Day of adenoidectomy

Overview

An adenoidectomy is a surgical procedure to remove the adenoids – small glands at the back of the nasal passage. The adenoids help fight infections but can become enlarged or infected, causing breathing and ear problems. The surgery is done to relieve these symptoms.

Yes, adenoidectomy is one of the most common surgeries in children, especially between ages 3 and 7.

It most often affects children, but teenagers and adults can also need the procedure if the adenoids remain enlarged or cause problems.

Symptoms

Common symptoms

• Chronic nasal congestion
• Loud snoring or noisy breathing
• Frequent ear infections or fluid in the ear
• Mouth breathing (especially while asleep)

Symptoms in children

• Difficulty breathing through the nose
• Pauses in breathing during sleep (sleep apnoea)
• Recurrent sore throats or tonsillitis
• Speech sounding ‘nasal’

Symptoms in older adults

• Less common, but can include persistent nasal obstruction
• Recurrent sinus infections
• Hearing loss due to chronic ear fluid

Causes

Main causes

• Enlarged adenoids blocking the nasal passages
• Repeated infections (adenoiditis) that do not get better with antibiotics
• Chronic ear infections or fluid behind the eardrum (glue ear)

Risk factors

• Frequent respiratory infections in early childhood
• Allergies causing nasal congestion

When to see a doctor

See a doctor urgently if:

• Your child has difficulty breathing or pauses in breathing during sleep
• You notice heavy bleeding from the nose or mouth after surgery
• Severe pain that does not improve with simple pain relief

Book a routine appointment if:

• Your child has had three or more ear infections in six months
• Persistent snoring or mouth breathing for more than three months

Diagnosis

The doctor will ask about your symptoms and look inside your nose and throat using a small light or a flexible camera (nasal endoscopy).

Tests that may be done

• Nasal endoscopy to see the size of the adenoids
• X-ray of the nasal passage (lateral neck X-ray) if needed
• Sleep study (polysomnography) if sleep apnoea is suspected

What to expect at your appointment

The examination is quick and can be done in the clinic. For children, the doctor may use a numbing spray and a very small camera. Your child may need to sit on your lap. There is no pain, but it might feel strange.

Treatment

Treatment for enlarged adenoids usually starts with managing infections and allergies. If symptoms are severe or long-lasting, surgery to remove the adenoids may be recommended.

Self-care at home

• Before surgery: follow the fasting instructions (no food or drink for several hours as advised by your hospital).
• After surgery: rest at home for the first day. Use simple pain relief as recommended by your doctor.
• Encourage soft, cool foods like yoghurt, ice cream, or soup for the first few days.

Medical treatments

Medical treatment before surgery may include antibiotics for bacterial infections, nasal steroid sprays to reduce swelling, or allergy treatments. After surgery, pain relief such as paracetamol or ibuprofen (in appropriate doses for age and weight) is often used. Your surgeon may sometimes prescribe a short course of antibiotics to prevent infection.

When is surgery considered?

Surgery is considered when non-surgical treatments have not helped and symptoms are affecting quality of life, such as sleep apnoea, frequent ear infections, or chronic nasal blockage.

Living with this condition

On the day of the adenoidectomy, you will arrive at the hospital, meet the surgical team, and your child (or you) will be taken to the operating theatre. The surgery itself takes about 30 minutes. Afterward, you will wake up in a recovery area. You may have a sore throat, but this usually improves with pain relief. Most people go home a few hours later.

Lifestyle tips

• Plan to take it easy for 24 hours after surgery – no school or work.
• Avoid blowing the nose or vigorous nose blowing for one week.
• Avoid strenuous activity or sports for about one to two weeks.

Diet and exercise

Stick to soft, cool foods and plenty of clear fluids for the first two days. Avoid hot, spicy, or crunchy foods that could irritate the throat. Light activity around the house is fine, but no running or jumping until your doctor says it is okay.

Mental health and emotional wellbeing

It is normal to feel anxious before surgery, especially for children. Talking to your child about what will happen in a calm, positive way can help. For adults, bringing a book or music to the hospital can ease nerves. After surgery, some children may be irritable or upset – this usually passes quickly. If you or your child feel very anxious, speak to your healthcare team.

Prevention

You cannot always prevent enlarged adenoids, but you can reduce the number of infections by washing hands regularly, avoiding close contact with sick people, and keeping up to date with vaccinations.

Vaccines

Keeping up with routine childhood vaccines, including the flu vaccine and pneumococcal vaccine, may help reduce respiratory infections that can lead to adenoid problems.

Screening programmes

There is no routine screening for adenoid enlargement. It is usually discovered when symptoms appear.

Complications

If left untreated

• Chronic ear infections can lead to hearing loss and speech delays in children.
• Sleep apnoea can affect growth, behaviour, and learning.
• Frequent sinus infections and breathing difficulties.

Long-term outlook

For most people, adenoidectomy is very effective. Symptoms such as snoring, breathing problems, and ear infections usually improve significantly. Complications are rare, and recovery is quick. Most children return to normal activities within a week.

Find support

International organisations

• ENT UK (British Association of Otorhinolaryngology)
• American Academy of Otolaryngology–Head and Neck Surgery

Local organisations

• NHS Choices · UK

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