What is an Adenoidectomy (Adenoid Removal)?
Adenoid removal, also called adenoidectomy, is a common surgery used 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.
Adenoid removal is often performed together with a tonsillectomy (removal of the tonsils). Chronic throat and respiratory infections often cause inflammation and infection in both glands. The combined tonsil and adenoid removal surgery is the second most common operation performed in children, according to the National Institutes of Health (NIH).
Why the Adenoids Are Removed
Frequent throat infections can cause the adenoids to become enlarged. Enlarged adenoids can obstruct breathing and block the Eustachian tubes, which connect the middle ear to the back of the 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
- sore throat
- difficulty swallowing
- difficulty breathing through the nose
- habitual mouth breathing
- obstructive sleep apnea (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 physician may recommend adenoid removal if your child has chronic ear or throat infections that:
- do not respond to antibiotic treatments
- recur more than five times per year
- recur three times or more within a two-year period
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 blood clots correctly and if your 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, do not give your child any medicine that can affect blood clotting, such as ibuprofen or aspirin. Acetaminophen (Tylenol) is allowed for pain, but if you are in doubt about which medicines are OK, 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
Adenoidectomy is performed under general anesthesia (drug-induced deep sleep), usually in an outpatient setting, meaning that you can go home on the day the surgery is performed.
The adenoids are usually removed through the mouth. The surgeon will insert a small instrument into your child’s mouth to prop it open, then remove the adenoids by making a small incision or by cauterizing (sealing the area using a heated device).
Cauterizing and packing the area with absorbent material like gauze will control bleeding during and after the procedure. Stitches are not usually required.
When the procedure is finished, your child will be taken to a recovery room until he or she wakes up. Medication will be prescribed to reduce pain and swelling. Your child will be released from the hospital, usually on the same day. Complete recovery from an adenoidectomy usually takes one to two weeks.
After an Adenoidectomy
A sore throat for one to two weeks after surgery is normal. It is important to drink a lot of fluids to avoid dehydration; good hydration actually helps to alleviate pain. For a couple of weeks, do not feed your child spicy or hot foods or foods that are hard and crunchy. Cold liquids and desserts are soothing on the child’s throat.
While your child’s throat is sore, good diet and drink options include:
- fruit juice
- ice cream
- apple sauce
- 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. The child may return to school in three to four days if he or she feels up to it.
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, which include 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