Adenoidectomy (Adenoid Removal): What to Expect

Key Takeaways

Adenoid removal is not a major surgery and is commonly needed for children between the ages of 1 and 7 years old, as the adenoids naturally shrink over time and are typically gone by the teenage years.
Before surgery, your child’s health care provider may advise stopping certain medications like ibuprofen or any other medications that can thin their blood. Your child will also need to fast for a few hours before the surgery.
It usually takes 7-10 days to recover from surgery for adenoid and tonsil removal. Keep your child away from environments where they can be exposed to germs. Avoid smoky areas and cigarette smoke to prevent irritation of the nasal passages.

Adenoidectomy, a surgical procedure to remove the adenoid glands, is one of the most commonly performed surgical procedures in children. Adenoidectomy is done if the adenoids have become enlarged or swollen due to infections or allergies, causing trouble breathing, frequent ear infections, or sinus infections.

Please continue reading to learn more about what to expect with adenoid removal.

What are the adenoids?

The adenoids are small lumps of tissue in the back of the throat, on either side of the upper airway, just behind your child’s nose. They are part of a child’s immune system and support the body’s ability to fight germs such as bacteria and viruses that are breathed in.

Remember that adenoids and tonsils are two different types of tissues that carry the same function as a front-line defense against inhaled or ingested germs. The adenoids usually shrink in size after age 7 and disappear by age 13. In adults, the adenoids are vestigial organs, meaning they just exist with no purpose.

Why do you need to remove adenoids?

Sometimes, the adenoids in a child’s airway can become enlarged or inflamed due to recurrent nasal infections, allergies, or other causes. Enlarged adenoids can partially block the child’s throat and airway and cause trouble breathing. They can lead to breathing through the nose. In severe cases, enlarged adenoids may cause breathing problems during sleep, especially if the tonsils are also enlarged (your child may stop breathing for short periods of time — this is called obstructive sleep apnea).

Swollen adenoids can cause symptoms such as snoring, nasal drainage, and restless sleep. They can lead to the accumulation of middle ear fluid, leading to frequent ear infections and sinus infections.

If this is the case, your child’s doctor may recommend adenoid surgery (having the enlarged adenoids removed). This will not affect your child’s health. Your child’s immune system will function normally.

Is adenoid removal a major surgery?

Adenoid removal is not a major surgery. It is an outpatient procedure done in a general hospital or children’s hospital. Adenoidectomy is done using general anesthesia given by a pediatric anesthesiologist (your child will be asleep and won’t feel any pain). The pediatric otolaryngologist (ENT surgeon) will remove the adenoid tissue at the back of the nose through your child’s mouth. There is no need to make an incision or cut, and no visible scars. The adenoids are destroyed using electrocauterization (application of a heated wire).

The procedure is quick and usually takes around 30 minutes. The surgeon may perform a tonsillectomy (having the tonsils removed) at the same time. Most children go home the same day after being observed in the recovery room for a few hours after surgery. Sometimes, it may be necessary to stay in the hospital overnight for monitoring.

What is the best age to remove adenoids?

Many children need their adenoids removed between the ages of 1 and 7 years. The adenoids start decreasing in size naturally after age 7 and are typically gone by the time a child is in their teens. A child’s tonsils are frequently removed at the same time as a child’s adenoid tissue.

How to prepare for adenoid removal?

Follow the instructions from your child’s health care provider. This may include stopping certain medications such as aspirin, ibuprofen (Motrin, Advil), naproxen (Aleve), or any other medications that can thin the blood. Certain medications may need to be stopped from one to two weeks before the procedure. Acetaminophen (Tylenol) is generally safe to use prior to the procedure. Your child’s healthcare provider will give you specific instructions regarding safe medication use.

Your child’s doctor may order some blood work before the scheduled adenoidectomy to make sure all the blood counts (red blood cells and white blood cells) are within normal range. These lab tests also make sure that there is no problem with blood clotting to prevent excessive bleeding during and after the surgery. These blood works are standard and should be expected.

Your child should not be eating or drinking before surgery. They will need to fast after midnight before the surgery because the stomach needs to be empty before general anesthesia. You should tell your child’s healthcare provider if your child has infections of the nose and throat (cold or flu) in the days before the surgery — the procedure may need to be postponed to a later date.

What is the downside of removing adenoids?

The downsides of having your child’s adenoids removed include temporary side effects such as fever, mild pain (neck pain, throat pain, and ear pain), sore throat, trouble swallowing, bad breath, noisy breathing, upset stomach, and vomiting. Your child’s doctor may prescribe pain medicine for a few days.

The surgery also carries a risk of infection and bleeding, risks associated with anesthesia, permanent changes in a child’s voice, and failure of the surgery to treat symptoms such as difficulty breathing and/or recurrent ear infections. Rarely, the adenoids may grow back, and a repeat surgery may be necessary.

How long does it take to recover from adenoid removal?

It usually takes 7-10 days to recover from adenoid and tonsil removal surgery. Individual recovery times can vary. Some children may take longer to recover fully. Parents should follow the specific post-operative care instructions provided by the healthcare provider.

Keep your child away from people who are sick and environments where they can be exposed to germs. Also, avoid smoking near your child, and keep your child from smoky areas, as this can irritate the nose and throat.

What to eat and drink after having the adenoids removed?

During recovery from adenoidectomy, encourage your child to eat cold and soft foods such as ice cream, popsicles, Jell-O, pudding, and mashed potatoes. Also, give your child plenty of fluids, including water, soups, and non-acidic fruit juices. Avoid hard, crunchy, acidic, or spicy foods, as they can irritate the throat and nasal passages.

When to call a doctor after an adenoidectomy?

Call your child’s throat surgeon if your child develops a high fever, has trouble swallowing, or coughs up bright red blood after having their adenoids surgically removed.

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