Adenoidectomy

Overview

An adenoidectomy is surgery to remove the adenoids — small glands at the back of the nose and throat that help fight infection. They are part of the immune system but can become enlarged or repeatedly infected, leading to breathing, ear, or sinus problems. Removing them is a common and generally safe procedure.

Adenoidectomy is one of the most common surgical procedures in children, though it is less common in adults.

Most often performed in children aged 1 to 8, but can be done in older children and adults when problems persist.

Symptoms

Common symptoms

• Noisy breathing
• Mouth breathing
• Snoring
• Sore throat or ear infections that keep coming back
• Blocked nose or clear runny nose

Symptoms in children

• Difficulty breathing through the nose
• Loud breathing or snoring
• Sleep apnoea (pauses in breathing during sleep)
• Ear infections or fluid in the ear
• Speech that sounds nasal or muffled
• Trouble swallowing

Symptoms in older adults

• Persistent blocked nose
• Ear pain or infections
• Sinusitis that keeps returning
• Headaches
• Feeling of fullness or pressure in the face

Causes

Main causes

• Enlarged adenoids due to repeated infections or allergies
• Chronic inflammation
• Sometimes the adenoids are simply larger in some children
• Ear infections or fluid build-up that doesn't improve

Risk factors

• Frequent infections in early childhood
• Allergies or asthma
• Exposure to tobacco smoke
• Family history of ear or sinus problems

When to see a doctor

See a doctor urgently if:

• Symptoms of sleep apnoea (pauses in breathing, gasping during sleep)
• Ear pain or fever that doesn't improve
• Difficulty swallowing or dehydration

Book a routine appointment if:

• Noisy breathing or mouth breathing that lasts more than a few weeks
• Recurrent ear or sinus infections
• Concerns about your child's hearing or speech

Diagnosis

A doctor will ask about symptoms and examine the nose, throat, and ears. They may use a small flexible tube with a light (endoscope) to look at the adenoids directly.

Tests that may be done

• Physical examination
• Nasal endoscopy
• A small X-ray of the upper airway
• Hearing test if ear infections are a concern

What to expect at your appointment

The examination is usually quick. If the doctor suspects other problems, they may arrange further tests.

Treatment

Treatment depends on how much the enlarged adenoids affect breathing, sleep, or ear health. Many children grow out of the problem by age 7 or 8. Surgery is considered when symptoms are severe or persistent.

Self-care at home

• Saltwater nasal rinses or nasal sprays made from salt water
• Plenty of fluids
• Over-the-counter pain relief for mild discomfort (ask your pharmacist)
• Avoiding smoke and allergens

Medical treatments

Doctors may prescribe medications such as antibiotics for bacterial infections or nasal steroid sprays to reduce swelling. These are usually tried before surgery is discussed.

When is surgery considered?

Surgery is considered when symptoms are severe, do not improve with other treatment, or affect breathing, sleep, or hearing.

Living with this condition

Recovery from adenoidectomy usually takes 1–2 weeks. Your throat may feel sore and you may have ear pain or a blocked nose. This is normal and settles as the area heals.

Lifestyle tips

• Take pain relief as recommended by your healthcare team
• Drink plenty of fluids
• Eat soft foods for the first few days
• Rest at home for a week
• Avoid strenuous activity for 2 weeks

Diet and exercise

Eat soft, cool foods like yogurt, jelly, or soup for the first few days. Avoid hard or spicy foods. You can return to gentle activity as you feel better, but avoid heavy lifting or contact sports for about 2 weeks.

Mental health and emotional wellbeing

Having surgery, especially for a child, can be stressful for the family. It is normal to feel anxious. Talk to your child before the procedure and reassure them. Ask your healthcare team about coping strategies.

Prevention

You cannot always prevent enlarged adenoids, but good hygiene and avoiding smoke may reduce the number of infections. Surgery is only needed if problems become serious.

Vaccines

Keeping up to date with childhood vaccinations, including the flu vaccine if offered, may reduce infections. Speak to your doctor for advice.

Screening programmes

There is no routine screening for adenoid problems. Your doctor will assess symptoms as they arise.

Complications

If left untreated

• If left untreated, severely enlarged adenoids can cause breathing problems, sleep apnoea, and repeated ear or sinus infections.
• In children, long-term ear infections can affect hearing and speech.

Long-term outlook

Most people recover quickly from surgery and see a big improvement in breathing and sleep. Complications are uncommon, and any problems are usually minor and temporary.

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