Name of the Procedure:

Adenoidectomy, secondary; age 12 or over
Common Name: Secondary Adenoidectomy
Medical Term: Secondary Adenoidectomy for patients aged 12 and older

Summary:

An adenoidectomy is a surgical procedure aimed at removing the adenoids, which are small lumps of tissue located at the back of the nasal cavity. This procedure is considered "secondary" if the adenoids have regrown after an initial removal or if the initial surgery did not fully address the issues.

Purpose:

Medical Condition: Chronic infections or breathing problems caused by enlarged or regrown adenoids.
Goals: To relieve breathing difficulties, reduce the frequency of ear infections, and alleviate symptoms such as snoring or sleep apnea.

Indications:

• Difficulty breathing through the nose
• Chronic ear infections or frequent sinus infections
• Sleep disturbances, including snoring or sleep apnea
• Diagnosis of enlarged adenoids that do not respond to medication

Preparation:

• Fasting for at least 6-8 hours prior to the procedure
• Medication review and potential adjustments, particularly blood thinners
• Pre-operative examination and diagnostic tests, such as X-rays or nasal endoscopy, to assess the adenoids

Procedure Description:

1. Anesthesia: General anesthesia is administered for patient comfort.
2. Access: A retractor is used to keep the mouth open.
3. Removal: The surgeon removes the adenoids using specialized instruments, such as a curette or a microdebrider.
4. Bleeding Control: Cauterization or packing may be used to control bleeding.

Duration:

The procedure typically takes about 30 to 45 minutes.

Setting:

Performed in a hospital, outpatient surgical center, or specialized clinic equipped for surgical procedures.

Personnel:

• ENT (Ear, Nose, Throat) surgeon
• Anesthesiologist
• Surgical nurse
• Operating room staff

Risks and Complications:

• Common: Sore throat, bleeding, nasal congestion, and temporary changes in voice.
• Rare: Adverse reactions to anesthesia, infection, or excessive bleeding.

Benefits:

• Improved breathing and airflow through the nasal passages
• Reduction in the frequency and severity of ear and sinus infections
• Better sleep quality and reduced snoring
• Noticeable improvements typically within a few days to weeks post-surgery

Recovery:

• Post-surgery observation for a few hours in the recovery room
• Instructions to avoid strenuous activities for at least one week
• Soft diet recommended initially to ease throat discomfort
• Pain management with prescribed medications, such as acetaminophen
• Follow-up appointment within 1-2 weeks after surgery

Alternatives:

• Medications such as nasal steroids or antibiotics
• Regular monitoring and lifestyle adjustments, if surgery is not preferred
• Sometimes observation with a "wait and see" approach for mild cases

Patient Experience:

During the procedure, the patient will be under general anesthesia and will not feel pain. Post-surgery, there may be throat soreness, mild pain that can be managed with medications, and a temporary sense of nasal congestion. Most patients can return to regular activities within a week, with full recovery expected in a couple of weeks.