Adenoidectomy

Indications

Obstructive sleep apnoea (OSA), 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 This may be reactionary or secondary, but is significantly rarer than after tonsillectomy (<1%).

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 and not usually included in the consent process.

 

Post-operative management

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

 

TTO

Simple analgesia. Some consultants will prescribe antibiotics.

 

 

 Page last reviewed: 23 September 2016