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  • Adenoidectomy

    Definition

    Adenoidectomy is the surgical removal of the adenoids. Adenoids are made of tissue located in the back of the nose near the throat. They are thought to be involved in developing immunity against infections in children.
    Anatomy of the Adenoids
    Nucleus Image
    Copyright © Nucleus Medical Media, Inc.

    Reasons for Procedure

    Adenoidectomy is usually done to remove enlarged adenoids that are causing a blockage in the nasal passage. It may also be used to treat long-term sinus infections and recurrent ear infections.

    Possible Complications

    Complications are rare, but no procedure is completely free of risk. If you are planning to have an adenoidectomy, your doctor will review a list of possible complications, which may include:
    • Infection
    • Re-growth of adenoid tissue
    • Bleeding
    • A permanent change in voice
    • Reaction to anesthesia
    Factors that may increase the risk of complications include:

    What to Expect

    Prior to Procedure

    Your doctor will likely do the following:
    • Physical exam of the tonsils, throat, and neck
    • Blood test
    • Review your medicines—You may be asked to stop taking some medicines up to one week before the procedure, such as:
      • Aspirin or other anti-inflammatory drugs
      • Blood thinners, such as clopidogrel (Plavix) or warfarin (Coumadin)
    • Order x-rays —to assess the size of the adenoids
    Do not eat or drink anything six hours prior to the procedure.

    Anesthesia

    General anesthesia is used. It will block any pain and keep you asleep through the procedure.

    Description of the Procedure

    The adenoids will be surgically removed through the mouth. A scalpel or another type of tool will be used to remove the adenoid tissue. An electrical current can also be used. Sometimes, the adenoids are removed through the nose. Gauze packs will be placed at the site of the procedure to prevent bleeding.
    Radiofrequency ablation is a type of procedure that uses heat to destroy tissue. It may be used to reduce the volume and size of the adenoids. This method often has less bleeding. It also seems to cause less pain.

    Immediately After Procedure

    You will be monitored in a recovery room until the anesthesia wears off.

    How Long Will It Take?

    Less than 45 minutes

    How Much Will It Hurt?

    Anesthesia prevents pain during the procedure. Pain after the procedure is not uncommon. Your doctor may prescribe pain medicine.

    Average Hospital Stay

    It may be possible to leave on the same day as the procedure. Your doctor may choose to keep you overnight if there are complications.

    Post-procedure Care

    Recovery will take 7-14 days. After the procedure, you may have:
    • Light bleeding
    • Nasal stuffiness or drainage
    • Sore throat
    • Bad breath
    • Difficulty swallowing
    • Ear or throat pain
    • Stiff or sore neck
    • Nasal speech
    To help relieve some discomfort and speed recovery:
    • Eat light meals of soft foods for the first several days.
    • Avoid hot liquids.
    • Take prescribed antibiotics to prevent infection.
    • Take pain medicine as needed.
    • Avoid swimming and rough or intense exercise.
    • Avoid forceful nose blowing.
    • Follow your doctor’s instructions .

    Call Your Doctor

    After you leave the hospital, contact your doctor if any of the following occurs:
    • A sudden increase in the amount of bleeding from the mouth or nose (If your child is swallowing a lot, check the back of their throat with a flashlight to look for blood.)
    • Redness, swelling, increasing pain, or any discharge from the nose or mouth
    • Increased swelling or redness of the eyes
    • Signs of infection, including fever and chills
    • Pain that cannot be controlled with the medicines you have been given
    • Uncontrolled nausea or vomiting
    • Noisy or difficulty breathing
    In case of an emergency, call for medical help right away.

    RESOURCES

    American Academy of Otolaryngology http://www.entnet.org/

    American Society of Pediatric Otolaryngology http://www.aspo.us/

    CANADIAN RESOURCES

    Canadian Society of Otolaryngology http://www.entcanada.org/

    Health Canada http://www.hc-sc.gc.ca

    References

    Adenoidectomy Patient Information. Duke University Health System. DukeHealth.org website. Available at: http://www.dukehealth.org/services/otolaryngology/care%5Fguides/adenoidectomy%5Fpatient%5Finformation . Updated October 5, 2010. Accessed October 30, 2012.

    Adenoidectomy. Canadian Society of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entcanada.org/public2/patient8.asp . Accessed October 30, 2012.

    All about adenoids. Kids Health.org website. Available at: http://kidshealth.org/kid/ill%5Finjure/sick/adenoids.html# . Updated November 2010. Accessed October 30, 2012.

    Gigante J. Tonsillectomy and adenoidectomy. Pediatr Rev . 2005;26(6):199-203.

    Paradise JL, Bernard BS, Colborn DK, Janosky JE. Assessment of adenoidal obstruction in children: clinical signs versus roentgenographic findings. Pediatrics . 1998;101(6):979-986.

    Shehata EM, Ragab SM, Behiry ABS, Erfan FA, Gamea AM. Telescopic-assisted radiofrequency adenoidectomy: a prospective randomized controlled trial. Laryngoscope . 2005;115(1):162-166.

    Tonsils and adenoids. American Academy of Otolaryngology website. Available at: http://www.entnet.org/HealthInformation/tonsilsAdenoids.cfm . Updated January 2011. Accessed October 30, 2012.

    6/3/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.

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