Adenoidectomy – A Surgery for Adenoid Removal
Adenoidectomy is a surgery performed to remove enlarged Adenoid tissue (which is a mass of lymphoid aggregate behind the nose, in an area called the Nasopharynx).
Indications for Adenoid removal (Adenoidectomy)
- Enlarged adenoids causing nasal obstruction and leading to sleep disturbed breathing in children
- Enlarged Adenoids causing recurrent middle ear infection, pain in the ears, impaired hearing in children.
- As part of a combined procedure which includes Myringotomy with Grommet insertion (also called Tube insertion)
How is the Adenoidectomy Procedure Performed?
Classically Adenoidectomy is performed through an open mouth (there is no mark, cut or incision outside or on the skin anywhere – it is all done through the Nose and Throat).
The ENT surgeon will use a mouth gag and tongue depressor to open the mouth of the child. The soft palate is then retracted by soft tubes inserted through each nostril and brought out from the mouth. This opens up the Nasopharynx – the region behind the nose where the Adenoids reside. Either under direct vision or using angled Endoscopes the Adenoid tissue is removed bit by bit till none is left.
The entire procedure takes about half to one hour depending upon the method used.
After the surgery the child is nursed in a special position and kept in the Recovery Room till completely recovered from the effects of anaesthesia.
Adenoid Surgery with Tube Insertion
Adenoids are soft tissue behind the nose that helps your child fight infection. As a result, fluid can build up behind the eardrums. This can cause pain and hearing loss.
During ear tube insertion, your child’s healthcare provider places a tiny tube into the eardrum to let fluid leave the middle ear. It also lets air enter the middle ear through the eardrum. By the time these tubes come out, the body’s natural passageway from the middle ear to the back of the nose may be working better.
This procedure is very common in children. Your child may need an ear tube insertion if he or she:
- Has had fluid in the ears for 3 or more months
- Has had a long-running ear infection
- Gets ear infections often
- Has an abnormal shape to his or her ears or mouth
- Has had certain ear injuries
Methods of performing Adenoidectomy
- Regular Cold Steel Adenoid removal – using Adenoid curettes and cage.
- Coblation assisted – using a Coblation wand which goes under the adenoid tissue and removes it using heat supplied via a dedicated console.
- Microdebrider assisted – using special Microdebrider probes and using suction and cutting.
Complications of Adenoidectomy
Complications of Anaesthesia – though safe there may be some complications related to the use of Anaesthetic agents and General Anaesthesia – these are best discussed with the Anaesthetist before the surgery. They may include drug related side effects, sedation, requirement for prolonged intubation or more.
Complications of the surgery
- Bleeding – though there is minimal bleeding during an Adenoidectomy sometimes there may be excessive intra operative or post operative period. There may be bleeding 7-10 days after the procedure – this is known as secondary haemorrhage and is usually controlled with antibiotics.
- Infection – may happen in the post operative period though a routine prophylactic is prescribed for about 48 hours post surgery.
- Nasal Regurgitation- if excessive tissue is removed – this usually recovers spontaneously over a period of time.
- Change of Voice – because bulky tissue is removed the voice may change (usually becomes clearer) after the surgery. If the patient is a child artist as singer you must discuss this with the surgeon and speech therapist because the voice after the surgery may be different.
Adenoidectomy - Post Operative Care
- Regular nursing
- Proper nutrition – usually there is minimal dietary restriction after an Adenoidectomy – chilly/ spicy/ hard food is usually better avoided for about a week. Sour things may be avoided for a few days.
- Medication as advised and gargles as prescribed
- Routine post op visit with the surgeon including a review of the Histopathology report.
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Thursday Morning Clinic Is Closed
Thursday Evening
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