Adenoids are treated by surgical removal.
How Are Adenoids Removed?
General anesthesia is the norm. Most often, with the assistance of a small mirror, adenoid tissue is "shaved" or curetted from the back of the nose. Occasionally, some other devices or electrocautery is used. With the advent of special cautery devices, we almost always completely dry the surgical site before the patient wakes up, eliminating the low-grade bleeding that used to be associated with adenoidectomies. The procedure typically takes 5-15 minutes to complete.
What Are the Complications of Adenoidectomy?
Complications are rare, and usually minor. Anesthetic risk is usually related to the health of the patient. Serious anesthetic complications can occur, but are very unusual. The adenoid "bed" usually becomes superficially infected, and can cause 7-10 days of bad breath, but serious infections are very rare. If adenoids are routinely removed in all children, without careful consideration and examination, a few children will have "velopharyngeal insufficiency," meaning that sounds or liquids can escape up the back of the nose affecting speech and/or swallowing. We have never encountered that complication, but it has been reported by other surgeons. In other words, some children should not undergo adenoidectomy - because of their special anatomy.
What Should We Expect Postoperative?
Adenoidectomy typically is much less painful than a tonsillectomy. Most children need no pain medications, but a few benefit from acetaminophen (Tylenol). Bad breath is common for 7-10 days. A few children will complain of a stiff or sore neck (from irritation of the neck muscles underneath the adenoid bed). The patient may consume a normal diet. We usually see patients 2-4 weeks postoperative - to ensure normal function and healing.
Should the Tonsils Be Removed Also?
In general, only if they are enlarged, or otherwise have been causing problems themselves. The tonsils rarely, if ever, are associated with ear disease. However, if we are removing adenoids because they are enlarged or obstructed, we tend to be relatively aggressive with borderline enlarged tonsils. Too often, several months later, when we left such tonsils, they became enough of a problem to warrant removal.