Adenoidectomy

Indications

• Obstructive sleep apnoea (OSA) in children, in combination with tonsillectomy
• Glue ear (otitis media with effusion), in combination with grommet insertion — increases longevity of effect of grommets
• Nasal obstruction due to adenoidal hypertrophy (somewhat controversial)

Procedure

Exposure as for tonsillectomy. The adenoid is removed using a curette, followed by a pack for haemostasis, or by suction monopolar diathermy or Coblation, under direct vision using a mirror.

Operative Time

10-15 minutes.

Complications

• Bleeding: may be reactionary or secondary, but is significantly rarer than after tonsillectomy (<1%). data-preserve-html-node="true"
• Halitosis: warn parents about this — it will pass with time.
• Nasal regurgitation of liquids / hypernasal speech: almost always resolves within weeks, but this is the reason adenoidectomy is performed with caution in those with submucous cleft palate.
• Grisel's syndrome: atlanto-axial subluxation. Extremely rare.

Post-Operative Management

Discharge the same day, or stay overnight for post-operative monitoring, depending on the indication (see UK multidisciplinary consensus statement on OSA). Follow-up may be booked depending on the indication for surgery.

TTO

Simple analgesia, if required.

Page last reviewed: 30 July 2026