Each child has adenoid tissue that sits at the back of the nose. Adenoids are important in the body’s defence against infections that could gain entry to your body during breathing.

They are most active in the first few years of life, after which other lymphoid tissue takes over and they disappear. Adenoids should normally no longer be present in adolescents and adults.

Adenoid growth may be the normal path of the immune system maturing in young children or it may be the result of nasal allergies at any age.

An adenoidectomy is a surgical removal of the adenoids undertaken in children, under a general anaesthetic, through the mouth.

It is commonly added to a tonsillectomy for children with obstructive sleep apnoea or to grommet insertion for children with glue ear. It is rarely undertaken on its own.

Using coblation, the procedure is quick (less than 15 minutes) with very few side effects or risks.

Adenoids that are large because of the body’s natural immune system maturing will eventually get smaller and disappear. In these cases, an adenoidectomy may need careful consideration. If your child has already been struggling with OSA or glue ear for some time, and waiting for the adenoids to naturally disappear is not an option, then an adenoidectomy procedure may be advised.

Adenoids that are large because of nasal allergies should be treated with allergen avoidance and nasal steroid sprays. An adenoidectomy for these patients will not cure the underlying problem as the adenoids will rapidly regrow as the allergen is breathed in. Adenoidectomy in these cases should only be considered if other treatments have failed. In such cases, adenoidectomy can be used to make nasal steroids more effective.

In children with glue ear that has come back after the first treatment, an adenoidectomy can be added to the second set of grommets to reduce the hearing loss and increase the duration of good hearing.

Adenoidectomy is a commonly performed procedure and is safe.

There are a few risks that parents should be aware of: adenoids may grow back and any benefit may be short lived; there will be a foul smell from the nose for a few days to a week – this is reduced with antibiotics; rarely, children may get an infection at the back of the nose and surrounding areas – this can be treated with antibiotics; changes in speech and swallow have been reported in less than 5% of cases and are temporary in most cases – newer techniques have reduced this risk further.

This is a minor procedure, performed under a general anaesthetic in an operating theatre. It is done as a day case which means you/your child will be able to go home later on the same day.

Your child will be expected to avoid food and liquids in the hours before you arrive (they can eat up to 6 hours and drink water up to 2 hours before their arrival to hospital).

You and your child will be checked into a ward and introduced to the nursing team. Your anaesthetist and surgeon will meet you before surgery: you will have a chance to ask any final questions at this stage. (Although it is recommended that questions are addressed before the surgery date itself).

A parent will be allowed to bring their child to the theatre area, where anaesthesia will be started. The surgery takes less than 15 minutes, however, is rarely done by itself. When combined with tonsillectomy it takes an hour, and if with grommets, 30 minutes. Another 30 minutes to wake up from the anaesthesia is normal. As the child is starting to wake up a parent will be allowed to come and see them. Most children are awake, eating and walking about within a few hours, and are free to go home once the nurses on the ward are happy.

It is important to establish a healthy and normal diet as soon as possible following adenoidectomy. A foul smell from the nose is common and is reduced with antibiotics. This will disappear of its own accord within a week. Snoring (and OSA if your child had this before surgery) may be worse in the first 2 nights following surgery but then rapidly improves.