The adenoids are lymphatic tissue which completes a ring of tonsillar tissue in the back of the throat and nose known as “Waldeyer’s ring. It is also known as the nasopharyngeal tonsil. It is thought to be important very early in life however as it enlarges can cause nasal obstruction, snoring, persisting nasal discharge and has a role in recurrent ear infections and middle ear effusions.

An adenoidectomy removes this tissue to improve symptoms. There is a small possibility that it can re-grow and the procedure be repeated if symptoms recur.

After Surgery

Pain following this surgery is usually minimal.
Paracetamol and/or Ibuprofen May be required for a few days or up to a week afterwards
It is common to feel throat or ear discomfort for 5 – 7 days.
A fever and runny nose is common following the adenoidectomy.  This does not typically require antibiotics.
Smelly/bad breath can persist for up to a few weeks after surgery.
Nasal congestion/swelling usually occurs afterwards. As the swelling improves, a runny nose and/or cough can occur.
Slight bleeding can occur from the nose.  Saline spray can help clear this if required. 
Very rarely the neck can become stiff with the child holding their head to one side. If this occurs, please contact the rooms urgently.

Follow up after surgery

A follow up appointment is typically arranged for 4 – 6 weeks after surgery.
Typically, a hearing test will be arranged, if grommets were placed in the ears at the same time.
If there are any other concerns, please contact the rooms.

Tonsillectomy is a painful procedure so a sore throat is normal and will require regular medication

Pain will often become worse between day 4 to day 6 after surgery

Pain relief:

Regular pain relief is essential (follow dosing schedules/instructions)

Follow dosage guidelines to avoid overdosing and these can be continued for as long as required

Oxycodone syrup maybe required intermittently

Pain relief will take around 30 minutes to work

Most children will require pain relief overnight for the first week

Some children are resistant to taking medication.

General Principles are:

Liquid pain relief is easier for children to take than tablets

Try mixing the pain relief with food or syrups they enjoy

Making a “Icey-pole” slushy with the pain relief, or with something sweet like apple sauce

Chewable paracetamol or suppositories are available for children not able/willing to take pain relief orally.

Food/Oral intake

Most foods are fine, avoid hot foods, or foods that are spicy or acidic. (Rough or chewy foods are fine)

Encourage normal diet – although “grazing” rather than full meals may be the norm.

Ensure adequate fluid intake – Icy Poles are a good trick in children.

Avoid strenuous activities eg trampolining, bike riding and swimming for 2 weeks.

If you are live away from the Adelaide metropolitan area, you should remain within an hour of the Adelaide CBD for 2 weeks post operatively due to potential for bleeding.

It is normal:

To have a fever in the first few days after surgery

White/yellow coating where the tonsils were is very normal and not an infection

Note an increase in pain between days 3–5

Very bad breath is very normal for 10 to 14 days post-surgery

Ear pain is not uncommon and is usually a referred pain from where the tonsils were

It is NOT normal:

To have bleeding: Any bleeding more than a tablespoon in size should present to the nearest Emergency Department.

To have a sudden increase in pain or fever after 48 hours post-surgery – please call the rooms if this occurs.

Pain following this surgery is usually minimal. One or two doses of paracetamol may be required

You may be prescribed ear drops to use post operatively. These should be used for 3 to 5 days unless advised differently. Rarely these can sting or cause discomfort when placed – if worried please contact me.

Keep the ears dry for the first 2 weeks. You can use cotton-wool dipped in Vaseline in each ear when having a bath or shower.

Avoid swimming until your surgeon has advised

When swimming re-starts, avoid diving to more than 1 metre depth.

If ear discharge occurs, please contact the rooms

A follow up appointment is typically arranged for 6 weeks after surgery. Typically, a hearing test will be arranged prior.

If there are any other concerns, please contact the rooms.

The small blood vessels in the septum (the firm tissue between the nostrils, which divides the nose into two halves) are fragile and can burst fairly easily, causing a nosebleed. Cautery is a very effective technique for treating persistent nose bleeds. During the procedure, the chemical applied to the vessels create a scab that may initially appear dark grey. It is important to protect this area from trauma and to let it heal, as disturbing it may cause further bleeding.

Some stinging or pain can occur after cautery in the nose, upper teeth and upper lip.  This may last for 1 -2 – days

Use simple paracetamol if needed

DO NOT blow your nose for 3 days.

AVOID nose picking or rubbing as this dislodges the scab and will bleed again.

Avoid strenuous activities or swimming for 1 week

Apply nasal ointment, or Vaseline to the nostrils every day for 2 weeks twice a day

It is normal to have some small bleeds after cautery.  Continue with the ointment/Vaseline if this occurs.

Inferior turbinates are the largest of 3 folds in the lateral wall of the nose, which can swell in response to irritants such as allergies or infection.  This results in a blocked nose, contributing to snoring and sleep apnoea. 

The reduction of the turbinates is usually conducted in conjunction with an adenoidectomy/adenotonsillectomy

The techniques to reduce these in size vary according to the age of the patient

Post operative information:

Pain is normal following this procedure and typically requires paracetamol or ibuprofen

The nose can become more blocked until swelling settles which can be 7 – 14 days

A low-grade fever is normal for around this time as well

A thick discharge can occur for about 1-week post-surgery and be associated with a cough. 

In the long term, the turbinates can regrow after being stimulated by the same irritants that lead to the requirement for surgery in the first place.  Often an intra-nasal spray such as Nasonex may be recommended for a period of time. 
Nasal wash with Flo Rinse or similar 3 – 4 times a day while the lining of the nose heals and returns to normal

A follow up appointment is typically arranged for 6 weeks after surgery.
If there are any other concerns, please contact the rooms on 8185 1661