Removing adenoids (adenoidectomy)

Adenoidectomy means surgical removal of the adenoids under a general anesthesia. Adenoids are located behind the nose. Surgery may be recommended if the adenoids are enlarged and cause nasal block, snoring, or recurrent sinus infections or nasal congestion impacts your child. If a doctor is also considering removing tonsils, adenoidectomy surgery at the same time is often recommended.

What are the symptoms that may mean an adenoidectomy is needed?

There are multiple reasons to have tonsils and/or adenoids removed, including sleep apnea, snoring and sinus infections.

Sleep apnea is detected on a test called a sleep study. This is an overnight test at a Children's Wisconsin Sleep Center that will check if your child has sleep apnea, or stops breathing during sleep. This test will also check if oxygen drops in the blood during sleeping as well as for other changes in the body during sleep. If your child has obstructive sleep apnea, adenoid removal as well as tonsil removal may be required. 

Snoring is another reason why adenoids may be removed. If snoring is loud and causes problems with getting a good night's sleep and/or problems with daytime fatigue or trouble with focusing, the adenoids may need to be removed.

If any of these concerning symptoms are present with your child, your doctor will refer you to an Ear, Nose and Throat specialist to review the history, examine your child, and discuss if adenoid removal surgery is needed.

How is an adenoidectomy performed?

Removal of the adenoids by an Ear, Nose, and Throat Specialist happens under a general anesthesia. The adenoids are removed through the mouth with special equipment, and the surgery takes about 30 – 45 minutes. If your child has sleep apnea, is less than three years old, or you live more than 45 minutes away, you may be asked to stay overnight after surgery.

Adenoid removal recovery is about five days. They usually can go home the same day, unless this is with tonsil removal or there are other health concerns. Pain is mild to moderate. Bleeding rate for adenoidectomy is less than 1%. During this time a child may experience the following:

• Mild to moderate sore throat
• Ear pain referred from the throat
• Scabs where the tonsils and adenoids were removed
• Bad breath
• Nausea and vomiting
• Low grade temperatures
• Bleeding from where the tonsils were removed can happen in up to 3% of children

Mild to moderate pain is expected after adenoidectomy surgery. Pain is mainly treated with acetaminophen (Tylenol) and ibuprofen (Motrin). If pain is severe and the other pain medicines do not work, your surgeon may prescribe a liquid narcotic called oxycodone.

Staying hydrated and managing pain helps the recovery go more smoothly and preventing complications of dehydration and pain.

Can I prevent the need for removal of adenoids?

If sleep apnea or snoring is present, adenoids should be removed due to stress of sleep apnea on the body. Untreated sleep apnea places children at risk for diabetes and high blood pressure. School performance and daytime behavior may also be negatively impacted.

If there is concern that obesity is causing sleep apnea or snoring, talk with your doctor about the best options for weight control.

How do adenoids develop?

Adenoids develop prenatally, and are very small when a child is born. The tonsils and adenoids are part of a whole system including the thymus and bone marrow that helps the body develop immunity. Removal of the adenoids will not interfere with your child's ability to fight infection. When a child is exposed to an infection, the adenoids may enlarge.

When should I contact a doctor?

You should contact your doctor if snoring is present along with difficulty sleeping at night, and fatigue is present during the day.

What happens after treatment?

Recovery after an adenoidectomy takes one to two weeks as part of adenoid removal recovery. Sport activities should be avoided for 2 weeks. Pain control with acetaminophen and ibuprofen will help prevent dehydration after surgery.

What is the long term outlook after adenoid removal surgery?

If adenoids are removed for chronic infection and congestion, this will improve your child's symptoms about 85% of the time. If congestion and infection remain, or your child still has snoring your doctor will talk to you about other medical therapies.