Adenotonsillectomy

The adenoids are a mound of lymphoid tissue in the space up behind the soft palate. Removal of adenoids is indicated to relieve nasal obstruction, snoring, sinusitis and ear infections. The adenoids normally shrink by the time the patient reaches puberty, but in a small group of patients, they will persist into adulthood.

The Tonsils are two clumps of tissue that sit on either side of the throat. Removal is usually for recurrent/persistent infection or large size causing obstruction.

Consultation
Treatment decisions will depend on a variety of factors, severity of symptoms, how many episodes of tonsillitis the patient has had and response to treatment.

Procedure
The removal of adenoids and tonsils are done under genera.

Adenoidectomy is usually performed with a curette through the mouth, by placing the curette behind the soft palate and scraping away the adenoid tissue.

Tonsillectomy is performed with the mouth held open by a special instrument, the tonsils are grasped and pulled away from the side wall of the throat, overlying lining and joining fibers are cut and the tonsil is peeled away from the adjacent muscles.

What to expect
Pain relief is important and postop pain is usually controlled with paracetamol in children, anti-infammatories are often required for adults. Antibiotics are usually taken for 5-7 days.

Children are usually off school for 5-7 days and adults are usually off work for 7-10 days.

Avoid strenuous activity for at least two weeks.

Post Procedure
Bleeding after the operation is rare. If this occurs early (within 24 hours), it may need to be controlled in the operating theatre. A secondary bleed (5-7 days) usually occurs as a result of local infection and normally settles with rest and antibiotics.

Occasionally the adenoids can grow back again after removal especially in the very young.

There may be a change in the pitch of voice this is rarely more than mild and temporary.