After discussing the medical history and examining you or your child it has been decided to perform an adenoidectomy. This is usually done when enlarged adenoids are blocking the nasal passages or when they may be contributing to ear or sinus problems. Adenoids, like tonsils, are tissue made up of white blood cells which are the type of cells that help the body fight infection. The adenoids are behind the nose. Although experiments do show increased activity of the infection fighting cells in the adenoids during infection, this activity seems to be lost when the adenoids become large or frequently infected. Studies have not shown any evidence that removing the adenoids increases a person’s risk for infection, other diseases or health problems. (The adenoids usually absorb in the teen years and are thus absent in adults.) As with any surgery there are some risks including a very small chance for bleeding, problems with anesthesia, or changes in voice or swallowing. If you have questions about these please call the office.

Prior to Surgery

It is very important that the patient avoid taking aspirin or aspirin like products such as Motrin, ibuprofen, Advil, Aleve, etc. for 2 weeks before and several days after surgery. These medications will thin the blood and increase the amount of bleeding at surgery and the chance for, as well as the severity of, bleeding after surgery. Tylenol (acetaminophen) may be taken as this does not thin the blood. Please follow the bottle directions.

Some children will benefit from watching a video tape in our office or reading a booklet about the surgery. Since you know your child best, it is up to you whether you want to make use of either of these items. Please ask the office staff if you are interested.

The Day of Surgery

On the day of surgery the patient should have nothing to eat or drink after midnight. An exception to this would be any medications the doctor has instructed you to take that morning. Failure to follow these guidelines may result in the cancellation of surgery.

You will need to arrive at the surgical facility well before the scheduled time of surgery. A day or two before surgery you will be called by the doctor’s nurse or someone from the facility and told specifically what time to arrive. After you arrive some information will be taken by a nurse and someone from the anesthesia department will talk to you.

Once in the operating room, young children will go to sleep by breathing gas through a mask; they will then have an IV started. Older children and adults will have an IV started first and then go to sleep by medication given through the IV. Sometimes this IV line will be placed before going to the operating room. Once asleep, a breathing tube will be placed through the mouth. During surgery the patient will be kept completely asleep by breathing gas given through this tube under the supervision of an anesthesiologist. The surgery takes about 30 minutes; it is performed through the open mouth. The doctor will talk to you after the surgery is done. Please stay in the waiting room the whole time the patient is in surgery. After surgery the patient will be in the recovery room for about 30 minutes. Parents may be able to sit with their child for part of this recovery time. After this, the patient and family will stay in another recovery area or hospital room until ready to leave, usually 1 to 2 hours after surgery.

Once you are Home

The patient should initially take liquids followed later in the day by solid foods. Good things early on include fruit juices, pop, popsicles, ice cream, milkshakes, instant breakfast, yogurt, pudding, jello, applesauce, scrambled eggs, etc. A normal diet can usually be eaten the day after surgery.

The patient will have some pain in the THROAT as well as in the EARS for a few days following surgery. The “ear” pain occurs because the adenoids sit straight in from the ears, not because there is a problem with the ears. The patient should take only Tylenol (acetaminophen) for pain. (follow label directions) As discussed above, do not take aspirin or aspirin like products such as Motrin, ibuprofen, Advil, Aleve, etc. for several days after surgery as this will thin the blood and increase the chance for, as well as the severity of, bleeding after surgery.

Strenuous activity should be avoided for 2 days after surgery as this will increase the risk of bleeding. It is ok to go to a movie, mall or be up and about the house during this time. The patient will usually miss a couple of days of school or work following surgery.

It is common to have some blood tinge in the saliva or nasal mucous after surgery. It is very unlikely for the patient to bleed significantly after surgery. Should any significant bleeding occur (spitting out clots or constant dripping) call the office day or night and your surgeon, or another Ear, Nose and Throat specialist, will return your call. In the unlikely event that you are unable to contact the doctor and if bleeding is significant then go to the emergency room.

Due to the bacteria in the throat there is always a low grade infection present during the healing phase of adenoidectomy. You will notice a fever (up to 101 F), some bad breath, and a stiff neck, (since the adenoids sit on the neck muscles), for about ten days after surgery. Tylenol will help with the fever, (follow label directions). Although this will resolve on its own, if the patient is not allergic, he or she may be given a prescription for an antibiotic.

You may also notice some voice changes after surgery due to swelling and the removal of enlarged tissues. This will resolve on its own, usually in three to four weeks. If the voice seems abnormal for more than two months please call the office.

If you have questions or problems please call the office (during regular business hours if at all possible).Please make an appointment now for your surgeon to check you in the office 3 to 4 weeks after surgery. There is no charge for this initial follow-up visit. Usually no further follow-up is needed.