Adenoid and Adenoidectomy

Enlarged adenoids (adenoid hypertrophy) are the overgrowth of the lymphoid tissue located at the back of the nose. Enlarged adenoids can cause an obstruction of the nasal airways resulting in mouth breathing, snoring and voice changes. These symptoms may worsen during an infectious process due to swelling. Chronic mouth breathing during the age of facial growth results in changes in the formation of jaws, teeth and the facial skeleton.

Adenoids and Adenoiditis  (Adenoid Infection)

Adenoids are part of the body’s immune system, consisting of two pads of lymphoid tissue located far back in the throat, near the nasal passages, and cannot be seen when looking in the throat.  Adenoids are larger in children and will shrink as they grow older. The adenoids, just like the tonsils, help trap bacteria from going further down the throat. Swelling due to virus or bacterial infections is common, especially in children.

Complications of Adenoiditis

• Recurrent infections may cause adenoids to remain enlarged
• Enlarged adenoids can block the eustachian tube causing recurring ear infections.
• Interference with breathing may cause obstructive sleep apnea (a few seconds where breathing stops during sleep)
• Blocking flow of mucus from the nasal passages

Enlarged Adenoids and Adenoiditis Symptoms

One or more of these symptoms may be present with adenoiditis

• Swollen glands
• Ear pain
• Mouth breathing
• Stuffy nose
• Snoring
• Waking often at night

Treatment for Adenoiditis

Treatment for adenoiditis usually begins with antibiotics; however, recurring infection may lead to other serious complications. Surgery may be required to treat some cases not responding to medication.

Adenoidectomy: Treatment for Adenoid Hypertrophy (Enlarged Adenoids)

When it has been determined that a child needs an adenoidectomy, the procedure is generally done as an outpatient, with few side effects. Adenoids are removed through the mouth with no external incisions. Children generally recover quickly – about 48 hours – with symptoms being relieved and without complication.

As with any surgery, however, there are risks. These are a few of the complications that are rare, but could occur:

• Opening nasal airway to improve breathing may fail
• Voice may permanently change
• Ear or sinus infections may not be resolved
• Bleeding

Post-Operative Adenoidectomy Instructions and Expectations

• Recovery: Recovery from anesthesia is usually about 90 minutes.  Nausea/vomiting occur uncommonly. If this persists, call the office for a prescription anti-nausea medication.
• Diet: Fluid intake/hydration is encouraged after adenoidectomy. Any liquid is fine, any temperature, just drink to the point of urinating about every 2-4 hours. There are no dietary restrictions after adenoidectomy.
• Activity: Activity may be increased as tolerated, with a return to school the next day in most cases. There are no activity restrictions.
• Pain: Most children do not experience pain. Those that do will complain of head or neck pain, headache, or you may notice neck stiffness.  If your child is uncomfortable, treat with ibuprofen and/or Tylenol as needed. If you have any questions about pain, or difficulty controlling it, please call the office.
• Fever: Variable, but expected as a response to healing. Call if fever is > 102.
• Snoring: Snoring may occur or persist for up to 14 days following adenoidectomy.
• A temporary change in voice can occur. This will resolve with time.
• Bad breathe:  Occurs in most children for 1-2 weeks after surgery. This will resolve.
• Bleeding: Extremely uncommon after adenoidectomy. Call your surgeon if you notice any bleeding from the nose or mouth.
• Medications: Pain medication(s) as per your surgeon’s instructions. Commonly used medications include ibuprofen (recommended) or acetaminophen. Antibiotic if prescribed by your surgeon.
• Follow-up appointment: A routine follow-up visit is usually made for about 2 weeks after surgery. This appointment is usually made when the surgery is scheduled.
• Post-Operative Instructions Adenoidectomy

Dr. Gamble and Dr. Kubala are ear, nose, throat, and sinus surgeons with offices located in Plano and Dallas. If you would like to schedule an appointment with our office, please call our Plano office at 972-378-0633 or Dallas office at 214-239-1641.