Adenoidectomy in children: what happens and what to expect

Adenoids sit at the back of the nose and help fight germs in young children, but they become unnecessary after around age three. When they are large they may block the nose, cause mouth breathing, snoring and disturbed sleep, or block the tube from the ear and lead to glue ear.

ENT UK lists alternatives: steroid nasal sprays may reduce blockage, adenoids shrink naturally with age so waiting is reasonable, and antibiotics give only short-term relief and are not recommended. Surgery is therefore for a child whose symptoms are significant or persistent.

For children over three, ENT UK says removing the adenoids at the same time as grommets seems to stop glue ear returning.

Tell the team about any loose, capped or crowned tooth, because the anaesthetic airway can damage them, and about any family history of bleeding disorders. A Dorset leaflet advises postponing surgery if the child has a sore throat or cold in the week before.

Explain what will happen in simple terms. Most units arrange a play specialist, and one parent usually goes to the anaesthetic room.

The operation is done under general anaesthetic through the mouth, with no cuts on the face. ENT UK says the adenoids are scraped away with a curette or removed with electrical instruments, and Dorset describes suction diathermy. It takes around 10 to 15 minutes.

Most children go home the same day if all is well; overnight stays can happen, particularly when other procedures are combined.

ENT UK says bleeding is the most serious risk, occurring in about 1 in 200 operations. Other risks include damage to loose or crowned teeth, fluid leaking into the nose (very rare), a temporary change in the voice and regrowth of adenoid tissue, which is uncommon. Anaesthetic risks are small and discussed beforehand.

A sore throat and blocked nose for a few days are common, and sore ears can occur because the throat and ears share nerves. Give pain relief as advised, avoiding aspirin under 16. Normal food helps healing. ENT UK and Dorset suggest at least a week off nursery or school, and Dorset adds resting at home away from crowds and smoky places.

• Any bleeding from the throat or nose: see a doctor as soon as possible, and call 999 if it is heavy.

• High temperature, or severe pain that medicine does not control.

• Signs of dehydration, such as not drinking and passing little urine.

• How much are the adenoids affecting my child and could we wait?

• Will tonsils or grommets be done at the same time?

• Will my child stay overnight?

• Who do I contact if there is bleeding?

Both settings use the same techniques. NHS paediatric ENT pathways usually require documented symptoms and sometimes hearing tests, while private care may offer quicker access. Children's anaesthetic expertise matters more than the setting, so ask about it if you are choosing privately.