Adenoidectomy (Adenoid Removal)

You may notice it at night first. Your child sleeps with the mouth open, snores, and tosses around the bed. During the day the nose is always blocked or running, the voice sounds as if they have a permanent cold, and perhaps a teacher has mentioned that they don't seem to hear properly in class.

The adenoids are a pad of lymph tissue at the very back of the nose, above the roof of the mouth. You can't see them by looking into the mouth. They're largest between about 3 and 7 years of age and usually shrink by the teens. When they're too big, they block the back of the nose and the openings of the Eustachian tubes, the small channels that let air into the middle ears. Adenoidectomy removes them through the open mouth under general anaesthesia, with no cuts on the face.

It's one of the shorter children's operations, and recovery is much easier than after tonsil removal. Most children breathe through the nose more easily within a couple of weeks. Where fluid behind the eardrums (glue ear) is the problem, removing the adenoids lowers the chance of it coming back after grommets, especially in children over about 4.

Children with enlarged adenoids are a regular part of our ENT department's paediatric work. We assess each child individually, check hearing with audiometry where the ears are involved, and suggest surgery only when symptoms are frequent and severe enough to warrant it. If the tonsils are also causing trouble, both can come out under one anaesthetic with a tonsillectomy.

Adenoids cause trouble in two ways: they block the airway at the back of the nose, and they block the ear tubes or hold on to infection. Your ENT surgeon confirms their size with a side X-ray of the neck or a look through a thin nasal endoscope.

Most children bounce back quickly, often faster than their parents expect.