Why is adenoidectomy carried out?

The adenoids are composed of tissue similar to tonsil tissue. They sit at the back of the nose, just above the soft palate (back part of the roof of the mouth).

Some children with large adenoids can have difficulty breathing through their nose. This can lead to snoring, and while we don't usually recommend adenoidectomy in children solely because of snoring, some children can also have sleep apnoea. This is when they appear to hold their breath or stop breathing for a few seconds. In these circumstances we would usually suggest an adenoidectomy, usually combined with a tonsillectomy.

The adenoids sit very close to the opening of the Eustachian tube into the back of the nose. This is the tube that connects the middle ear (space behind the eardrum) with the nose, and is what we use to equalise pressure on an aeroplane. Some children with glue ear or repeated ear infections may be helped by an adenoidectomy.

Occasionally adenoids may be removed for other symptoms such as a chronic nasal discharge or chronic cough.

Are there any alternatives to surgery?

As children grow, their adenoids tend to shrink. This means that sometimes we may recommend a period of "watchful waiting" to see if symptoms improve over time. Occasionally we may suggest treatment with a course of nose drops to try and reduce nasal obstruction as an alternative to adenoidectomy.

How is the surgery performed?

The operation is carried out under general anaesthetic (the child is completely asleep). The adenoids are removed via the nose and mouth, with no external scars. We generally now use a technique called suction diathermy. This is a very precise and controlled way of removing the adenoids using special lighting and mirrors, carefully vapourising and cauterising the adenoids.

What can I expect after the surgery?

Adenoidectomy is generally carried out as a day-case procedure. We do however ask that children stay on the ward for 6 hours after the operation to make sure that they have recovered sufficiently and to check for any signs of bleeding. The main exception to this is children with sleep apnoea, whom we generally monitor overnight after the operation as they can be particularly sensitive to the anaesthetic.

Adenoidectomy is not a particularly painful procedure, and paracetamol and ibuprofen are normally sufficient for pain relief. We recommend that children stay at home taking things quietly for one week after the operation to allow things to heal.

What are the risks of the surgery?

All operations, however carefully and expertly they are carried out, have risks attached.

Whilst we always do our best to operate only when we think there is a good chance of the surgery being successful, there is always a chance that the symptoms we are trying to treat may not improve following the operation.

Adenoids can also occasionally regrow. This would show itself as the original symptoms improving for a time then gradually returning. If this occurs, a further adenoidectomy can be performed if necessary.

There is a very small chance of bleeding from where the adenoids have been removed. This will normally show itself as a nosebleed or occasionally the child may seem to be swallowing blood. This can occur anytime in the week or so following surgery, but in practice it is extremely rare for any bleeding to occur after the child has left hospital.

We often prescribe a course of antibiotics to reduce the chances of an unpleasant  nasal discharge that can sometimes occur during healing. Despite this there is a small chance of post-operative infection.

Because we are operating through the mouth there is also a very small chance of damage to teeth. Please make sure that you inform BOTH the surgeon AND the anaesthetist before the operation if your child has any loose teeth.