Adenoidectomy

Adenoids are checked via nasal optic examination using a flexible endoscope (no pain) to evaluate the upper airway condition of children who are cooperative. A topical anesthetic is applied to the nasal cavity. This procedure is done in the clinic. The examination begins with an assessment of the nasal cavity and its structures up to the nasopharynx with a good view of the auditory tube. Generally, the nasal optic examination is painless and well tolerated by children. Video recording is usually done so that it is possible to review the images and a copy will be given to the patient.

X-ray would be used if the child is uncooperative with the nasal optic examination. This is helpful in determining the size and shape of the adenoids.

Is the Adenoids a Liability?

They become a liability when they become infected (adenoiditis) or when they grow too large in size (adenoid hypertrophy).

What problem does Enlarged Adenoids cause?

Enlarged adenoids can cause snoring, obstructive sleep apnea, running nose and in some instances hearing problem thus causing nose and throat obstruction to breathing while they are sleeping. Obstructive sleep apnea is when a child briefly stops breathing while sleeping. It often occurs because of a blockage in the airway.

For a better understanding on the implications of enlarged adenoids, please watch my video featured here.  I have explained in detail the problem enlarged adenoids (adenoid hypertropy) could have on the child and the risks of not treating this problem.

Adenoid hypertrophy and adenoiditis can cause block nose, hearing loss, snoring, sleep apnea, academic underperformance, and growth retardation in children.

When should Adenoids be removed?

Adenoids should be removed if they cause sleeping or breathing problems. Your doctor may also recommend an adenoidectomy for your child with chronic ear or throat infections that

• persist even after antibiotics are taken
• occur more than a few times a year

At what age would the Adenoids Disappear?

Adenoids begin to shrink around age 5 to 7 in children, and in most children, they would be  almost completely gone by the teenage years.

Outgrowing Your Adenoids

Some parents will say leave the enlarged adenoids alone until their children “grow out of it.” Yes, in most cases, they will, but based on all the recent studies, there’s plenty of evidence that before they “grow out of it,” there can be potential long-term consequences, including their risk for developing obstructive sleep apnea, growth retardation, blocked and runny nose, sore throat, cough and potentially heart disease and stroke later in life.

Adenoidectomy Procedure

The surgery is done under general anaesthesia and this procedure is usually done as a day procedure. This surgery usually takes about 45 minutes. The child needs to fast 4 hours prior to the surgery.  No food/drinks/water is allowed.

For a younger child, there will be a shorter fasting period. The operation is done via the oral cavity therefore no incision will be made on the nose or face.

What are the latest techniques for removing the adenoids?

Surgery to remove the adenoids is performed

• under general anaesthesia
• child is in supine position
• mouth is open, & a tonsil gag is applied
• a nasal endoscope is used to visualise the adenoids
• adenoids are removed with microdebrider, curette, coblator to improve healing and reduce the side effect of pain after surgery

If the child has fever on the day prior to the surgery date, the doctor should be informed as the surgery might be postponed if the child is found unfit for surgery. It should also be brought to the doctor’s attention if the child has any history or family history of bleeding disorder or has any problem with previous anaesthetic event.

What are the risks of an Adenoidectomy?

Other than the usual risk of anaesthesia, an adenoidectomy is generally a safe medical procedure and complications are very rare. The outcome is good with many satisfied parents reporting great improvements in concentration, school performances, social skills.

Nonetheless, although rare, some risks of this surgery include bleeding and infection at the site of surgery.

What to expect after an adenoidectomy?

After the surgery, the child might be still sleepy as he/she is still recovering from the general
anesthesia but this effect will wear off after some time. After which, he will be allowed to drink and eat.

Should there be a slight presence of blood in the child’s sputum, this is normal.

What are the things to take note after adenoidectomy?

Few days after the surgery, the child may experience sore throat and dryness of the mouth but it will slowly improve given sometime when the throat muscles are back to normal. Normal eating habits should resumed and this is greatly encouraged to prevent debris from accumulating and will also aids in the recovery process. Pain killer that has been prescribed to the child must be taken to minimize any throat discomfort and the entire course of antibiotics should be completed.

Is there any diet restrictions post surgery?

No, there is no diet restriction post surgery and normal diet is greatly encouraged.

Is there anything I should avoid post adenoidectomy?

During the first week post surgery, it is encouraged that the child should avoid contact with people suffering from coughs, colds or other infections. Contact with smoking individuals and crowded places should also not be encouraged.

How long is the recovery after adenoidectomy?

Complete recovery after the procedure will take about 1-2 weeks depends on the immune system of each child.

What are the side effects of having the adenoids removed?

There are other lymph nodes in the body that would act as defence mechanism. Many studies have shown that children that have their adenoids removed suffer no loss in their immunity to diseases.

What are the risks of an Adenoidectomy?

Other than the usual risk of anaesthesia, an adenoidectomy is generally a safe medical procedure and complications are very rare. The outcome is good with many satisfied parents reporting great improvements in concentration, school performances, social skills.

Nonetheless, although rare, some risks of this surgery include bleeding and infection at the site of surgery.