Adenoidectomy
The adenoids, like tonsils, are made of lymphoid tissue and are part of the defence system. The adenoids are in the post-nasal space, which is at the back of the nose and above the palate. By the age of 6 months, the adenoids are largely redundant and therefore removal does not affect the child’s immune function.
The adenoids often become inflamed, and if enlarged, can cause nasal obstruction with mouth breathing or snoring. They often contribute to frequent, prolonged colds, and are implicated in persistent glue ear, causing hearing loss.
The adenoids spontaneously regress and become smaller by the age of about 10 years. However, they can remain enlarged in some adults with rhinitis or sinusitis.
Adenoidectomy is indicated if a child is suffering from significant nasal obstruction and upper respiratory tract infections and is often part of the treatment of glue ear.
The operation
The operation is carried out under general anaesthetic. The procedure is performed through the mouth and there are no external incisions. It usually takes about 20 minutes, but will be longer if combined with other procedures, such as the insertion of grommets or tonsillectomy.
Length of stay in hospital
Adenoidectomy alone is usually carried out as a day-case, but if it is carried out in conjunction with tonsillectomy, this may occasionally necessitate an overnight stay.
Post-operative symptoms
Adenoidectomy, alone, causes mild soreness and a general feeling of ill health. Any discomfort may be easily relieved by Calpol.
It is common to experience an unpleasant smell from the nose and bad breath for about 7 to 10 days. Your child may be given antibiotics to try to reduce this.
Post–operative care
For the first three or four days, your child should be encouraged to rest or play quietly and should avoid any contact with people with coughs or colds in order to avoid the risk of secondary infection. Gradually, after 3 or 4 days, more activities may be resumed. You should encourage your child to take a normal diet, and to drink plenty, as this will help recovery.
If your child appears to have a temperature, this may signify an infection, which might need antibiotic treatment, and you should contact either your GP or us.
Post-operative bleeding
Rarely, during the first post-operative week, a blood vessel may re-open in the adenoid bed and start to bleed. If this occurs, you should contact the ward promptly or go straight to the nearest Accident & Emergency Department.
Length of time off school
Your child should stay off school for 7 days. Swimming and other sports should be avoided for 2 weeks.
Possible complications of Adenoidectomy
Adenoidectomy is usually a very straightforward and common procedure, but as with any operation there is always a small risk of a complication.
a) General Anaesthetic
General anaesthetics are very safe in this day and age. The Anaesthetist will visit your child on the ward before the operation and discuss the risks of the anaesthetic and any other concerns with you.
b) Bleeding
There is a very small risk of bleeding from the throat in the first post-operative week. This will nearly always stop spontaneously after a few minutes however very rarely it might be necessary for your child to be readmitted to hospital to stop the bleeding.
c) Palatal leak
After adenoidectomy there is a very small risk that fluids and air may leak from the back of the mouth up into the nose. This is extremely rare, and when it does happen is usually transient although rarely can be persistent.
d) Injury to the teeth, mouth or tongue
Very rarely during adenoidectomy the teeth, mouth or tongue can be injured.
If you have any concerns once you have returned home, do not hesitate to telephone for advice to one of the following numbers:
Children & Young Persons Unit: 0117 9804000 ext 4544
Level 4 ward Tel: 0117 980400 ext 4283
Spire Bristol Hospital Tel: 0117 9804000
or myself for advice via my PA Mrs Lorraine Goulder Tel: 0117 9804050