Adenoidectomy- Ear Nose And Throat (ENT)

Adenoidectomy, or adenoid removal, is a common surgery to remove adenoids. While adenoids help defend your child’s body against viruses and bacteria, they can occasionally swell and expand.

Allergies, infections, or other factors may bring on this swelling (inflammation). Moreover, some kids may be born with unusually big adenoids. As a result, surgery may be required to remove swollen adenoids that partially restrict your child's airway.

Along with tonsil removal, adenoidectomy is one of the most frequent surgeries performed on children.A doctor may advise an adenoidectomy if your child's swollen adenoids bother them and do not improve with medication.

What Are Adenoids?

The adenoid glands are found behind the soft palate in the roof of the mouth, where the throat and nose converge. A look into someone's mouth would not reveal their adenoids.

As a component of the immune system, the adenoids make antibodies, which are defense proteins. These help fight infections, illnesses, and the germs you breathe in, like bacteria and viruses.

Adenoids are considered a remnant with no purpose or a vestigial organ in adults. This is because the adenoids are more prominent when you are a child, often shrink during adolescence, and may vanish by adulthood.

Tonsillectomies, or the removal of the tonsils, are frequently carried out by doctors in tandem with adenoidectomy. Both glands are often inflamed and infected due to persistent throat and respiratory infections.

Symptoms Of Enlarged Adenoids

The following signs and symptoms are brought on by swollen adenoids that block the airways:

  • Frequent ear infections
  • Throat pain
  • Having trouble swallowing
  • Breathing through the nose is difficult
  • Habitual mouth breathing
  • Obstructive sleep apnea characterized by intermittent breathing pauses while you sleep
  • Recurrent middle ear infections brought on by swollen adenoids and blocked eustachian tubes can have significant consequences, including hearing loss, leading to speech difficulties.

When Do The Adenoids Need Removal?

A child's adenoids may occasionally swell or get more prominent. This may occur following a bacterial infection, viral infection, or allergic reaction to a drug.

Swollen adenoids typically only cause minor discomfort; therefore, no treatment is required. Nonetheless, it can be highly uncomfortable for certain kids and interfere with their day-to-day activities.

Your child may need to have their adenoids removed if the following conditions are present:

  1. Breathing issues—Your child may struggle to breathe through their nose and may end up breathing through their mouth instead, leading to problems like chapped lips and a dry mouth.
  2. Problems sleeping—your child may begin to snore, and in severe situations, some kids' breathing may become erratic as they sleep, making them feel drowsy throughout the day (sleep apnea).
  3. Ear problems—Recurring or ongoing ear issues, such as glue ear (when fluids accumulate in the middle ear) or middle ear infections (otitis media).
  4. Sinus problems—Persistent or recurrent sinusitis­ that causes symptoms including a runny nose all the time, facial pain, and nasal-sounding speech.

Adenoidectomy is not usually necessary in adults. Their adenoids have often receded, so they are unlikely to be an issue.

How Does A Doctor Decide Whether A Child Requires An Adenoidectomy?

A healthcare professional will inspect your child's adenoids after gathering adequate medical history using an X-ray or a tiny camera inserted in your child's nose.

Your doctor might advise having your child's adenoids removed depending on their symptoms and how they look.

What Does The Procedure Treat?

An adenoidectomy treats enlarged adenoid glands that partially obstruct your child's airway. Many conditions result from a narrowed airway that needs to be treated, including the following:

  • Trouble sleeping
  • Breathing issues
  • Ear infections and impaired hearing
  • Chronic nasal discharge, congestion, and recurrent sinus infections.

What To Expect?

Adenoidectomy typically takes 30 minutes and is performed by an Otolaryngologist or ear, nose, and throat (ENT) surgeon. After the surgery, your child must wait in the recovery area until the anesthetic wears off, which might take up to an hour.

Adenoidectomies can occasionally be performed as day cases, in which case your child might be able to return home the same day. But, if the treatment is performed in the afternoon, your child could spend the night at the hospital.

Before, during, and after the procedure, you can expect the following:

Before the procedure

Your doctor may suggest a blood test to determine whether your child's blood clots correctly and the white and red blood count is normal because the mouth and throat bleed more quickly than other parts of the body. In addition, blood tests done before surgery can help the doctor ensure there would not be too much bleeding during and after the procedure.

