An adenoidectomy is indicated when a person has large or hypertrophied adenoids that cause persistent nasal obstruction, recurrent ear, nose or throat infections (like rhinitis, otitis and sinusitis) or sleep apnea.

The adenoids are a set of lymphatic tissues that are located in the region between the throat and the nose. They are a part of the immune system, and are responsible for detecting viruses and bacteria and producing antibodies against them. However, adenoids can grow too large and becoming swollen. In these cases, they can cause symptoms such as snoring and difficulty breathing.

An adenoidectomy is performed by an otorhinolaryngologist under general anesthesia, who will completely or partially remove the adenoids. Recovery takes about 2 weeks, during which it is important to rest, avoid crowded places and to take medication as prescribed by the surgeon.

When it's indicated

Adenoidectomy may be recommended in the following situations:

Persistent nasal obstruction
Difficulty breathing or breathing through the mouth
Sleep apnea
Snoring
Difficulty swallowing and eating
Changes in speech development in children
Recurrent ear, nose and throat infections
Loss of hearing or smell

Adenoid surgery can be performed from the age of 6, but in more severe cases, such as heavy sleep apnea, in which breathing stops during sleep, the doctor may advise surgery even earlier.

This surgery can be done alone or in combination with a tonsillectomy (surgical removal of the tonsils) or myringotomy (a surgery that involves drainage of fluid from the eardrum).

Does an adenoidectomy impact immunity?

Adenoid surgery does not impact immunity negatively, as the body has other defense mechanisms it can utilize.

Preparation for surgery

To prepare for adenoid surgery, it is recommended to fast for at least 8 hours, as general anesthesia is required.

It is important to inform your doctor of all medications, supplements, vitamins or natural products that you use regularly, as some may interfere with recovery or increase the risk for bleeding.

You should also inform your doctor if you are allergic to anesthetics or any other medication.

How surgery is performed

Adenoid surgery is performed by an otolaryngologist in a hospital setting under general anesthesia. They are removed from the mouth, usually through the following steps:

Application of general anesthesia
Oral intubation to keep the airway open
Placing a device in the mouth to keep it open
Removal of adenoids
Nasal irrigation with saline solution
Placement of an absorbent material on the site to control bleeding

Adenoid surgery can be performed using different techniques, such as laser ablation, coblation with total or partial removal of the adenoid, or endoscopic excision. It generally lasts around 30 minutes.

When performed with a tonsillectomy, the adenoidectomy is completed first. When done in combination with a myringotomy, it is performed second.

After an adenoidectomy, the person will typically remain in the hospital for 24 hours so that they can be monitored and so that the effect of the anesthesia wears off.

What is recovery like?

Although adenoid surgery is a simple and quick procedure, recovery from surgery lasts about 2 weeks. During this time it is important to:

Rest and avoid sudden head movements
Eat soft, cold and liquid foods for 3 days or as advised by your doctor
Avoid crowded places, such as shopping malls
Avoid contact with people with respiratory infections
Take antibiotics as advised by your doctor

When recovering, it is expected to feel pain, especially in the first 3 days. The doctor may prescribe analgesic or anti-inflammatory medications to help relieve discomfort, such as acteaminophen or ibuprofen.

Possible risks

Adenoid surgery is a safe procedure, however, like any other type of surgery, it is associated with general risks, such as bleeding, infections, anesthesia complications, vomiting, fever and swelling of the face. These should be reported immediately to the surgeon.

Can an adenoid grow back?

Although it is rare, an adenoid can grow back if not removed properly. This risk increased if the surgery is performed during childhood.

When to see our doctor

You should follow-up with your surgeon at least once following surgery for an assessment, but you should especially see a doctor if you experience any of the following:

Intense pain that does not improve with medication
Chest pain
Fever, above 38ºC (or 100.4ºF)
Neck pain or stiffness
Bleeding from the nose or mouth;
Vomiting
Dark stools or stools with bright red blood
Difficulty feeding

These symptoms may indicate complications from surgery, and you should seek urgent medical assistance to prevent further worsening.