Adenoids are glands located above the roof of the mouth, behind the nose. They look like small lumps of tissue, and serve an important purpose in young children. Adenoids are part of the immune system and help protect the body from viruses and bacteria. Adenoids begin to shrink around age 5 to 7 in children, and can be almost completely gone by the teenage years.

While adenoids help protect the body from viruses and bacteria, they sometimes become swollen and enlarged or chronically infected. This can be due to infections, allergies, or other reasons. Some children may also be born with abnormally large adenoids.

When a child’s adenoids become enlarged, they can cause problems by partially blocking his or her airway. When this happens, children can have breathing problems, ear infections, or other complications, which can lead to snoring or more serious conditions such as sleep apnea (stopping breathing) at night.

Chronic (long-term) nasal drainage, congestion and sinus infections can also be seen. Enlarged adenoids can also affect the recurrence (return) of ear infections and chronic fluid in the ear, which can result in temporary hearing loss.

Adenoidectomy, or adenoid removal, is surgery to remove the adenoid glands.

It is a common procedure that is typically performed for one or more of several common indications:

  1. Adenoid hypertrophy (enlargement) causing mouth breathing, nasal obstruction, snoring or restless sleep.
  2. Recurrent ear infections and/or chronic middle ear fluid.
  3. By request of your child’s orthodontist to help with mouth breathing in order to optimize the orthodontic outcome.

Night before Surgery:

No solid foods (that includes milk, cream etc.) for 8 hours prior to surgery. Typically this means no solid foods after midnight before the surgery. Small volumes of clear liquid may be drunk up to 4 hours prior to surgery. If your child is still nursing, you may nurse up to 4 hours before surgery.

Hospital Stay:

Adenoidectomy surgery is usually done in an out-patient setting and does not require an overnight hospital stay. 

Lab Work: 

Complete blood work up and post nasal x-ray might be done prior to surgery.

Surgical Steps:  

An adenoidectomy is a straightforward, relatively short procedure usually done on an outpatient basis. Your child will be placed under general anesthesia for the procedure.

During surgery, the doctor will widely open your child’s mouth with a retractor while the child is asleep, and then remove the adenoids using one of several techniques. The doctor may use an electrical device to help stop the bleeding.


  • Most children will be able to return home on the day of their surgery.
  • The child’s activity should be judged on how the patient feels, and common sense. Children may be out of school for 5-7 days
  • Eating is not usually a problem after adenoidectomy. We allow diet as tolerated post- operatively.
  • It is important that the patient drinks plenty of fluids to prevent dehydration. Any fluid, such as water, milk, apple juice, orange or grape drinks and carbonated beverages are all acceptable during the postoperative period. Popsicles, slushies and ice chips are also good substitutes for fluids
  • Generally, there is little or no pain after adenoidectomy. Occasionally your child might experience a Stiff neck, This is caused by spasms of the neck muscles. This will subside as the healing continues. In case mild pain occurs paracetamol syrup will be sufficient.
  • You might notice Bad breath/Nasal congestion post operatively and this is produced by the healing tissues in the area of surgery and can last up to ten days but should resolve completely after that.
  • There is up to a 10% chance of adenoid tissue regrowth over time. This is mostly related to the child’s age at the time of surgery, as well as the cause of the adenoid overgrowth initially.
  • Follow up after 3-4 weeks.


  • Tongue numbness/Taste Change: During adenoidectomy, an instrument is used to push your child’s tongue into a position so that the surgery can easily be performed. The pressure from the instrument on the tongue occasionally can cause the sides or tip of the tongue to feel numb, or cause a temporary change in taste for a couple weeks. Sometimes parts of the tongue will swell for a few days. Additionally there is a remote risk of tongue weakness or partial paralysis from the mouthpiece. These problems are rare and typically subside spontaneously. Extremely rarely would these be permanent.
  • Burn: There is a potential risk of burn injury with cautery or Coblation. Specific precautions are taken in surgery to avoid this problem
  • Fever: The patient may develop a low-grade temperature (up to 101degrees). If this occurs, it is recommended that you increase fluid intake. Paracetamol syrup will be prescribed to your child upon discharge which will help decrease the fever.
  • Voice change: There might be some voice changes noticed after surgery, This is related to the increased space and improved air flow through the postnasal area after adenoidectomy.
  • Some individuals may regurgitate fluid through their nose while drinking, (termed velo-pharyngeal insufficiency), which usually is temporary but it rarely can be permanent occurring in about 1 in 2000 adenoidectomy patients.
  • Bleeding: Bleeding after adenoidectomy is extremely rare. Bleeding is defined as continuous bright red blood from the nose like a nose-bleed, or bright red blood expectorated from the mouth. Some children may swallow blood and later vomit it up. A small amount of bloody drainage can occur from the nose after adenoidectomy within the first 12 to 24 hours. This usually subsides spontaneously, and can be normal. If heavy bleeding occurs, it usually happens within the first 24 hours or between the 7th to 10th day after surgery, but may occur up to two weeks after the operation.