Definition of adenoidectomy: what is it?
CPT and ICD-10 codes for adenoidectomy
Who needs adenoidectomy?
Adenoidectomy is most commonly performed in children, especially those experiencing recurrent infections, chronic nasal obstruction, or sleep-disordered breathing caused by enlarged adenoids. While there is no strict minimum age, the procedure is typically recommended for children over the age of two, as adenoids tend to shrink naturally after early childhood. However, in some cases, younger children may require surgery if symptoms are severe. Although less common, adults may also need adenoidectomy if they suffer from chronic infections or nasal blockages that do not respond to other treatments. Ultimately, the decision to perform adenoidectomy depends on the severity of symptoms and the impact on a person’s quality of life, regardless of age.
Indications for adenoidectomy
Adenoidectomy is generally recommended when the adenoids cause significant health issues. Common indications include:
- Chronic nasal obstruction causing difficulty breathing through the nose
- Recurrent or persistent ear infections (otitis media)
- Frequent sinus infections
- Obstructive sleep apnea, where enlarged adenoids block the airway during sleep
- Failure of medical treatments like antibiotics or nasal sprays to improve symptoms
- Speech or swallowing difficulties related to enlarged adenoids
Procedure of the adenoidectomy surgery
Adenoidectomy: primary vs. secondary
Before and after adenoidectomy
Before
Before an adenoidectomy, patients typically undergo a thorough evaluation that may include a physical exam, medical history review, and sometimes imaging or sleep studies to determine the severity of symptoms. It’s important to follow all preoperative instructions provided by the surgeon, such as fasting for a specified period before surgery, to ensure safety during anesthesia. Preparing emotionally, especially for children, can also help ease anxiety about the procedure.
After
After the surgery, patients may experience mild throat soreness, nasal congestion, or a low-grade fever, which usually improve within a few days. Pain can generally be managed with over-the-counter medications. Most children return to normal activities within a week but should avoid strenuous exercise or swimming for about two weeks to allow proper healing. Follow-up appointments with the healthcare provider ensure the recovery is progressing well and address any concerns.
Adenoidectomy recovery
The recovery time after an adenoidectomy is generally short and uncomplicated. In the post adenoidectomy period, patients might have mild throat pain, nasal stuffiness, and a slight decrease in appetite, but these symptoms generally resolve within a few days. Managing discomfort with over-the-counter pain medications and ensuring plenty of rest and hydration can help speed healing. Monitoring for any signs of complications during the post-operative phase is important, and contacting a healthcare provider if symptoms like excessive bleeding, high fever, or severe pain arise is essential.
Common post adenoidectomy symptoms
After an adenoidectomy, patients may experience several symptoms as part of the healing process, including:
- Bad or stinky breath, caused by healing tissue or dried blood in the throat
- Low-grade fever, which is normal shortly after surgery but should be monitored
- Snoring, which may persist or temporarily worsen due to swelling
- Coughing, often from throat irritation or mucus drainage
- Throat pain or discomfort, common for several days after the procedure
- Ear pain, caused by referred pain or irritation of the Eustachian tubes
- Vomiting, sometimes related to anesthesia effects or swallowing blood during surgery
- Temporary hearing changes, especially if ear tubes are placed during the procedure
How long does bad breath last after adenoidectomy?
Benefits of adenoidectomy surgery
The benefits of adenoidectomy include:
- Improved breathing by removing nasal obstructions
- Better sleep quality and reduction of obstructive sleep apnea symptoms
- Decreased frequency of ear and sinus infections
- Improved hearing due to fewer ear infections
- Reduced need for repeated antibiotic treatments
- Relief from chronic mouth breathing and associated issues like dry mouth
Overall enhancement in quality of life, including better breathing, sleep, and fewer infections.
Cost of adenoidectomy
The cost of an adenoidectomy can vary widely depending on factors such as the healthcare provider, geographic location, whether the procedure is performed in a hospital or outpatient surgery center, and if it’s combined with other surgeries like tonsillectomy. In the United States, the total cost—including surgeon fees, anesthesia, facility charges, and follow-up visits—can range from approximately $3,000 to $10,000 or more. Insurance coverage often helps reduce out-of-pocket expenses, but it’s important for patients and families to check with their insurance providers about coverage details, copayments, and deductibles. Additionally, some facilities offer payment plans or financial assistance to help manage the cost.
Complications and risks of adenoidectomy
Although adenoidectomy is generally considered a safe procedure, like any surgery, it carries some risks and potential complications. Common risks include bleeding during or after surgery, infection at the surgical site, and reactions to anesthesia. Some patients may experience temporary side effects such as nasal dryness, a sore throat, or changes in voice quality. Rare but more serious complications can include damage to surrounding tissues, persistent nasal regurgitation, or airway obstruction. It’s important for patients and caregivers to discuss these risks with their healthcare provider and follow all pre- and post-operative instructions to minimize complications.
Signs of infection after adenoidectomy
It’s important to monitor for signs of infection following an adenoidectomy, including:
- High fever (above 101°F or 38.3°C) that doesn’t improve with medication
- Increased or worsening throat pain
- Redness, swelling, or discharge around the surgical site
- Persistent or worsening nasal discharge, especially if thick, yellow, or foul-smelling
- Excessive or continuous bleeding
- Difficulty swallowing
- Unusual fatigue or weakness
- Swollen glands in the neck
If any of these symptoms appear, contacting a healthcare provider promptly is essential to prevent complications.
What to eat after adenoidectomy
After an adenoidectomy, it’s best to focus on foods that are soft and easy on the throat, such as:
- Yogurt
- Applesauce
- Mashed potatoes
- Smoothies
- Soups (not too hot)
- Soft cooked cereals (like oatmeal)
- Ice cream or popsicles (for soothing the throat)
It’s also important to:
- Stay well-hydrated with water, clear broths, and non-citrus juices
- Avoid spicy, acidic, or rough-textured foods that can irritate the throat
- Gradually return to a normal diet as comfort allows, usually within a week
Behavior changes after adenoidectomy
It’s common for children to experience temporary behavior changes following an adenoidectomy due to discomfort, anesthesia effects, and the overall recovery process. They may become more irritable, tired, or clingy than usual, and their appetite might decrease for a few days. Some children might also have trouble sleeping or seem restless as their body heals. These changes are usually short-lived and improve as pain subsides and normal routines resume. Parents and caregivers should offer extra comfort and patience during this time and consult a healthcare provider if unusual or prolonged behavior changes occur.
Adenoidectomy vs. Tonsillectomy
Adenoidectomy and tonsillectomy are both common surgical procedures that involve the removal of lymphoid tissues in the throat but serve different purposes. An adenoidectomy removes the adenoids, which are located higher up behind the nasal cavity, and is typically done to relieve nasal obstruction, chronic ear infections, or sleep apnea caused by enlarged adenoids.
In contrast, a tonsillectomy involves removing the tonsils, which sit on either side of the back of the throat, and is often performed to treat recurrent tonsillitis or severe tonsil-related breathing problems.
Sometimes, both procedures are done together, especially in children who experience multiple throat and airway issues. The recovery and risks for each surgery can vary, so doctors decide based on the specific symptoms and needs of the patient.
FAQs about adenoidectomy
Is adenoidectomy a minor or major surgery?
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