Adenoids are tissue that is similar to the lymph nodes or glands found throughout the body. They are located high in the throat behind the nose and the roof of the mouth (soft palate) and are not visible through the mouth without special instruments. The function of adenoids is to catch incoming germs while we breathe. Children who have their adenoids removed do not have a greater incidence of infection following surgery.

Chronic nasal congestion
Children with enlarged adenoids often have difficulties with continuous nasal congestion, frequent colds and “sinus-like infections.” They may be more prone to post-nasal drip causing chronic cough and upper respiratory concerns. Nasal obstruction and mouth breathing are common. Removing the adenoids can greatly improve these symptoms.

Obstructive Sleep Apnea
For some children, the adenoids become so enlarged that they cause obstructive problems during sleep. Common symptoms include snoring, very restless sleep (tossing and turning), frequent arousals, fatigue or hyperactivity during the day. A common cycle occurs: as the child slips into a deep sleep, the airway relaxes and obstructs. The child’s oxygen saturation decreases, and as a result, his or her brain responds by creating arousal and movement. The child then goes into a light sleep. This cycle continues all night, denying the child the deep sleep (also known as REM sleep) that he or she requires. Some parents will hear pausing or gasping during this cycle. Lack of sleep has been shown to affect school performance, concentration and behavior negatively.

Chronic ear infections or middle ear effusions (fluid in the ear)
Removing a child’s adenoids can often help resolve long-term problems with ear infections or middle ear effusions. Adenoids often enlarge and cause obstruction of the eustachian tube (a small tube that connects the middle ear space to the back of the nose). This does not allow the middle ear space to drain and ventilate properly, which can lead to chronic ear issues. Tympanostomy tubes (ear tubes) are often used in this situation. Children over two years of age or children who require additional sets of tubes will often benefit from an adenoidectomy.

The surgery is performed in the Pediatric Operating Room at Yale-New Haven Children’s Hospital and takes approximately 20-30 minutes. The child will receive an intravenous line (IV) in order to receive medication and fluids during the surgery. Following the operation, the child will go to the Post-Anesthesia Care Unit (PACU). Parents or guardians can be with the child at this time. It is normal for children to be disoriented and upset as they come out of the anesthesia. The child will be ready to go home once he or she is drinking and acting normally, which often takes an hour or two. The child will be given two prescriptions: an antibiotic and a pain medicine. Parents or guardians should make sure that the child takes them as directed.

As with any surgery, there are some associated risks:

• The child will receive general anesthesia for the procedure. There is a small risk of complication occurring due to the anesthesia. However, every precaution is taken to ensure the safety of the child.
• There is a very low risk of postoperative bleeding which would require a trip back to the hospital for evaluation.
• Nearly all children experience mild discomfort for one to three days, however the vast majority feel back to themselves after that time. Some of the common complaints following the surgery may include ear pain, neck pain, congestion and cold-like symptoms, fever, snoring, voice changes, night terrors, nausea and extremely bad breath. To lessen discomfort, pain medication will be prescribed. The child may also receive ibupropin, such as Motrin, starting 24 hours after the surgery. An antibiotic will also be prescribed to help lessen the bad breath that develops after surgery.

There are no limitations to diet following surgery. In fact, children who eat and drink well have quicker, easier recoveries. They may eat or drink anything that they want … just as long as they eat and drink. If a child is having postoperative pain, the parent or guardian should ensure that the child is taking pain medicine. This will make it easier for the child to eat.

Narcotics (such as Tylenol and codeine or hydrocodone) are very effective in reducing the pain. However, they do make some children feel nauseous. Once 24 hours have passed after surgery, the child may receive ibupropin such as Motrin. This is very effective in controlling the pain.

There are no limitations to activity. Children will self limit themselves. Most children will return to school and other extracurricular activities two or three days following the operation. However, they may return sooner if they are feeling up to it.

For a physician referral, click here or call (203) 688-2000 or toll free (888) 700-6543. Visit Connecticut Pediatric Otolaryngology for more information.

• If a child has any bleeding (from the mouth or nose or vomiting blood), take him or her to the emergency room.
• If a child has not urinated in 24 hours, call your doctor or take the child to the emergency room.
• If the child has a fever greater that 101.5 for more than 48 hours, call your doctor.

Last revised: Jan. 26, 2007 (dh)

Home page URL: http://www.ynhh.org

All information is intended for your general knowledge and is not a substitute for medical advice or treatment for specific medical conditions. You should seek prompt medical care for any specific health issues and consult your physician before starting a new fitness regimen.