Your doctor has recommended an adenoidectomy for your child. The following information is provided to help you prepare for the surgery, and to help you understand more clearly the associated benefits, risks, and complications.
The adenoids are a mass of lymphoid tissue located behind the nasal passages. Adenoids may become infected and remain enlarged or chronically infected, and subsequently lead to obstructed breathing, snoring/sleep apnea, sinus or ear infections, or other problems. Adenoidectomy is a surgical procedure performed to remove the adenoids.
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In most situations, the surgery is performed as an outpatient at either the hospital or the surgicenter. In both facilities, quality care is provided without the expense and inconvenience of an overnight stay. An anesthesiologist will monitor your child throughout the procedure. Usually, the anesthesiologist will call the night before surgery to review the medical history. If he/she is unable to reach you the night before surgery, he/she will talk with you that morning. If your doctor has ordered preoperative laboratory studies, you should arrange to have these done several days in advance.
Your child should not take aspirin, or any product containing aspirin, within 10 days of the date of your surgery. Non-steroidal anti-inflammatory medications (such as ibuprofen/Advil or naproxen/Aleve) should not be taken within 7 days of the date of surgery. Many over-the-counter products contain aspirin or non-steroidal anti-inflammatory type drugs, so it is important to check all medications carefully. If there is any question, please call your doctor’s office or consult your pharmacist. Acetaminophen/Tylenol is an acceptable pain reliever. Often, your doctor will give you several prescriptions for post-operative pain at the visit BEFORE the operation. It is best to have these filled prior to the date of your surgery.
It is advised that you be honest and up front with your child as you explain his/her upcoming surgery. Encourage your child to think of this as something the doctor will do to make them healthier. Let them know they will be safe and that you will be close by. A calming and reassuring attitude will greatly ease your child’s anxiety. You can assure them that most children have minimal pain following an adenoidectomy. Let them know that if they do have pain, it will only be for a short time, and that they can take medicines which will greatly reduce it.
Your child must not eat or drink anything 6 hours prior to their surgery time. This even includes water, candy, or chewing gum. Anything in the stomach increases the chances of an anesthetic complication.
If your child is sick or has a fever the day before surgery, call the doctor’s office. If your child wakes up sick the day of surgery, still proceed to the surgical facility as planned. Your doctor will decide if it is safe to proceed with surgery. However, if your child has chickenpox, do not bring your child to the office or to the surgical facility.
Tell your surgeon if your child has had a cold or sore throat in the week before the operation.
If your child has a high temperature and cough, the operation may have to be postponed for a few weeks to ensure they’ve fully recovered and to reduce their risk of developing complications as a result of the surgery.
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An adenoidectomy is carried out under general anaesthetic, so your child will be unconscious during the procedure and won’t feel any pain.
Your child’s mouth will be propped open and after the adenoids have been located, the surgeon will remove them by scraping them away with an instrument called a curette, or by applying heat using a diathermy instrument. A diathermy instrument produces high-frequency electrical currents that burn the adenoids.
After the adenoids have been removed, the diathermy instrument may be used to stop the bleeding (cauterisation), or a pack made out of gauze may be applied to the skin in the mouth. When this is removed, the operation is complete.
After surgery, the patient wakes up in the recovery area and is given medication to reduce swelling and pain. When the patient has recovered from surgery, he or she is sent home and usually given a week’s course of antibiotics to be taken by mouth. The patient may also develop a sore throat, especially when swallowing or speaking, or moderate pain at the back of the nose and throat, for which pain medication is prescribed. Normally, the pain goes away after a week. A child who has undergone an adenoidectomy should rest at home for at least one week to avoid possible infections at school. Swimming should not be allowed for at least 10 days after the operation. If there is any sign of bleeding or infection (fever, increased pain), the treating physician should be immediately contacted.
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The operation is usually done by an ear, nose and throat (ENT) surgeon and takes around 30 minutes. Afterwards, your child will need to stay in the recovery ward for up to an hour until the anaesthetic has worn off. After the procedure, your child will stay in a recovery room until they wake up. You’ll receive medication to reduce pain and swelling. Your child will typically go home from the hospital on the same day as the surgery. Complete recovery from an adenoidectomy usually takes one to two weeks.