Adenoidectomy

An adenoidectomy is an operation to remove the adenoids. The adenoids are clusters of lymphatic tissue, found at the back of the throat and just above the tonsils.

They form part of the immune system although in a minor capacity only.

The adenoids develop from the time you are born and grow until they reach their full size when you are 4 or 5 years old. They start to shrink from age 7 and have almost disappeared by the time you become an adult.

But they can cause problems which necessitates their removal.

It used to be common practice to remove the adenoids along with the tonsils, especially in children but this practice is less common nowadays.

Reasons for adenoidectomy

There are certain situations in which the adenoids need to be removed which include:

• Enlarged adenoids which are restricting breathing or swallowing.
• Recurring throat infections which include swollen or enlarged adenoids.
• Sleep apnoea caused by enlarged adenoids
• Glue ear

Enlarged adenoids

Swollen or enlarged adenoids are the most common reason for their removal. In these cases the adenoids have become swollen as a result of an infection which then impedes breathing.

It can also cause snoring due to the fact of having to breathe through the mouth instead of the nose. This breaks the sleep pattern and leads to tiredness the following day.

Recurring throat infections

Another factor is repeated throat and ear infections. This is something which children are particularly prone to although they do grow out of this in time. Both of these infections can affect the adenoids.

Sleep apnoea

Sleep apnoea is where the breathing becomes interrupted during sleeping. The muscles and soft tissues of the throat collapse during sleep which can partially or completely cut off the airway. This stops the breathing for an instant but is enough to wake the sleeper.

Glue ear

Glue ear is a condition which often affects children. Children are notoriously prone to developing ear infections due to the fact that their immune system is not as developed as an adult.

Fluid builds up in the middle ear which then turns to a thick, viscous substance –similar to glue, which then blocks the ear. This prevents the child from hearing as normal.

Swollen or enlarged adenoids can block the Eustachian tubes which normally drain fluid away from the ear. But if these become obstructed, fluid then builds up before becoming a glue-like substance. Removal of the adenoids will enable the Eustachian tubes to function as per normal.

Swollen or enlarged adenoids often affect the speech causing it to have a nasal sound.

How is adenoidectomy performed?

This procedure is performed as day surgery and under a general anaesthetic. It takes around 30 minutes in total to complete and is carried out by an ear, nose and throat (ENT) surgeon.

If your child is undergoing this surgery then he or she will be able to go home a few hours afterwards. But if he/she has not fully recovered then he/she will have to stay in overnight.

The procedure starts with the surgeon using an instrument to open your child’s mouth enabling access to the adenoids. He or she will then remove the adenoids.

There are several ways of doing so which include scraping them away using a curette or burning them using diathermy. Diathermy emits heat waves to burn away tissues and also seals blood vessels to prevent any bleeding.

A gauze dressing will also be applied to area to help stop any bleeding. This dressing is removed shortly afterwards.

Recovery after adenoidectomy

Expect your child to feel sleepy, woozy or even nauseous after having a general anaesthetic. This is normal and will ease after a short period of time.

Your child will be given painkillers during this time to ease any pain and discomfort. You will also be given a supply of painkillers to take home with you as your child may still require them.

Once your child has recovered, he/she will be able to go home.

Your child may have sore throat or a stiff jaw after surgery but this will ease although painkillers will help. Over the counter products such as paracetamol and ibuprofen are suitable although you may wish to check with your pharmacist first.

Do NOT give your child aspirin. Aspirin should never be given to children under 16.

Encourage your child to start eating and drinking as soon as they feel ready to do so. They may find this difficult to do at first so give your child soup or other soft foods to start with. Ensure that your child has plenty of drink to avoid becoming dehydrated.

Do you need to keep your child off school?

Keep your child at home for a few days to rest and recover. Doing so will prevent them from picking up any viruses or bacterial infections.

Your child’s throat will take some time to heal so avoid any smoky environments or coming into contact with people who have a cold or some other infection.

This advice is much the same for adults. If you undergo an adenoidectomy then drink plenty of fluids, take painkillers if you need to and use a salt water gargle.

Risks of adenoidectomy

This is a safe procedure with very few risks. However, all forms of surgery have a small percentage a risk.

There are side effects such as an allergic reaction to the anaesthetic although this is very rare. These include dizziness, headache and nausea.

Bleeding is another common effect following surgery. This usually stops after a short period of time but in a few cases it becomes heavy – known as a haemorrhage, which requires urgent attention.

Infection is a risk with all types of surgery. In this case, the area where the adenoids were located can develop a bacterial infection which will require treatment with antibiotics.

Other complications include:

• Bad breath
• Sore throat
• Earache
• Stuffy nose
• Nasal sounding voice

These tend to be temporary and disappear after a couple of weeks. But if they persist for a month or so then seek medical advice.

The risks as well as the benefits of adenoidectomy will be explained to you before surgery.