adenoidectomy surgery
What’s an adenoidectomy?
When adenoids need to be removed?
Preparing for an adenoidectomy
How an adenoidectomy is performed?
After an adenoidectomy and recovery
What are the chances of adenoids growing back?
Can adenoids grow back twice?
What’s an adenoidectomy?
The adenoid is a single mass of tissue located way in the back of the nose where the nose joins the throat. (Although most people say “adenoids” as if there is more than one, we really have just one adenoid.)
The adenoid (also sometimes called the pharyngeal tonsil) is part of our immune system. Our immune system helps us fight germs that cause illness. You can think of the adenoid as a germ processing center. It helps our bodies learn to recognize different kinds of germs so that we can fight them better.
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When adenoids need to be removed?
A child's adenoids can sometimes become swollen or enlarged. This can happen after a bacterial or viral infection, or after a substance triggers an allergic reaction.
In most cases, swollen adenoids only cause mild discomfort and treatment isn't needed. However, for some children, it can cause severe discomfort and interfere with their daily life.
Adenoids may need to be removed if your child has:
- breathing problems your child may have difficulty breathing through their nose and may have to breathe through their mouth instead, which can cause problems such as cracked lips and a dry mouth
- difficulty sleeping your child may have problems sleeping and may start to snore; in severe cases, some children may develop sleep apnoea (irregular breathing during sleep and excessive sleepiness during the day)
- recurrent or persistent problems with the ears – such as middle ear infections (otitis media) or glue ear (where the middle ear becomes filled with fluid)
- recurrent or persistent sinusitis leading to symptoms such as a constantly runny nose, facial pain and nasal-sounding speech
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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 medication that can affect blood clotting, such as ibuprofen or aspirin. You may use acetaminophen (Tylenol) for pain. If you’re in doubt about which medications 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 medication to be taken before the surgery, give it to your child with a small sip of water.
How an adenoidectomy is performed?
(The procedure)
In the operating room, the anesthesiologist will usually use a mixture of gas and an intravenous medication for the general anesthetic. In most situations, an IV will have been started either in the preoperative holding room or after the child has been given a mask anesthetic. During the procedure, your child will be continuously monitored by pulse oximeter (oxygen saturation) and heart rhythm (EKG). The surgical team is well trained and prepared for any emergency. In addition to the surgeon and the anesthesiologist, there will be a nurse and a surgical technician in the room.
After the anesthetic takes effect, the doctor will remove the adenoids through the mouth. There will be no external incisions. The base of the adenoids will be cauterized with an electrical cauterizing unit. The whole procedure usually takes less than 45 minutes. Your doctor will come to the waiting room to talk with you once your child is safely in the recovery room.
After an adenoidectomy and recovery
Having 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:
- water
- fruit juice
- Gatorade
- Jell-O
- ice cream
- sherbet
- yogurt
- pudding
- 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 ziplock plastic 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. They may return to school in three to five days if they feel up to it and have the surgeon’s approval.
What are the chances of adenoids growing back?
Unlike the tonsils, your surgeon cannot completely remove all adenoid tissue in the back of the nose (although today's instruments allow us to do a pretty good job).
It is possible for your tonsils and adenoids to grow back following a tonsillectomy or adenoidectomy. The rate of regrowth varies from 1.3% to 26%. 6,7 The correlation of adenoid regrowth and recurred symptoms is controversia.
Can adenoids grow back twice?
During a tonsillectomy, most of the tonsils are removed. However, some tissue often remains, so tonsils occasionally can regenerate (regrow) although they probably won't grow back completely or to their original size. If you're worried that your daughter's tonsils are growing back, talk to your doctor.
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