Preparing for adenoidectomy

Overview

An adenoidectomy is a surgery to remove the adenoids — small pads of tissue at the back of the nose. These glands help fight infections in young children, but they can sometimes become enlarged or infected and cause problems with breathing, ear infections, or hearing. This surgery is common and usually safe.

Yes, adenoidectomy is a very common surgery in children. It is one of the most frequent ear, nose, and throat (ENT) operations.

It most often affects children between the ages of 1 and 7, but can also be done in older children and adults if adenoids cause ongoing problems.

Symptoms

Common symptoms

• Snoring or noisy breathing while asleep
• Mouth breathing (keeping mouth open during the day or night)
• Frequent ear infections
• Hearing loss that comes and goes (due to fluid in the middle ear)
• Runny or stuffy nose that does not go away

Symptoms in children

• Difficulty feeding or swallowing
• Breathing pauses during sleep (sleep apnoea signs like gasping, choking)
• Irritability or daytime tiredness from poor sleep
• Speech problems (e.g., sounding ‘nasal’ or muffled)

Symptoms in older adults

• Chronic sinus infections that do not improve with treatment
• Bad breath (halitosis) from infected adenoids
• Postnasal drip (mucus dripping down the throat)

Causes

Main causes

• Recurrent or chronic adenoid infections (adenoiditis) — caused by viruses or bacteria.
• Allergies that cause the adenoids to swell and stay enlarged.
• Enlarged adenoids from birth (some children have naturally bigger adenoids).

Risk factors

• Frequent colds or ear infections in early childhood
• Exposure to secondhand smoke (tobacco smoke)
• Family history of adenoid problems
• Obesity (can contribute to sleep apnoea, which may be linked to enlarged adenoids)

When to see a doctor

See a doctor urgently if:

• Your child has pauses in breathing while asleep (sleep apnoea).
• Your child is struggling to breathe, especially at night.
• There is bleeding from the nose or mouth that does not stop after 10 minutes.

Book a routine appointment if:

• Your child snores loudly every night and mouths breathes during the day.
• Your child has had 3 or more ear infections in the past 6 months.
• Your child complains of ear pain or muffled hearing that does not go away.
• You notice a constant stuffy nose that is not helped by allergy medicines.

Diagnosis

A doctor will check your child’s health history and do a physical exam. They may look at the adenoids using a small camera (nasendoscopy) through the nose, or use an X-ray to see if they are enlarged.

Tests that may be done

• Nasendoscopy (flexible tube with a light and camera inserted through the nose)
• Lateral neck X-ray (to see the size of the adenoids)
• Sleep study (polysomnography) if sleep apnoea is suspected

What to expect at your appointment

The doctor will ask about symptoms like snoring, ear infections, and breathing. They may put a thin, numbing spray in the nose before the camera test. The test is brief and usually well tolerated. You will get the results the same day and discuss whether surgery is recommended.

Treatment

Treatment for enlarged or infected adenoids depends on the cause and severity. Mild cases may improve with time or medicine. Surgery (adenoidectomy) is considered when symptoms are severe or do not go away.

Self-care at home

• Use a cool-mist humidifier in your child’s bedroom to keep nasal passages moist.
• Encourage your child to drink plenty of fluids when they have a cold.
• For mild snoring, try changing your child’s sleep position (e.g., side sleeping).
• Avoid exposure to tobacco smoke, which can worsen adenoid inflammation.

Medical treatments

For infections, doctors may prescribe antibiotics if a bacterial infection is confirmed. Nasal steroid sprays (like fluticasone) can reduce swelling from allergies. But these treatments do not shrink the adenoids permanently. If ear infections are linked to fluid build-up, a small tube (grommet) may be placed in the eardrum at the same time as adenoidectomy.

When is surgery considered?

Surgery is recommended when enlarged adenoids cause serious problems such as sleep apnoea (breathing pauses during sleep), frequent ear infections (more than 3 in 6 months), hearing loss, or recurrent sinus infections that do not respond to treatment. Your ENT specialist will explain the risks and benefits of adenoidectomy for your child.

Living with this condition

After adenoidectomy, your child will need to rest at home for about 1 to 2 weeks. They may have a sore throat, ear pain, or a stuffy nose. Most children feel better within a week. Follow your doctor’s advice on pain relief, eating, and activity.

Lifestyle tips

• Offer soft, cool foods like yogurt, applesauce, and ice cream for the first few days.
• Avoid hot, spicy, or hard foods that could irritate the throat.
• Keep your child home from school or daycare for 7 to 10 days to allow healing and reduce infection risk.
• No heavy play or sports for 2 weeks to prevent bleeding.

Diet and exercise

After surgery, encourage your child to drink plenty of fluids (water, juice, milk). Solid foods can be gradually added as the throat feels better. Light activity like walking is fine, but avoid running or jumping for at least 2 weeks.

Mental health and emotional wellbeing

Surgery can be scary for a child. Talk to them in simple terms about what will happen. Most children cope well with support from parents. Let the doctor or nurse know if your child seems very anxious — they can offer extra help. For parents, it is normal to feel worried, but remember that this is a very common surgery with a high success rate.

Prevention

Enlarged adenoids cannot always be prevented, but you can lower the risk of infections that cause swelling. Frequent hand washing, avoiding sick people, and keeping your child away from tobacco smoke may help.

Vaccines

Staying up to date with routine childhood vaccines (like the flu vaccine and pneumococcal vaccine) may reduce the number of infections that affect the adenoids. Talk to your GP or health visitor.

Screening programmes

No regular screening is needed for adenoid problems. If your child has symptoms like snoring, ear infections, or hearing trouble, bring it up at their well-child check-ups.

Complications

If left untreated

• Persistent sleep apnoea — can affect growth, learning, and heart health over time.
• Hearing loss from repeated ear infections — may delay speech development.
• Chronic sinus infections that are hard to treat.
• Changes in facial bone growth (rare, from chronic mouth breathing).

Long-term outlook

Most children who have an adenoidectomy recover fully and have much better breathing, fewer ear infections, and improved hearing. The surgery is very safe, and the adenoids usually do not grow back. After recovery, children often sleep better, have more energy, and need fewer trips to the doctor for ear or sinus problems.

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