Things to Know about Adenoidectomy

Adenoids are glands above the mouth’s roof and behind the nose. They are a part of the lymphatic system and protect the body from viruses and bacteria. The adenoids and tonsils trap the germs and protect the body from infections via oral and nasal routes. They began to shrink at 6-7 years of age and completely disappear by the teens. 

They are not directly visible. Adenoids are enlarged when infected; however, they restore to their standard size once the infection subsides. Although in some instances, they might remain enlarged even when the infection is gone. The surgical procedure performed to remove the adenoids is called an adenoidectomy. 

Symptoms of enlarged adenoids:

• Stuffy nose
• Sleeping difficulties
• Hearing concerns
• Snoring
• Sore throat
• Difficulty swallowing
• Nasal obstruction (difficulty breathing through the nose)
• Sleep apnea
• Chronic recurrent ear infections
• Sinus infections
• Recurrent tonsillitis

Before the surgery:

1. The nurse practitioner will inquire about the child’s health and inform you of the timing from when the child has to avoid food and liquids.
2. Gum, cough drops, and candy are not allowed before the surgery. If the child has taken any of these, the surgery will be delayed for 2 hours after the gum is spat out. If the chewing gum is swallowed, surgery will get delayed for 6 hours from when consumed.

You must follow the guidelines above, or the surgery will get delayed.

The surgery day:

• The child’s medical insurance and photo ID will be required before the surgery
• A list of medications the child is on
• Your child’s favorite toy
• The child will be weighed, along with vitals measurement before the surgery
• Before the procedure, you must have a conversation with the anesthesiologist and the surgeon regarding your inquiries and concerns
• The nurse practitioner will explain to you all the routines, procedures, home care, and protocols to be followed
• The surgery takes 20-30 minutes
• The child stays in the recovery room until he awakens and breathes easily with no cough or swallowing concerns. Some can go home early after the surgery
• The entire recovery period is 1-2 weeks
• Rarely the adenoid tissue removed might grow back

Surgery: 

Adenoidectomy is a short procedure performed on an outpatient basis by an ENT surgeon. 

• The first step is the administration of general anesthesia
• A retractor widens the child’s mouth, following which the surgeon removes the adenoids. They might use an electrical device to stop the bleeding
• The child is then placed in the recovery room until they awaken from anaesthesia
• Mostly the children can return home on the day of surgery

Home care:

One week after the surgery, it is normal for the child to have:

• Stuffy nose or snoring
• Fever of 100-101 degrees F
• Bad breath
• Thick nasal discharge
• The first two hours following the surgery, the child is given clear liquids, for example, 7-up/apple juice/popsicles. The child might have solid food if he handles the liquid well
• The patient can be given pain killer Tylenol or Ibuprofen in case of sore throat/headache. The child can return to their daily activities as soon as they feel normal. They might go back to school in 2-3 days

When to call the doctor:

You must contact the doctor if-

• If the nasal drainage lasts for 14 days
• If you notice the signs of dehydration like dry mouth/sunken look around the eyes/ reduced urinary flow/no tears on crying
• Signs of bleeding from the mouth or nose after the surgery
• If the child’s temperature is greater than 101 degrees F

Follow-up:

General follow-up is advised after 4-6 weeks. The surgeon’s staff will connect with you in that period. If there are any concerns before that, you can call the physician as needed.

Risks: 

The doctor must clearly explain all the risks associated with the procedure before the surgery. They can include:

• Excessive bleeding
• Recurrent infections
• Risks associated with anesthesia
• Failure to resolve the underlying problems(ear infection/nasal drainage/breathing concerns)
• Permanent vocal quality change

Conclusion: 

If the enlarged adenoids are causing trouble like breathing issues, difficulty swallowing, or recurrent ear infections, removing them surgically is the best option. The surgery is very safe and effective for most affected children. However, you must research thoroughly before deciding. For example, specific sources suggest that adenoid removal may increase the risk of certain infections. Adenoidectomy, as with other surgical options, has the risk of infections and other complications. Mostly the children recover without any health concerns. However, parents must discuss the risks and benefits of the procedure before opting for it.