An adenoidectomy is the surgical removal of the adenoids—small lumps of tissue that lie in the back of the throat behind the nose.
The adenoids are removed if they block breathing through the nose and if they cause chronic earaches or deafness. The adenoids consist of lymphoid tissue—white blood cells from the immune system. They are located near the tonsils, two other lumps of similar lymphoid tissue. In childhood, adenoids and tonsils are believed to play a role in fighting infections by producing antibodies that attack bacteria entering the body through the mouth and nose. In adulthood however, it is unlikely that the adenoids are involved in maintaining health, and they normally shrink and disappear. Between the ages of two and six, the adenoids can become chronically infected, swelling up and becoming inflamed. This can cause breathing difficulties, especially during sleep. The swelling can also block the eustachian tubes that connect the back of the throat to the ears, leading to hearing problems until the blockage is relieved. The purpose of an adenoidectomy is thus to remove infected adenoids. Since they are often associated with infected tonsils, they are often removed as part of a combined operation that also removes the tonsils, called a T&A ( tonsillectomy and adenoidectomy).
Demographics information is difficult to provide because adenoidectomy is routinely performed in an outpatient setting, for which demographic data are not well recorded. Good information is available from the 1970s and 1980s when the surgery was performed in an inpatient setting. In the United States in 1971, more than one million combined T&As, tonsillectomies alone, or adenoidectomies alone were performed, with 50,000 of these procedures consisting of adenoidectomy alone. In 1987, 250,000 combined or single procedures were performed, with 15,000 consisting of adenoidectomy alone. Now, almost all adenoidectomies are performed on an outpatient basis unless other medical problems require hospital admission or an overnight stay. T&A is considered the most common major surgical procedure in the United States.
An adenoidectomy is performed under general anesthesia. The surgeon removes the adenoids from behind the palate. Stitches are usually not required.
The adenoids are most commonly removed through the mouth after placing an instrument to open the mouth and retract the palate. A mirror is used to see the adenoids behind the nasal cavity. Several instruments can then be used to remove the adenoids.
Adenoids may also be removed through the nasal cavity with a surgical suction instrument called a microdebrider. With this procedure, bleeding is controlled either with packing or suction cautery.
The primary methods used to determine whether adenoids need removal are:
When the patient arrives at the hospital or the day-surgery unit, a nurse or a doctor will ask questions concerning the patient's general health to make sure he or she is fit to undergo surgery. They will also check that the patient has not had anything to eat or drink and will record pulse and blood pressure. The doctor or nurse must be informed if the patient has had any allergic or unusual reactions to drugs in the past. The patient will be asked to put on a hospital gown and to remove any loose orthodontic braces, false teeth, and jewelry. In the past, an adenoidectomy usually called for an overnight stay in hospital. However, it is increasingly more common to have this operation on an outpatient basis, meaning that the patient goes home on the same day. The surgery is usually performed early in the morning to allow a sufficient observation period after the operation.
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.
Risks and complications include those generally associated with surgery and anesthesia. Very few complications are known to occur after this operation, except, very rarely, bleeding (which occurs in 0.4% of cases). Bleeding is more a concern with a very young child because he or she often will not notice. For this reason, a child is always kept in observation at the hospital or clinic for a few hours after the operation. If bleeding does occur, the surgeon may insert a pack of gauze into the nose to stop the blood flow for subsequent removal after a day or two. The other possible complications are those associated with any operation, including infection of the operated area, which may result in light bleeding, increased pain, and fever. Infection is usually treated with antibiotics and bed rest.
Adenoidectomy is an operation that has very good outcomes, and patients are expected to make a full and quick recovery once the initial pain has subsided. Adenoid tissue rarely regrows, but some instances have been reported. The exact mechanism is unknown but may be related to incomplete removal.
There is no good evidence supporting any curative non-surgical therapy for chronic infection of the adenoid.
Antibiotics have been used for as long as six weeks in lymphoid tissue infection, but with failure to eradicate the bacteria. With reported incidences of drug-resistant bacteria, use of long-term antibiotics is not a recommended alternative to surgical removal of infected adenoids.
Some studies indicate some benefit from using topical nasal steroids. Studies show that while using the medication, the adenoids may shrink up to 10% and help relieve nasal blockage. However, once the steroid medication is stopped, the adenoids can again enlarge and continue to cause symptoms. In a child with nasal obstructive symptoms, a trial of topical nasal steroid spray and saline spray may be attempted for controlling symptoms.
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Monique Laberge, Ph.D.
