What is an adenoidectomy?

Adenoidectomy is the removal of adenoids, often performed to resolve breathing obstructions, throat infections, and recurrent childhood ear disease.

Adenoidectomy is a safe and common throat operation. However, as with all surgical procedures, there are some risks associated with it.

In rare cases, significant postoperative bleeding may occur. Bleeding usually happens in the first 24 hours after surgery and is short lived. Most bleeding is treated as an outpatient.

Sustained bleeding may need to be treated in the operating room under general anesthesia and in rare cases, a blood transfusion may be recommended. Though anesthetic complications exist, they are uncommon.

How are the adenoids removed?

The adenoids are removed through the mouth. Using a mirror, we can see the back of the nose through the open mouth. Methods of removal include electrocautery, coblation, or microdebrider removal.

Bleeding is controlled by thermal sealing of the blood vessels, usually at the same time. Adenoidectomy is sometimes performed in conjunction with a tonsillectomy.

Read more about tonsils and adenoids.

Does an adenoidectomy hurt?

Yes, for a few days after surgery the throat can be sore, but not nearly as sore as when we remove the tonsils.

Swallowing will be painful after surgery, which can lead to poor oral intake of fluids and dehydration. Sometimes dehydration requires fluid replacement through an IV.

In addition to the sore throat, ear or neck pain may be present. Ear pain is quite common and is called “referred pain.” The ears are not usually infected, but the nerves that transmit pain sensations from the adenoid area also transmit pain from the ears, causing the pain to feel like it is in the ears.

Neck pain may be from the position in the operating room, but it should be reported to the doctor’s office if you or your child has any trouble turning the head.

What eases the pain?

We recommend acetaminophen (Tylenol) for the pain. Your doctor may give you a prescription pain medicine to take for the first few days after surgery as well.

An ice pack on the neck may also help. Most importantly, taking in plenty of fluids and regularly using the pain medication for the first few days will make it easier to recover.

What should I expect during recovery?

• Nausea/vomiting: There are several factors that can contribute to nausea and vomiting. Some people are sensitive to the anesthesia medicines, which can last for 24 hours after surgery. Sometimes swallowed blood makes people sick to the stomach. If you or your child vomits blood, note if it is clumpy and purple or brown, or if it is bright red. Please report this to the doctor’s office. Some people get sick from the pain medicine or from the antibiotics. It is important to note the time between the last medicine dose and the vomiting. Report the time to the doctor’s office.
• Stinky breath: Foul smelling breath is common after this surgery. The scabs in the back of the nose serve as home base for bacteria living in the mouth and throat. They are full of nutrients that the bacteria live off of. Over-the-counter saline nasal spray can be used to help thin out the mucous and improve the odor and congestion. If the foul smell becomes totally repulsive, please call the doctor’s office.
• Fever: A low-grade temperature or fever up to 101.5° F is common after this surgery. Report any fever of 102 degrees F or more to your doctor’s office.
• Diet: You can eat anything you want following surgery, but please make sure to drink plenty of liquids. Some thickened foods like Jell-O, apple sauce, pudding, yogurt, ice cream, popsicles, Flavor-ice, Italian ice, and fruits like watermelon have a lot of water in them and are easier to swallow with a painful throat than plain water.
• Activity: Return to daily activities when you feel well enough. Some people are ready in a few days; others may need a whole week. It is recommended that children avoid heavy playground activities, physical education class, or sports teams for two weeks.

What problems should I report to the doctor’s office?

Report any bleeding immediately. Bleeding usually happens between seven and 10 days after surgery when the wet scabs in the back of the throat are sloughing off. Ninety-eight percent of the time this is a brief bleed that is not significant.

Call your doctor's office if you experience any of the following:

• A temperature of more than 102°F
• Ear pain that lasts more than three days or severe ear pain
• Neck pain associated with a stiff neck or fixed head position