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What is an adenoidectomy?
An adenoidectomy is the surgical removal of the adenoids. The adenoids are glands located in the throat behind the nose. They are not visible through the mouth.
The adenoids fight infection, but they can become infected and enlarged themselves. This can cause persistent breathing difficulty, sleep apnea (pauses in breathing during sleep), sinus infections, ear infections, and hearing loss.
The adenoids are largest in infants and younger children. Large adenoids are more likely to become infected. This is why doctors perform most adenoidectomies on younger children. Adenoids begin to shrink around age five and may disappear in time. It is rare for adults to have an adenoidectomy.

Other procedures that may be performed
Doctors often remove the tonsils (tonsillectomy) during the same procedure. The tonsils are also infection-fighting glands located in the throat. Tonsils can become infected and enlarged along with the adenoids and cause similar problems.

Why is an adenoidectomy performed?
when the adenoids become infected or enlarged and cause persistent:
• Excessive and loud snoring due to enlarged adenoids that block the breathing passages
• Difficulty breathing through the nose due to enlarged adenoids
• Recurrent ear infections, possibly leading to hearing loss
• Sinus infections, also known as sinusitis
• Sleep apnea, or pauses in breathing during sleep
To treat cancer or a tumor affecting the adenoids.

How is an adenoidectomy performed?
An adenoidectomy is usualy done in a hospital or surgical clinic setting. Some children may need to stay overnight in the hospital for observation.
I will open your child’s mouth and remove or cauterizing the adenoids through the mouth. Cauterizing is sealing blood vessels or tissues with heat. We will cauterize the remaining blood vessels to reduce bleeding. MICRODBRIDER is generally use by me to shave the adenoids.
COABBLATOR is also use to shave n cautrise the adenoids at the same time.

Types of anesthesia that may be used -
I will perform an adenoidectomy using general anesthesia. General anesthesia is a combination of intravenous (IV) medications and gases that put your child in a deep sleep. Your child will be unaware of the procedure and not feel pain.

What to expect the day of your child’s adenoidectomy?
The day of surgery, you can expect to :
• Talk with a preoperative nurse. The nurse will perform an exam of your child and ensure that all needed tests are in order. The nurse can also answer questions and make sure you understand and sign the surgical consent form.
• Remove all of your child’s clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home. Your care team will give your child blankets for modesty and warmth.
• Talk with the anesthesiologist about your child’s medical history and the type of anesthesia used
• A surgical team member will start an IV.
• The anesthesiologist will start your child’s anesthesia.
• The surgical team will monitor your child’s vital signs and critical body functions. This occurs throughout the procedure and recovery until your child is alert, breathing effectively, and all vital signs are stable.

What are the risks and potential complications of adenoidectomy?
As with all surgeries, an adenoidectomy involves risks and potential complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.
General risks of surgery
The general risks of surgery include :
• Anesthesia reaction, such as an allergic reaction or breathing problems
• Bleeding, which can lead to shock
• Infection and septicemia, which is the spread of a local infection to the blood

Potential complications of adenoidectomy
Complications of adenoidectomy include:
• Ear pain
• Pain or difficulty when swallowing, which typically goes away after a few days
• Re-growth of the adenoids, although this is very rare
• Throat pain, which usually goes away after a few days

Reducing your risk of complications
You can reduce the risk of some complications by making sure your child follows the treatment plan and:
• Following activity, dietary and lifestyle restrictions and recommendations before surgery and during recovery
• Notifying your child’s doctor immediately of any concerns, such as bleeding, fever, or increase in pain
• Taking medications exactly as directed
• Telling all members of the care team if your child has any allergies

How do I prepare for my child’s adenoidectomy?
You are an important member of your child’s healthcare team. The steps you take before surgery can improve your child’s comfort and outcome.
You prepare your child for surgery by:
• Answering all questions about your child’s medical history and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your child’s medical conditions, medications, and allergies at all times.
• Getting preoperative testing as directed. Testing varies depending on your child’s age, health, and specific surgery. Preoperative testing may include blood tests, radiologic imaging of the adenoids, and other tests as needed.
• Ensuring that your child does not eat or drink min 6 hr before surgery as directed. Surgery may be cancelled if your child eats or drinks too close to the start of surgery because your child can choke on stomach contents during anesthesia.
• Ensuring that your child stops taking medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners.
• Talking with your child about what to expect during and after the surgery. Allow your child to express feelings. Tell your child that he or she will have a sore throat for a few days after the surgery. Reassure your child that medications will make him or her comfortable.
• Tell your child that the surgery will improve comfort and health, such as improving breathing or reducing earaches or infections.

What can I expect after the adenoidectomy?
Knowing what to expect will help make your child’s road to recovery as smooth as possible.

How long will it take to recover?
Your child will stay in the recovery room after surgery until fully alert and breathing effectively, and the vital signs are stable. Your child will stay for several hours longer to watch for bleeding and make sure he or she can drink fluids.
Recovery after surgery is a gradual process. Recovery time varies depending on general health, age, and other factors. Full recovery takes one to two weeks.

Will my child feel pain?
Pain control is important for healing and a smooth recovery. There will be some discomfort after your child’s procedure. I will treat the pain so your child is comfortable and gets enough rest. Call me if your child’s pain gets worse or changes in any way because it may be a sign of a complication.

When should I call u doctor?
It is important to keep your child’s follow-up appointments after an adenoidectomy. Call me right away or seek immediate medical care if your child has:
• Bleeding, spitting blood, vomiting blood, or blood coming from the nose
• Breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or wheezing
• Change in alertness, such as passing out, unresponsiveness, or confusion
• Chest pain, chest tightness, chest pressure, or palpitations
• Fever. A low-grade fever (lower than 101 degrees Fahrenheit) is common for a couple of days after surgery. It is not necessarily a sign of a surgical infection.
• Inability to urinate, pass gas, or have a bowel movement
• Pain that is not controlled by pain medication or increased problems swallowing or sore throat
• Unexpected drainage, pus, redness or swelling of the mouth or nose

How might adenoidectomy affect my child’s everyday life?
An adenoidectomy helps prevent frequent ear and sinus infections and their symptoms. This allows your child to breathe and sleep better and to be more active and engaged with play and school.

          Dr. Prashant Manohar kewle © 2014
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