Adenoidectomy Surgery

Adenoidectomy, also called adenoid surgery, is a safe and highly effective procedure to treat chronic nasal obstruction, recurrent infections, and breathing difficulties. Adenoids are lymphoid tissues at the back of the nasal cavity that contribute to immunity in early childhood. Enlarged or chronically infected adenoids can cause nasal blockage, sleep-disordered breathing, and persistent ear or sinus problems.

History of Adenoidectomy Surgery

Adenoidectomy dates back to the early 20th century, when ENT surgeons began removing enlarged or diseased adenoids to relieve nasal obstruction and ear problems. Often performed alongside tonsillectomy (tonsil-adenoidectomy), the procedure has evolved from blind curettage to precise, endoscopic and powered instrumentation techniques, improving surgical accuracy and minimizing complications.

What Are Adenoids and Why Adenoidectomy Is Required?

Adenoids are small lymphoid pads located behind the nose and roof of the mouth. While they play a role in early immunity, enlarged or chronically infected adenoids can cause:

Chronic Nasal Obstruction: Mouth breathing, persistent congestion, snoring, and facial growth changes.
Recurrent Ear Infections (Otitis Media): Eustachian tube blockage causing fluid accumulation, hearing loss, and repeated infections.
Sleep-Disordered Breathing & Obstructive Sleep Apnea (OSA): Snoring, restless sleep, breathing pauses, and daytime fatigue.
Sinusitis and Persistent Infections: Chronic sinus infections unresponsive to medical therapy.
Mouth Breathing & Dental Problems: Dental malocclusion and poor facial development from long-term mouth breathing.

Pre-Operative Evaluation for Adenoidectomy

Clinical History & Physical Examination: Review symptoms and assess oral/nasal cavity.
Nasal Endoscopy: Flexible or rigid endoscopy to assess adenoid size and airway obstruction.
Audiometry or Tympanometry: Evaluate middle ear function in children with recurrent ear infections.
Obstructive Sleep Assessment: Identify sleep-disordered breathing or OSA if clinically indicated.
Radiologic Imaging (if needed): Lateral neck X-ray or CT to confirm adenoid enlargement in select cases.
Medical Optimization: Treat active infections and evaluate comorbidities to reduce surgical risk.

Latest Advances in Adenoidectomy Surgery

Endoscopic-Assisted Adenoidectomy: Direct visualization improves removal, reduces bleeding, and lowers recurrence.
Powered Instrumentation: Microdebriders enable precise and efficient tissue removal.
Coblation Adenoidectomy: Low-temperature radiofrequency energy reduces thermal injury and postoperative discomfort.
Radiofrequency Ablation (RFA): Shrinks adenoid tissue with minimal bleeding and faster recovery.
Combined Adenoidectomy & Tonsillectomy Techniques: Advanced methods reduce operative time and morbidity when performed together.

Potential Side Effects and Risks

Postoperative Pain & Discomfort: Mild throat or nasal soreness, usually short-lived.
Minor Fever: Low-grade fever in the first 1–2 days post-surgery.
Nasal Regurgitation: Temporary nasal regurgitation of liquids, resolving in a few days.
Bleeding: Rare, but may occur in the first 24–48 hours post-surgery.
Temporary Voice Changes: Transient alterations in voice quality may occur.
Infection: Rare, treatable with antibiotics.
Recurrence of Symptoms: Possible regrowth of adenoids, especially in younger children with persistent allergic or infectious triggers.

Results and Outcomes of Adenoidectomy Surgery

Improved Breathing and Nasal Airflow: Relief from nasal obstruction, enabling normal nose breathing.
Reduced Snoring & Sleep Apnea Symptoms: Better sleep quality and daytime alertness.
Decreased Ear Infections: Fewer episodes of chronic or recurrent otitis media, especially with ventilation tubes.
Enhanced Hearing Function: Improvement in Eustachian tube function and resolution of conductive hearing loss.
Improved Quality of Life: Positive effects on behaviour, school performance, sleep, appetite, and general wellbeing.
Indian Clinical Outcomes: Studies demonstrate high success rates, low complication rates, and measurable improvements in patient-reported outcomes.

Conclusion

Adenoidectomy is a safe, effective, and commonly performed ENT surgery providing relief from nasal obstruction, breathing difficulties, sleep-disordered breathing, and recurrent ear infections. Modern advances — including endoscopic visualization, powered instrumentation, and minimally invasive techniques — enhance precision, safety, and outcomes. Comprehensive pre-operative evaluation, meticulous surgical technique, and careful postoperative care ensure excellent clinical results. Indian clinical data support its high success rate, making adenoidectomy a cornerstone of pediatric ENT care across the country.