Do not give your child blood-thinning medications, such as ibuprofen or aspirin, in the week leading up to surgery. Acetaminophen (Tylenol) can be used as a pain reliever. Consult your doctor if you are unsure about the proper medications to give to your child.

Your youngster should avoid eating or drinking after midnight the day before surgery. This includes water. Give your child the medication with a little sip of water if the doctor has prescribed it to be taken before the procedure.

During the procedure

A surgeon will carry out an adenoidectomy while your child is sedated with general anesthesia. Often, the adenoids are removed through the mouth.  The surgeon will insert a little tool inside your child's mouth to hold it open.

The adenoids will be removed with a little incision or through cauterization, which involves securing the area with a heated object.

Controlling bleeding before, during, and after the procedure and packing the region with absorbent material, such as gauze, will be required. Usually, stitches are not necessary.

After the procedure

Your child will stay in the recovery room until they wake up from the anesthetic. Members of your child's care team will take them there. A caregiver will check to see if your child can breathe, cough, and swallow once they are awake.

After the surgery, on the same day, your child will normally be discharged.

Medication will be given to decrease the pain and swelling. Your child might have to spend the night in the hospital if your doctor wants to keep an eye on him or her.

An adenoidectomy patient typically takes one to two weeks to fully recover. It is normal to experience a painful throat for two to three weeks following surgery. To prevent dehydration, it is critical to consume plenty of liquids. In fact, adequate hydration helps with pain relief.

Over the first few weeks, avoid giving your child hot, spicy, or crunchy foods. Instead, desserts and cold beverages can help your child's throat feel better.

Good food and drink choices while your child's throat is sore include the following:

  • Fruit juice
  • Water
  • Apple sauce
  • Jell-o
  • Gatorade
  • Sherbet
  • Ice cream
  • Pudding
  • Yogurt
  • Warm beef or chicken broth
  • Soft-cooked vegetables and meats

Pain and swelling can be eased with the use of an ice collar. Ice cubes can be put in a ziplock bag with a towel wrapped around it to create an ice collar. Put the collar on your child's neck at the front.

After surgery, your youngster should not engage in vigorous exercise for up to a week. Then, if they feel well enough and the surgeon gives the go-ahead, kids may return to school in three to five days.

What Are The Benefits Of Adenoidectomy?

An adenoidectomy is typically a safe procedure that relieves your child's symptoms and discomfort. Although your child's adenoids are a component of their immune system, removing them would not compromise immunity as the system is quite adaptable.

Your kid does not require adenoids to fight infection. Instead, the absence of enlarged adenoids will make them healthier.

The Risks Of Adenoidectomy

As previously mentioned, adenoidectomy procedures are incredibly safe, and complications are extremely rare. But complications are still possible, just like with any kind of surgery.

There is a slight possibility of:

  • Mild pain
  • Bleeding
  • Infection: If a tooth is knocked out or injured during the treatment, your kid can be given antibiotics to help avoid infection.
  • Your child may also have little reaction to the anesthetic, such as breathing difficulties or an allergic reaction.
  • Permanent changes in the voice quality
  • Failure to address underlying nasal discharge, ear infections, or breathing issues.

If your child is allergic to any medications, let the doctor know. The adenoids on your child's tonsils might also regrow. Since the adenoids are positioned so far back in your child's nasal passage, removing all traces of the tissue is impossible. If the tissue continues to create trouble, your child may need surgery twice. However, this is very uncommon.

When To Seek Medical Help After Surgery?

Once you bring your child home following surgery, keep an eye on them. If you see any of the following, get in touch with your doctor right away:

  • Black or brown cough
  • Bright red bleeding from their mouth
  • Blood in their spit
  • Very high fever, hot or shivering sensations
  • Severe pain that does not improve with the use of medications
  • Dehydration and difficulty swallowing
  • Difficulty turning their neck
  • Not urinating at least once per eight hours
  • Vomits after taking medicine on the first day.

Get immediate medical care if your child shows the following symptoms:

  • Has bleeding after the first day that lasts longer than 10 minutes
  • Vomits blood or anything that resembles coffee grounds
  • Has blood trickling from the nostrils or covering the tongue

The Outlook

Adenoidectomies have a long history of successful results. After surgery, the majority of kids:

  • Have fewer and less severe throat infections
  • Have fewer ear infections
  • Breathe more easily through their nose


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