An adenoidectomy is performed by an ENT (ear, nose, and throat) board-certified surgeon.
Just a note to comfort people who are timid about surgery in the ear, nose & throat. It was not bad.
Children may be confused, though, and they just need lots of tender loving care and attention. Cool liquids & Jello help a lot, too!
Wendy
Our daughter before arriving in USA was very healthy baby and we never used antibiotics before . When we arrive in USA she start to have cuagh , after sinuses and now ear infections . So , now recomendation is to put tubes and remove adenoids . I regret that I have not read this book 3 months ago ,as I believe I could make some changes in her getting beter and do not need any surgeries . She now 3,5, y.o. . Please be aware about source of the problem , mainly it is liquid in the noise , that caused by allergies !!! If you solve this problem , all others will solve itself . Read a book , try not to give immideatly antibiotics , as if you give offten you trapt in a cycle and you have to have surgery as bacteria getting more resistant . Here , in USA I do not like how much antibiotics have given to children for no reason , this leads to much more problems in the future . When I was child and have ear pain , I was never been giving antibiotics , just change in a diet and warming us the ears and it works .
regards
mucus since, just wondering if most toddlers[he is 2/12] get lots of infection after adenoids are removed until there immune system builds up.
I am naturally concerned as a parent. Has anyone got a similar experience and what did they do, particuarly to help their child before the surgery.
Many thanks in advance.
We never did any x-rays to see things better inside, just doctor examination. I wonder now if I should've have ask for that. I'm always worried if there is more going on than just large adenoids... who can answer that? In one way, I want him to go for surgery so that he can breath better and to see if this strange behaviour stops. Although I am very nervous about the surgery risks as I said before, especially general anesthesia. Or should we don't even think about surgery and wait to see if time would make things get better by its own? But what if things in the back of his nose get worse? Yesterday he got a cold and now is nose is running again and he sounds very congested. Don't know if it's safe for him to go for surgery like this. Is it? I am waiting for tomorrow morning to call the doctor's office before we drive to the hospital. If the surgery goes forward, all I hope is that all goes well! I can not lose the sun of my life!
Looking forward to any reply. Thank you!
If anybody from Riyadh, KSA knows any good hospital please suggest me. Coz I got appointment in Obeid Hospital though i can go for Al Hammadi but the doctor in Obeid seems to be experienced i am planning his surgery in Obeid. Requests for instant replies in this regards.
If anybody from Riyadh, KSA knows any good hospital please suggest me. Coz I got appointment in Obeid Hospital though i can go for Al Hammadi but the doctor in Obeid seems to be experienced i am planning his surgery in Obeid. Requests for instant replies in this regards.
1 day absolutly fine i can belived,
3 day tempeture taken to the hospital doctor give some antibiotics
7 day blood clot a lot, very scary taken to ER then transffert to other hospital, stay x 2 day she didnt need any surgery because the bleeding stop ,sience she is been ok normal pain medicines at time, but today 12 days after operation she is coughing really dont know what to do im so scare i regret so much take her tonsils out she was never in too much pain after the operation just normal i suppose then the bleeding, she is ok know i dont know what to expect anyone can can help please..
thank you :)
Is this normal for his babies his age (2-3 yrs)?
untill what age we can wait with out surgery?
Regards
Basheer
Now after having 2 weeks from the operation i come know through normal xray report post nasal space severely narrowed due to adenoid enlargment.
I suffered most of my life because my problems weren't detected till 4 years ago sept 2010. It took me four years to come to conclusion that there is a chance to get better with surgery or live miserably for rest. I decided to go for surgery. I pigmy faith in very experienced surgeon who is in prime of his practice and very genuine and very busy. Surgery done 7 days ago and I am resting at home. Surgery was piece of cake and if I can go through it then anyone can. Recovery is bit tough in my case because I wasn't aware that adenoids can give you more pain then nose procedure. I felt so good after surgery that I started eating like normal and didn't take pain mess after day one and now I end up with swollen throat which is under control if I take sins meds. Breathing is so good on day seven that I lived best day of my life in bed. Please get the best surgeon if possible because every surgery can have complications. I didn't want a surgeon who cost bit less but does 10 surgeries in a day. It's best to pay bit more and wait but get the job done with minimum risks. I will keep you posted on as to how I go because new journey is just started.
Good luck and trust me surgery is easy bit if surgeon is good . BTW my surgery was done is Australia.
The doctor said its not normal to have these problems, and Im worried he thinks I am lying about it