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Adenoid removal

What are adenoids?

Normal and enlarged adenoids
Normal adenoid vs. enlarged adenoid blocking the eustachian tube

Adenoids, also known as pharyngeal or nasopharyngeal tonsils are masses of lymphatic tissue behind the nasal cavity, hidden by the soft palate and the uvula.

Adenoids are part of a ring made up of lymphatic tissue (the so-called Waldeyer ring) which can be found in the oral cavity and the pharynx. Being part of the immune system, the ring serves as our first line of defense against infections by acting as a biological filter station.

When is adenoidectomy (surgical removal of adenoids) recommended?

Enlarged adenoids usually cause problems in childhood. Normally adenoids disappear by the late teens. If they are still present in adulthood, surgical removal and a histological examination become necessary.

In case of a nasal infection (acute rhinitis, sinusitis, etc.) or allergy adenoid tissue swells. After recurrent infections adenoids may remain enlarged, causing a blockage in the nasal passage.

You may experience the following symptoms in case of enlarged adenoids:

  • mouth breathing, snoring, sleep disturbances, daytime fatigue
  • difficulty swallowing
  • constant nasal congestion
  • chronic runny nose, sinus infections, coughing, bronchitis
  • impaired hearing, reccurrent middle ear infections, earache

If the adenoids become large enough to cause the above symptoms, removal is the only solution that provides permanent relief.

You might wonder if your body will be able to fight off infections after the surgery. The answer is yes, sufficient amounts of lymphatic tissue will remain in the oral cavity and the pharynx (palatine tonsils, lingual tonsils, etc.).

How is the surgery performed?

Adenoid removal, also known as adenoidectomy, is performed under general anesthesia. The surgery takes about 20-40 minutes.

Adenoids are taken out through the oral cavity with a specialized instrument called an adenotome.

What are the risks and benefits of the surgery?

Risks

As with any surgery, there are some risks associated with adenoid removal, including infections and bleeding.

You will receive a patient information sheet and an informed consent form which will provide you with detailed information regarding the risks of the operation, as well as what to expect before, during and after the procedure. By all means feel free to discuss the possible risks or any other concerns with your ENT surgeon before making a treatment decision.

There are certain risks associated with general anesthesia too, these will be explained to you on a separate information sheet. You will be required to sign a second informed consent form regarding anesthesia. You will also have some preoperative tests to ensure that these risks are reduced to a minimum.

It is important to call your surgeon immediately if you develop a fever, permanent nasal bleeding, blood spitting or vomiting, or a severe headache after your release from the hospital.

Benefits

Removal of the adenoids may reduce the frequency and severity of nasal and ear infections. It may also prevent the development of various, potentially serious middle ear conditions and hearing impairment which could otherwise only be resolved by major ear surgery.

In addition, you can finally stop taking the antibiotics you previously needed to help fight infections caused by adenoid enlargement.

Am I a good candidate for adenoid surgery?

Your ENT (ear, nose and throat) surgeon will decide if surgery is necessary in your particular case.

You will be asked to undergo some tests (nasal endoscopy, blood and allergy tests, CT scan of the nasal cavity and paranasal sinuses, ECG), and to see your anesthesiologist and internist before your operation. This is to ensure that your general health allows an adenoidectomy under general anesthesia to be carried out safely.

All of our patients are asked to complete a detailed medical history form. It is important to fill out the questionnaire to the best of your knowledge because the answers you provide will help our surgeon decide whether you are eligible for adenoid removal surgery.

How to prepare for the surgery?

  • Prepare a list of all of your symptoms and any known medical conditions, past illnesses and allergies, even if they seem unrelated to your current condition. For this purpose, you will be given a detailed form to be filled out, followed by a physical examination.
  • Be aware of any restrictions to adhere to prior to procedure. Your ENT surgeon will provide you with all the information you need to prepare for the diagnostic tests.
  • List all the drugs and medications you take, including vitamins and supplements.
  • Ask a family member or friend to accompany you to your appointment and aks them to help you recall the information to be provided during your consultation.
  • Before adenoid removal you will receive a patient information sheet and an informed consent form which you will be requested to read carefully and sign. These documents will contain everything you need to know regarding preparation, the surgery itself and recovery.

What to expect after adenoid removal?

You can expect to have moderate pain (sore throat) during the first few days after surgery. The pain can be significantly reduced by the use of oral pain killers.  You may expect nasal stuffiness and discomfort for about 3 to 10 days.

You should only take medication approved by the ENT surgeon at our clinic. In order to ensure a safe and fast recovery follow your doctor’s recommendation at all times regarding post-operative care.

It is normal to feel a bit groggy and sleepy for about a day after surgery until the effect of general anesthesia wears off.

If there is no bleeding, you will be discharged on the first day after surgery. You will be advised to rest as much as possible for about two weeks, avoiding any intense physical activity due to an increased risk of bleeding at the site of surgery (nasal bleeding, blood spitting or vomiting). You also need to be careful when blowing your nose. For the first two weeks you are advised to wipe your nose without blowing. Your surgeon will give you further instructions regarding post-operative care upon discharge from the hospital.

Why is regular follow-up important?

The first follow-up appointment will take place a week after your operation. Your doctor will want to monitor how your recovery is progressing, checking for signs of infection and bleeding. In some cases a second follow-up exam might be necessary.