Adenoid surgery

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What are adenoids?

The adenoids are small pads of tissue found behind the back of the nose above the throat. They cannot be seen by looking in the mouth. Adenoids can become very large and block the eustachian tubes (the tubes from the middle ears to the back of the nose) and cause ear infections. Large adenoids can also block the nasal airway causing your child to breathe through his mouth and snore at night. Adenoids can become infected and carry germs (bacteria).

Your body can still fight germs without your adenoids. We only take them out if they are doing more harm than good.

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Why take them out?

  • Blocked-up nose: Very large adenoids can block the nasal passages. This causes snoring and keeps your child from being able to breathe through his nose. Severe blocking may lead to more serious problems (such as sleep apnea). Removing the adenoids lets the child breathe normally through the nose.
  • Recurring ear infections: Very large adenoids can block the eustachian tubes and lead to ear infections or the failure of ear infections to clear. If a child has surgery to place Grommet tubes in the eardrums at the same time the adenoids are taken out, it can help prevent recurring ear infections.

What are the alternatives if the adenoids not removed?

Your adenoids get smaller as you grow older, so you may find that nose and ear problems get better with time. Surgery will make these problems get better more quickly, but it has a small risk. You should discuss with your surgeon whether to wait and see, or have surgery now.

For some children, using a steroid nasal spray will help reduce congestion in the nose and adenoids, and may be helpful to try before deciding on surgery. Antibiotics are of little help and only produce temporary relief from infected nasal discharge. They have side effects and may promote bacteria that are resistant to antibiotics.

Have a second opinion

If you would like to have a second opinion about the treatment, you can ask your specialist. He or she will not mind arranging this for you.

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Adenoid surgery-How it is done

Arrange for a week off school. Let us know if your child has a sore throat or a cold in the week before their operation – it may be safer to put it off for a few weeks. We often give a short course of antibiotics before the operation.

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Your child will be put to asleep for the operation. We will take out the adenoids through his or her mouth, and then stop the bleeding before he or she is woken up.

In some hospitals, adenoid surgery is done as a day case, so that the patient can go home on the same day as the operation. Some surgeons may prefer to keep children in hospital for one night. Either way, we will only let him or her go home when he or she is eating and drinking and feels well enough.

Most children need about a week off school. They should rest at home away from crowds and smoky places. Stay away from people with coughs and colds.

How long will it take to recover?

Most children are back to normal within 24 hours after surgery. Some children take a few days to recover. More snoring or nasal congestion is normal and is caused by temporary swelling in the back of the nose. Bad breath is also normal and is caused by the scabs that form after surgery. The snoring, congestion, and bad breath should be gone within 10 to 14 days after surgery.

Post operative Instructions after Adenoid Surgery

1. Pain Medicines

Most children have little pain after the operation. Most of the pain will be toward the back of the neck. Your child may have a sore throat for a few days. Give regular doses of pain medicine Like Paracetamol, syrup 4 to 5 times a day for a week. . You can also have your child suck on ice chips or chew gum.

A fever between 99°F (37.5°C) and 101°F (38.4°C) is normal for a few days after surgery and can be treated with Paracetamol. DO NOT USE ASPIRIN because this increase the chance of bleeding.

2. Antibiotics and decongestants are continued for another 5 days.

3. Diet

Begin giving your child cool, clear liquids as soon as she wants to drink. Gradually add foods that your child feels like eating until the diet is back to normal.
Your child may feel sick to her stomach, vomit, feel tired and cranky. This should get better within a few hours..

4. Activity

It is best for your child to rest at home for the first 3 to 4 days after surgery. Normal activities can start as soon as your child feels up to it. There is no rule for the right time to go back to school, but a guideline is 5 to 7 days. Your child should not play rough or play contact sports until 14 days after the surgery.

Possible complications

Adenoid surgery is very safe, but every operation has small risks. The most serious problem is bleeding, which may need a second operation to stop it. However, bleeding after adenoidectomy is very uncommon. It is very important to let us know well before the operation if anyone in the family has a bleeding problem.
During the operation, there is a very small chance that any loose tooth (milk tooth) may be removed to prevent aspiration.

Some children feel sick after the operation. This settles quickly.

A small number of children find that their voice sounds different after the surgery. It may sound like they are talking through their nose a little. This usually settles by itself within a few weeks.

The child’s throat may be a little sore. Prepare normal food. Eating food will help your child’s throat to heal. Chewing gum may also help the pain.

Your child may have sore ears. This is normal. It happens because your throat and ears have the same nerves. It does not mean your child has an ear infection.

Give painkillers as needed for the first few days. Do not use more than it says on the label. Do not give your child aspirin – it could make your child bleed. (Aspirin is not safe to give to children under the age of 16 years at any time, unless prescribed by a doctor).