Adenoidectomy

Adenoidectomy is the surgical removal of the adenoid for reasons which include impaired breathing through the nose, chronic infections, or recurrent earaches. The effectiveness of removing the adenoids in children to improve recurrent nasal symptoms and/or nasal obstruction has not been well studied. The surgery is less commonly performed in adults in whom the adenoid is much smaller and less active than it is in children. It is most often done on an outpatient basis under general anesthesia. Post-operative pain is generally minimal and reduced by icy or cold foods. The procedure is often combined with tonsillectomy (this combination is usually called an "adenotonsillectomy" or "T&A"), for which the recovery time is an estimated 10–14 days, sometimes longer, mostly dependent on age. Adenoidectomy is not often performed under one year of age as adenoid function is part of the body's immune system but its contribution to this decreases progressively beyond this age. The indications for adenoidectomy are still controversial. Widest agreement surrounds the removal of the adenoid for obstructive sleep apnea, usually combined with tonsillectomy. Even then, it has been observed that a significant percentage of the study population (18%) did not respond. There is also support for adenoidectomy in recurrent otitis media in children previously treated with tympanostomy tubes. Finally, the effectiveness of adenoidectomy in children with recurrent upper respiratory tract infections, common cold, otitis media and moderate nasal obstruction has been questioned with the outcome, in some studies, being no better than watchful waiting. In 1971, more than one million Americans underwent tonsillectomies and/or adenoidectomies, of which 50,000 consisted of adenoidectomy alone. By 1996, roughly a half million children underwent some surgery on their adenoid and/or tonsils in both outpatient and inpatient settings. This included approximately 60,000 tonsillectomies, 250,000 combined tonsillectomies and adenoidectomies, and 125,000 adenoidectomies.