The tonsils form a ring of tissue around the throat known as Waldeyer’s ring. Lymphoid tissue is found at the back of the nose and in the throat, which is known as the pharynx. This has 3 parts: the nasopharynx (back of the nose), the oropharynx (back of the mouth) and the hypopharynx (just above your voice box). There are 3 different areas of tonsillar tissue, known as lymphoid tissue, that make up your tonsils. The adenoids are one of these, found behind your palate at the back of your nose, and can cause a number of conditions including snoring, sleep apnoea, nasal blockage, recurrent ear infections, muffled hearing and eustachian tube dysfunction (pressure sensations in the ear). Depending on the cause, they can be removed, which is done through the mouth so there are no scars.
Enlarged adenoids
Enlarged adenoids can contribute to or cause sleep apnoea by blocking the nasal passageways when asleep, leading to difficulty in breathing or temporary pauses in breathing. Sleep apnoea in children can cause poor concentration, behavioural problems and reduced brain development. In extreme cases, sleep apnoea can cause a strain on the heart, and we would therefore recommend surgery with an adenoidectomy (with or without tonsillectomy) if there was a suspicion of enlarged adenoids causing sleep apnoea. Enlarged adenoids in adults can easily be seen by passing a small camera to the back of the nose. But if there is doubt in children, or it is unclear if the adenoids are enlarged, we can request a sleep study to look at a child’s overnight oxygen levels and breathing pattern; or have a look at the back of the nose – either under a general anaesthetic (and proceed to remove the adenoids), or if the child would tolerate it, we could pass a small camera through the nose to have a look at the back of the nose.
If the adenoids are symptomatic we can consider removing them with a short operation.
Adenoidectomy: risks of surgery
An adenoidectomy is performed under a general anaesthetic and, like any operation, the risks include:
- Pain (requiring simple painkillers)
- Bleeding – there is a very small risk that bleeding could start at any point for up to 2 weeks after the operation. If this is the case, we would recommend attending A&E immediately
- Infection – identified by a bad smell or increasing pain, and managed with antibiotics
- There is a very small chance of damage to the teeth (usually already wobbly in children or diseased in adults)
- A stretched jaw which will settle over a few weeks
- A small cut to the lip or gums which will heal very quickly without any intervention
Post-operative information
Following the operation, you will need one week off school or college if combined with extracapsular tonsillectomy. You should take regular painkillers and eat and drink normally. If your pain increases, or you notice a foul smell or you develop bad breath, this may be a sign of infection and you should be prescribed antibiotics. If you have any bleeding where you are spitting out blood you should attend A&E immediately or call an ambulance. Children may swallow blood rather than spitting it out, so if they seem off colour, are swallowing a lot or complain of feeling sick or vomit blood, please seek medical advice. If you have any questions following your surgery, please contact my Practice Manager and we will endeavour to help.