Adenoidectomy | Tonsillectomy | Tonsillectomy (Spanish)

Adenoidectomy (removal of adenoid)

Your child is going to undergo the surgical procedure known as adenoidectomy.  Following is much of the information that you will need to understand what is going to happen and what to expect after the surgery.

What are adenoids? The adenoid is an organ in the back of the throat, in the nasopharynx, made of lymphoid tissue.  The nasopharynx is the space behind the soft palate and uvula.  Lymphoid tissue is made up of white blood cells - the cells that recognize “foreign invaders” and trigger a response from the immune system.  This helps to fight off infection.  Lymph nodes are similar structures that are found throughout the body, and they replace the function of the adenoid when the adenoid is removed.  For this reason, the body does not “miss” or need the adenoid.

Why do adenoids need to be removed? Adenoidectomy is typically performed for one of 2 reasons.  One is if they become large and cause difficulty breathing - snoring, disrupted sleep, sleep apnea, nasal obstruction, etc.  The second reason is for chronic or recurrent ear infections.  The adenoid is located in between the Eustachian tube openings in the throat, which connects to the ears. 

How are adenoids removed? Adenoidectomy is performed under general anesthesia (completely asleep and unaware), in an operating room.  This may be performed in the outpatient surgical center or in the hospital.  Your ENT physician performs the surgery, and there is an Anesthesiologist (Dr.) and an Anesthetist (Nurse) who will administer and monitor the anesthesia.  The procedure is performed through the mouth - there are no visible scars.  A cautery device is used to stop any bleeding during the surgery, and these days, bleeding is extremely rare during the surgery.

What happens immediately after surgery? After surgery, the anesthesia is stopped and the child is allowed to wake up.  He or she will then go to the recovery room to be monitored for approximately ½ hour to one hour.  When the recovery nurses feel that your child is doing well enough, he or she may be discharged home.  Pain medicine will be administered and vital signs will be monitored.

What can I expect when I go home?  It typically takes about 2–6 days for full recovery following adenoidectomy.  During this time, there may be some pain in the throat, but some children complain of head ache, ear pain, or even neck pain.  This is usually controlled with over-the-counter pain medicine, such as Tylenol (Acetaminophen) and/or Motrin (Ibuprofen).  If your child needs stronger medicine, you will be given a prescription for Tylenol with codeine.  In some cases, the narcotic pain medicine can cause nausea.  Anti-nausea medicine, in a suppository form, may be prescribed as well.  You are encouraged to use this if your child experiences nausea. Your child may also experience constipation from the narcotic, which can be relieved by drinking apple or prune juice or a gentle laxative.

What can your child eat or drink after adenoidectomy? After you go home, your child must drink fluids.  Your child does not have to eat anything solid if he or she chooses not to, but if your child does not drink sufficient fluids, he or she may become dehydrated.  If your child urinates 4-5 times each day, enough fluids are being consumed.  If your child urinates 1-2 times or less each day, he or she is at risk of becoming dehydrated and should call us to let us know.  Avoid acidic drinks, such as orange or grapefruit juice, as they may burn.  Also, avoid drinking too much plain water – your child will feel better if he or she drinks something with electrolytes in it such as apple or grape juice, Gatorade, sweet tea, etc.  Your child may eat anything soft.  Advance to regular foods as desired.

Should I expect fever? It is common to run fever the first 2 - 5 days following adenoidectomy.  While it is possible to catch a cold or flu while recovering from surgery, fever is common after adenoidectomy just from the surgery itself.  In most cases, the Acetaminophen and/or Ibuprofen in the pain medicines will keep the fever under control. Increasing fluid intake also helps control fever.  If there are any other worrisome symptoms accompanying the fever, such as cough, shortness of breath, chest pain, painful urination, leg pain or swelling, this may indicate a dangerous infection and you should contact us or go to the emergency room as soon as possible.

What are the complications of adenoidectomy?  Complications are extremely rare following adenoidectomy.  The most common is severe bad breath for 1-2 weeks following surgery.  There is nothing you can do to “fix” this, but as time passes, it always gets better.  The second complication from adenoidectomy is called velopharyngeal insufficiency (VPI for short).  This shows up as difficulty drinking without liquids coming out of the nose, and sound “leaking” from the nose during speech.  This gets better in 99% of cases without any specific treatment, usually within the first month or 2 following surgery.

What follow-up is necessary? Your physician will want to see your child in the office in 2 to 4 weeks following surgery.  Your child may resume normal activities as you feel he or she is ready.  If, at any time following the surgery, you experience any problems or have any questions, feel free to call our office at any time.