Adenoidectomy: Removing Enlarged Adenoids

Adenoids are small glands tucked behind the nose that can swell up and cause snoring, mouth breathing, and repeated ear infections in children. Adenoidectomy — surgical removal of the adenoids — is one of the most common childhood ENT procedures. Here's what it involves.

What Are Adenoids, and What Is Adenoidectomy?

The adenoids are a small pad of lymphoid tissue located high in the throat, behind the nose, where it meets the back of the mouth. Like the tonsils, they're part of the body's immune system and help trap germs breathed in through the nose — this is especially active in early childhood. Adenoidectomy is the surgical removal of this tissue when it becomes chronically enlarged or infected and starts causing more problems than it solves.

Why Do Adenoids Become a Problem?

• Chronic infection from repeated colds and throat infections can cause the adenoids to swell and stay swollen
• Allergies that keep the tissue inflamed over time
• Natural enlargement — adenoids are naturally larger in young children and tend to shrink with age, but in some children they grow disproportionately large relative to the airway
• Recurrent middle ear infections, since swollen adenoids can block the eustachian tube opening near the back of the nose

Adenoids sit high in the throat, behind the nose

Signs and Symptoms

• Chronic mouth breathing, especially noticeable at night
• Loud snoring or pauses in breathing during sleep (possible sleep apnea)
• Persistent nasal blockage or a constantly "stuffy" nose
• Recurrent ear infections or fluid behind the eardrum
• A nasal, muffled quality to speech
• Frequent sinus infections

When Is Surgery Recommended?

Adenoidectomy is usually considered when enlarged adenoids cause significant nasal obstruction, contribute to obstructive sleep apnea, or are linked to recurrent ear infections and fluid buildup that hasn't responded to medication. It's often combined with tonsillectomy in children who have problems with both — this combined operation is commonly called an adenotonsillectomy, or "T&A."

How the Surgery Works

1. Anesthesia. Adenoidectomy is performed under general anesthesia, almost always as a same-day outpatient procedure.
2. Approach. Because adenoids sit behind the nose, the surgeon works through the mouth using a small mirror or an endoscope — no external incisions are needed.
3. Removal. The adenoid tissue is removed using a curette (a scraping instrument), a microdebrider (a rotating shaving tool), or suction cautery/electrocautery, which removes tissue while controlling bleeding.
4. Bleeding control. The area is checked carefully and any bleeding is controlled with cautery or gentle pressure packing before the child wakes up.

The whole procedure typically takes 20–30 minutes.

Recovery

• Same day: Most children go home a few hours after surgery; a sore throat, mild ear pain, and bad breath are common initially.
• First week: Soft, cool foods (ice cream, yogurt, mashed potatoes) are easiest to manage; plenty of fluids help.
• 7–10 days: Most children are back to normal activity, with noticeably easier nasal breathing and quieter sleep.

The adenoids are part of the upper airway and immune tissue ring

Risks and Considerations

• Temporary bad breath, snoring, or nasal-sounding voice while the area heals
• Bleeding (uncommon but possible in the first one to two weeks)
• Infection
• Very rarely, a change in voice resonance (velopharyngeal insufficiency) if healing tissue affects the soft palate's closure
• Adenoid tissue can occasionally regrow partially in young children

The Takeaway

Adenoidectomy is a short, well-tolerated procedure that can make a big difference for children who struggle with blocked noses, disrupted sleep, or repeated ear infections. If your child snores heavily, breathes mostly through their mouth, or keeps getting ear infections, it's worth having an ENT specialist take a look at their adenoids.