Adenoidectomy, primary; younger than age 12

CPT4 code

Name of the Procedure:

Summary

An adenoidectomy is a surgical procedure to remove the adenoids, which are glands located in the roof of the mouth, behind the nose. This procedure is commonly performed on children under the age of 12.

Purpose

An adenoidectomy is usually done to address chronic infections or breathing problems caused by enlarged adenoids. The goals are to reduce the frequency of infections, improve breathing, and eliminate symptoms such as snoring and sleep apnea.

Indications

Chronic ear infections
Recurrent sinus infections
Obstructive sleep apnea
Difficulty breathing through the nose
Persistent snoring
Nasal speech with a "nasal" quality

Preparation

The patient may need to fast for 6-8 hours before the procedure.
Parents may be instructed to stop certain medications that can affect blood clotting, such as aspirin.
A pre-operative assessment, including a physical exam and possibly blood tests, will be conducted.

Procedure Description

Anesthesia: The patient is put under general anesthesia to ensure they are asleep and pain-free.
Exposure: A small instrument is used to hold the mouth open.
Removal: The adenoids are removed using a curette (a surgical instrument) or a microdebrider (a powered tool).
Control Bleeding: Any bleeding is managed through cauterization or the use of absorbent materials.
Completion: The area is inspected, and anesthesia is reversed to wake the patient.

Duration

The procedure typically takes about 30-45 minutes.

Setting

Adenoidectomies are usually performed in a hospital or an outpatient surgical center.

Personnel

Surgeon (often an ENT specialist)
Anesthesiologist
Surgical nurses

Risks and Complications

Common: Sore throat, bad breath, minor bleeding
Rare: Excessive bleeding, infection, reaction to anesthesia, changes in voice quality

Benefits

Improved breathing through the nose
Reduction in the frequency of ear and sinus infections
Enhanced sleep quality, including reduced snoring and sleep apnea symptoms

Recovery

Most children can go home the same day.
Pain relief is managed with over-the-counter medications like acetaminophen or ibuprofen.
Soft foods and plenty of fluids are recommended.
Full recovery typically takes 1-2 weeks.

Alternatives

Watchful waiting for minor symptoms
Antibiotic treatment for infections
Nasal steroids to reduce inflammation
Pros: Non-surgical options can avoid risks associated with surgery.
Cons: These may not be effective for severe or chronic symptoms needing surgical intervention.

Patient Experience

The child will be under anesthesia and will not feel pain during the procedure.
Post-procedure, there may be a sore throat and discomfort, managed with medication.
Parents should follow care instructions to ensure a smooth recovery, which includes rest and avoiding strenuous activities.

By providing such comprehensive information, it ensures that patients and their families are well-informed about the procedure, expectations, and aftercare.