What is an adenoidectomy?
An adenoidectomy, or adenoid removal, is surgery to remove the adenoid glands. Although adenoids help protect the body from viruses and bacteria, they sometimes become inflamed and enlarged or become chronically infected. This can be due to infections, allergies, or other reasons. Some children can also be born with abnormally large adenoids.
When a child’s adenoids are enlarged, they can cause problems by partially blocking her airway. When this happens, children can have breathing problems, ear infections, or other complications, which can lead to snoring or more serious conditions, such as sleep apnea (stoppage of breathing) at night.
Chronic (long-term) nasal discharge, congestion, and sinus infections may also be seen. Enlarged adenoids can also affect the recurrence (return) of ear infections and chronic fluid in the ear, which can lead to temporary hearing loss.
Surgery is often needed to remove the glands. Removing them has not been shown to affect a child’s ability to fight infection. Adenoidectomy is mostly done in children who are between 1 and 7 years old. When the child is 7 years old, the adenoids begin to shrink and are considered a vestigial organ in adults (a purposeless remnant).
How does a physician define if a child needs an adenoidectomy?
If you suspect that your child has a problem with the adenoids due to problems with breathing, ears, or recurrent sinus infections, you should see your doctor. After taking a medical history, the doctor will examine your child’s adenoids, either with an X-ray or with a small camera placed in your child’s nose.
Based on your child’s symptoms and if her adenoids seem enlarged, her doctor may endorse that the adenoids be removed.
What are the risks and complications of adenoidectomy?
Your child’s surgery will be done safely and with care for the best possible results. You have the right to be informed that surgery may involve risks of unsuccessful results, complications, or injury from known and unforeseen causes. Because persons differ in their response to surgery, their anaesthetic reactions, and their healing results, ultimately, results or potential complications cannot be guaranteed.
The subsequent complications have been reported in the medical literature. This list is not envisioned to include all possible complications. They are listed here for your information only, not to scare you, but to make you more aware and knowledgeable about this surgical procedure.
- Failure to resolve ear or sinus infections, or relieve nasal drainage.
- Bleeding. In very infrequent situations, the essential for blood products or a blood transfusion. You have the right if you wish, to have autologous blood (your own blood) or designated donor-directed blood prepared in advance in case an emergency transfusion is necessary. We recommend that you consult with your doctor if you are interested.
- A permanent change in voice or nasal regurgitation (rare).
- Need for additional and more aggressive surgery, such as sinus, nasal, or tonsil surgery.
- Failure to improve nasal airways or resolve to snore, sleep apnea, or mouth breathing.
- Need for evaluation, treatments or environmental controls of allergies. Surgery is not a cure or a substitute for good allergy management or treatment.
Before adenoidectomy surgery
In most situations, the surgery is performed on an outpatient basis at the hospital or surgical centre. Both facilities provide quality care without the expense and inconvenience of spending the night. An anesthesiologist will screen your child throughout the procedure. Typically, the anesthesiologist will call the night before surgery to review your medical history. If he cannot reach you the night before surgery, he will speak with you that morning. If your doctor has ordered preoperative lab studies, you must arrange for them to be done several days in advance.
Your child should not take aspirin or any products that contain aspirin, within 10 days of the date of their surgery. Non-steroidal anti-inflammatory drugs (such as Ibuprofen / Advil or Naproxen / Aleve) should not be taken within 7 days of the date of surgery. Many over-the-counter products contain aspirin or nonsteroidal anti-inflammatory drugs, so it is important to review all medications carefully. If you have any questions, call your doctor’s office or ask your pharmacist. Acetaminophen / Tylenol is an acceptable pain reliever. Often times, your doctor will give you several prescriptions for postoperative pain at the visit BEFORE the operation. It is best to fill them out before your surgery date.
It is recommended that you be honest and frank with your child when explaining his upcoming surgery. Encourage your child to think of this as something the doctor will do to improve his health. Let them know that they will be safe and that you will be around. A reassuring and reassuring attitude will greatly ease your child’s anxiety. You can assure them that most children have minimal pain after adenoidectomy. Let them know that if they have pain, it will be for a short time and that they can take medication that will reduce it considerably.
Your child should not eat or drink anything for 6 hours before surgery. This even includes water, candy, or gum. Whatever in the stomach increases the chances of an anaesthetic complication.
If your youngster is sick or has a fever the day before surgery, call the hospitals. If your child wakes up sick the day of surgery, proceed to the surgical centre as planned. Your doctor will decide if it is safe to continue with the surgery. However, if your child has chickenpox, do not take him to the office or surgery centre.
Preparing for adenoidectomy procedure
The mouth and throat bleed more easily than other areas of the body, so your doctor may order a blood test to determine if your child’s blood is clotting properly and if his white and red blood cell count is normal. Preoperative blood tests can help your child’s doctor make sure there will not be excessive bleeding during and after the procedure.
In the week before surgery, do not give your child any medications that can affect blood clottings, such as ibuprofen or aspirin. You can use acetaminophen (Tylenol) for pain. If you have questions about which medications are appropriate, speak with your doctor.
The day before surgery, your child should not eat or drink after midnight. This includes water. If the doctor prescribes medicine for you before surgery, give it to your child with a small sip of water.
How an adenoidectomy is performed?
A surgeon will do an adenoidectomy under general anaesthesia, a drug-induced deep sleep. This is usually done in an outpatient setting, which means your child can go home on the day of surgery.
Adenoids are usually removed through the mouth. The surgeon will insert a small instrument into your child’s mouth to keep it open. The adenoids will then be detached by making a small cut or cauterizing, which involves sealing the area with a heated device.
Cauterizing and covering the area with absorbent material, such as gauze, will control bleeding during and after the procedure. Stitches are not usually necessary.
After the procedure, your child will stay in a recovery room until he wakes up. You will receive medicine to reduce pain and swelling. Usually, your child will go home from the hospital the same day as the surgery. Full recovery from an adenoidectomy usually takes one to two weeks.