you may be asked to stop taking some medicines up to one week before the procedure like:
- Aspirin or other anti-inflammatory drugs
- Blood thinners, such as clopidogrel (Plavix) or warfarin (Coumadin)
Order x-ray films—to assess the size of the adenoids

Do not eat or drink anything six hours prior to surgery time.

Anesthesia

General anesthesia is used. It will block any pain and keep you asleep through the procedure.

Description of the Procedure

The adenoids will be surgically removed through the mouth. A scalpel or an electrical current may be used to remove the adenoid tissue. Sometimes, the adenoids are removed through the nose. Gauze packs will be placed at the site of surgery to prevent bleeding.

Radiofrequency ablation is a type of procedure that uses heat to destroy tissue. It may be used to reduce the volume and size of adenoids. This method often has less bleeding. It also seems to cause less pain.

Immediately After Procedure

You will be monitored in a recovery room until the anesthesia wears off.

How Long Will It Take?

Less than 45 minutes

How Much Will It Hurt?

Anesthesia prevents pain during the procedure. Pain after the procedure is not uncommon. Your doctor may prescribe pain medicines.

Average Hospital Stay

It may be possible to leave on the same day of the procedure. Your doctor may choose to keep you overnight if complications arise.

Post-procedure Care

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

To help relief some discomfort and speed recovery:

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.
Be sure to follow your doctor’s instructions.

Call Your Doctor

After you leave the hospital, contact your doctor if any of the following occurs:

A sudden increase in the amount bleeding from the mouth or nose (If your child is swallowing a lot, check the back of the throat with a flashlight to look for blood.).
Redness, swelling, increasing pain, or any discharge from the nose or mouth
Increased swelling or redness of eyes
Signs of infection, including fever and chills
Pain that can't be controlled with the medications you've been given
Uncontrolled nausea or vomiting
Noisy or difficult breathing

In case of an emergency call 911.

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 October 2009 by Elie Edmond Rebeiz, MD, FACS and Brian P. Randall, MD

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