What are the adenoids?

Adenoids are small glands located at the back of the nose. In younger children, they are there to fight germs. We believe that after the age of about two years, the adenoids are no longer needed.

Do we need our adenoids?

Your body can still fight germs without your adenoids. They probably only act to help fight infection during the first two years of life: after then, we only take them out if they are doing more harm than good.

Why do adenoids cause problems?

Sometimes children have adenoids so big that they have a blocked nose, so that they have to breathe through their mouths. They snore at night.Some children even stop breathing for a few seconds while they are asleep(Sleep Apnoea). The adenoids can also cause ear problems by preventing the tube which joins your nose to your ear, from working properly.

Some benefits of removing adenoids

• For children with glue ear.
• Reduces colds.
• Removing the adenoid may reduce the problem of a blocked nose when your child has a cold.

Is there an age limit for adenoidectomy?

Adenoidectomy is generally avoided in children under 15 kg of weight, approximately under 2 years of age, because of the small risk of blood loss during or after the operation. There is no upper age limit, but the adenoid has usually shrunk to almost nothing by the teens.

How are the adenoids removed?

The traditional technique is to use a curette, which is a special type of surgical cutting device. This is a safe technique, although a consideration for small children having the operation is that the blood loss may be higher at the time of surgery.

Other techniques are becoming more popular:

Electric diathermy and Coblation dissection have the advantage of less blood loss at the time of surgery.

The laser has fallen out of Favor because of the much higher levels of pain after the operation.

Is it true that the adenoid may grow back?

This is possible but uncommon.

Who is suitable for day case surgery, and who would require inpatient stay?

Generally, children who are fit and well with no bleeding or bruising disorders are fit for day surgery.

What is the recovery time after surgery?

It is wise to allow a one-week convalescence period.

Is there any long-term risk to having your adenoids removed (e.g., reduced immune function)?

There is NO good evidence that adenoidectomy reduces immune function or makes people more prone to chest infections.

What makes you decide to remove the tonsils at the same time?

If your child gets lots of tonsillitis (sore throats) or has difficulty breathing at night, then we may decide to take out the tonsils at the same time as the adenoids.Its a twin surgery works well.

Preparing for your child's operation or things to do before your child's operation

Arrange for a week at home or off school after the operation.

Things we need to know before the operation

Let us know if your child has a sore throat or cold in the week before the operation - it will be safer to put it off for a few weeks.

It is very important to tell us if your child has any unusual bleeding or bruising problems, or if this type of problem might run in your family.

How is the Surgery done?

Your child will be asleep.

We will take his or her adenoids out through the mouth, and then stop the bleeding. This takes about 10 minutes.

Your child will then go to a recovery area to be watched carefully as he or she wakes up from the anesthetic.

He or she will be away from the ward for about an hour in total.

How long will my child be in hospital?

The adenoid surgery is done as a day case so that he or she can go home on the same day as the operation. Very rarely may prefer to keep children in the hospital for one night,especially the children with a sleep disorder for observation. Either way, we will only let him or her go home when he or she is eating and drinking and feels well enough.

Most children need no more than a week off nursery or school. They should rest at home away from crowds and smoky places. Stay away from people with coughs and colds.

Can there be problems?

Adenoid surgery is very safe, but every operation has small risks.

The most serious problem is bleeding, which may need a second operation to stop it. However, bleeding after adenoidectomy is very uncommon. It is very important to let us know well before the operation if anyone in the family has a bleeding problem.

After the operation

• Some children feel sick after the operation. This settles quickly.
• A small number of children find that their voice sounds different after the surgery. It may sound like they are talking through their nose a little. This usually settles by itself within a few weeks. If not, speech therapy is helpful.
• Your child's nose may seem blocked up after the surgery, but it will clear by itself in a week or so.
• Your child's throat may be a little sore
• Give painkillers as needed for the first few days.
• Do not use more than it says on the label.
• Do not give your child aspirin- it could make your child bleed. (Aspirin is not safe to give to children under the age of 16 years at any time, unless prescribed by a doctor).
• Prepare normal food. Eating food will help your child's throat to heal.
• Chewing gum may also help the pain.
• Your child may have sore ears
• This is normal. It happens because your throat and ears have the same nerves. It does not usually mean that your child has an ear infection.
• Your child may also feel tired for the first few days

Red Flag:

In case of bleeding, see a doctor promptly; contact GP, ward, or nearest hospital casualty department.