42835 Adenoidectomy, secondary; younger than age 12

Name of the Procedure:

Adenoidectomy, Secondary; Younger than Age 12
Common name(s): Adenoid Removal, Adenoidectomy

Summary

An adenoidectomy is a surgical procedure to remove the adenoids, which are glands located in the upper part of the throat behind the nose. This procedure is typically performed on children who experience repeated infections or breathing issues due to enlarged or chronically infected adenoids.

Purpose

Adenoidectomy addresses problems such as chronic ear infections, nasal obstruction, and sleep apnea caused by enlarged or infected adenoids. The primary goal is to alleviate symptoms like difficulty breathing, frequent ear infections, and to improve overall quality of life by ensuring a clear airway.

Indications

• Chronic or recurrent ear infections not responding to antibiotics
• Persistent nasal congestion or obstruction
• Difficulty breathing through the nose
• Sleep disturbances like snoring or sleep apnea
• Recurrent sinus infections

Preparation

• Fasting: Usually no food or drink after midnight before the surgery.
• Medication adjustments: Specific instructions regarding any medications the child is taking will be provided.
• Preoperative assessment: Physical examination and possibly a blood test to ensure the child is fit for surgery.
• Anesthesia consultation: Discussion with an anesthesiologist to plan anesthesia based on the child’s health history.

Procedure Description

1. Anesthesia: General anesthesia is administered to ensure the child is asleep and pain-free.
2. Access: The surgeon uses a small mirror or an endoscope to view the adenoids through the mouth.
3. Removal: Surgical instruments are used to remove the adenoids. The area may be cauterized to prevent bleeding.
4. Completion: The child is woken up in the recovery room once the surgery is complete.

The tools typically include a small mirror, endoscope, and surgical instruments like curettes or electrocautery devices.

Duration

The procedure usually takes about 20 to 30 minutes.

Setting

Adenoidectomy is typically performed in an outpatient surgical center or hospital operating room.

Personnel

• ENT (Ear, Nose, and Throat) surgeon or otolaryngologist
• Anesthesiologist
• Surgical nurse
• Operating room technician

Risks and Complications

• Common risks: Bleeding, infection, swelling, or pain.
• Rare risks: Adverse reaction to anesthesia, changes in voice, or regrowth of adenoids. Complications are managed with appropriate medications and follow-up care.

Benefits

• Reduction in frequency and severity of ear and sinus infections.
• Improvement in nasal breathing and reduction in mouth breathing.
• Alleviation of sleep disturbances like snoring or sleep apnea. Benefits are usually realized within a few weeks as the body heals.

Recovery

• Post-procedure care: Pain management with prescribed medications, hydration, and rest.
• Activity: Limit strenuous activity for several days.
• Diet: Soft foods and plenty of fluids are recommended initially.
• Follow-up: An appointment with the surgeon for a postoperative check-up.

Full recovery typically occurs in about one to two weeks.

Alternatives

• Antibiotic therapy: For treating infections without surgery.
• Watchful waiting: Monitoring symptoms to see if they improve without intervention.
• Nasal steroids: May help shrink adenoids and alleviate symptoms. Compared to these alternatives, adenoidectomy offers a definitive solution for persistent or severe cases but involves the risks associated with surgery.

Patient Experience

• During the procedure: The child will be under general anesthesia and will not feel anything.
• Post-procedure: Soreness in the throat, mild to moderate pain managed with medication, possible ear soreness. Comfort measures include pain relievers and cold fluids or foods to soothe the throat. Most children are back to their usual activities within a week or two.