Name of the Procedure:

Adenoidectomy, primary; age 12 or over.
Common name(s): Adenoid removal surgery

Summary

An adenoidectomy is a surgical procedure to remove the adenoids, which are small lumps of tissue located at the back of the nasal cavity. This procedure is commonly performed to alleviate breathing problems or recurrent infections in patients aged 12 years or older.

Purpose

The medical condition or problem it addresses:

• Chronic infection of the adenoids
• Difficulty breathing through the nose
• Obstructive sleep apnea
• Recurrent ear infections

The goals or expected outcomes of the procedure:

• Improved breathing
• Reduced frequency of infections
• Better sleep quality
• Overall improvement in respiratory health

Indications

• Chronic or recurrent adenoid infections not responsive to antibiotics
• Nasal obstruction causing difficulty breathing
• Obstructive sleep apnea
• Recurrent middle ear infections with hearing loss

Preparation

• Patients may be asked to fast for several hours before the procedure.
• Instructions to stop certain medications, especially blood thinners, may be provided.
• Pre-operative assessments, such as blood tests or imaging studies, might be required.

Procedure Description

1. Anesthesia: The procedure is performed under general anesthesia, ensuring the patient is asleep and pain-free.
2. Positioning: The patient is positioned to allow easy access to the adenoids through the mouth.
3. Access: The surgeon uses a small mirror or endoscope to view the adenoids.
4. Removal: Specialized instruments are used to remove the adenoid tissue.
5. Bleeding Control: Any bleeding is controlled using cauterization or packing.
6. Completion: The procedure does not typically require stitches.

Duration

The procedure typically takes 30 to 45 minutes.

Setting

The procedure is usually performed in an outpatient surgical center or hospital.

Personnel

• Otolaryngologist (ENT surgeon)
• Anesthesiologist
• Surgical nurses
• Operating room staff

Risks and Complications

• Common risks: Bleeding, infection, mouth or throat pain
• Rare risks: Anesthesia complications, injury to surrounding tissues, voice changes

Benefits

• Improved nasal breathing
• Reduced frequency of throat and ear infections
• Enhanced quality of sleep and daytime functioning
• Benefits are often noticeable within a few days to weeks post-surgery.

Recovery

• Patients can usually go home the same day.
• Post-procedure instructions include rest, hydration, and a soft diet.
• Pain management with prescribed medications.
• Avoid strenuous activities for at least a week.
• Follow-up appointment to monitor healing.

Alternatives

• Medical management with antibiotics and nasal steroids
• Continuous Positive Airway Pressure (CPAP) for sleep apnea
• Watchful waiting in mild cases

Pros of alternatives: Non-surgical, fewer immediate risks. Cons of alternatives: May not be as effective, longer duration of treatment, potential side effects from medications.

Patient Experience

• During the procedure: The patient will be under general anesthesia, so they will not feel or remember anything.
• After the procedure: Mild to moderate pain and discomfort in the throat, managed with pain relievers. Swelling and congestion are common but temporary.
• Pain management may include prescribed pain medications and throat lozenges.