Adenoidectomy (Adenoid Surgery)

Adenoidectomy refers to the surgical removal of the adenoid tissue (also known as the adenoids). The adenoids are lymphoid tissues located at the back of the nasal cavity, in the upper part of the throat, and play an important role in the immune system. Commonly active in children, the adenoids help the body defend against infections. However, in some cases, the adenoids may become excessively enlarged, affecting breathing, speech, sleep quality, and increasing the frequency of illness, which may make adenoidectomy necessary.

What Are Adenoids? Why Are They Important?

Adenoids are small lymphoid tissues that are part of our immune system. They are located at the junction of the nose and the throat. Like the tonsils, adenoids help defend the body against infections. Particularly in childhood, the adenoids form an important line of defense against upper respiratory infections.

However, the adenoids shrink once their function is completed. After puberty, they usually become much less active and lose almost all of their function in adulthood. However, this is not always the case; in some cases, the adenoids may continue to cause problems.

Adenoid Enlargement in Children: Symptoms and Problems

Adenoid enlargement is quite common in childhood. As adenoids frequently encounter microbes, they may swell and sometimes fail to return to their normal size. This condition can lead to various health problems. Symptoms of enlarged adenoids include:

• Nasals Congestion: Children develop a habit of breathing through the mouth.
• Sleep Problems: Snoring, restlessness during sleep, and even sleep apnea (breathing pauses) can occur.
• Ear Infections: Enlarged adenoids may block the Eustachian tubes, leading to recurrent ear infections.

These problems can negatively affect a child’s quality of life and health. In such cases, adenoidectomy can offer an effective solution.

Adenoid Problems in Adults: Rare but Important

Adenoid problems are less common in adults but cannot be entirely ruled out. Generally, adenoid tissue shrinks after puberty. However, in some individuals, adenoids continue to enlarge or cause problems due to chronic infections. Conditions in adults that may require adenoidectomy include:

• Chronic Sinusitis: Swollen adenoids can block the nasal cavity, create an infection source, and prevent sinus drainage, leading to sinusitis.
• Sleep Apnea: Breathing pauses and snoring during sleep may be caused by enlarged adenoids.
• Difficulty Breathing: Breathing problems in adults can significantly affect work and social life.

There is often confusion between adenoids (also known as geniz eti) and nasal polyps (conchae). Though the enlargement of these two different structures causes distinct problems, they may present similar symptoms, which can lead to confusion. In fact, adenoid enlargement is a condition commonly seen in childhood and typically shrinks in adolescence. However, nasal polyps (concha hypertrophy) are common in both children and adults.

How Is Adenoidectomy Performed?

Adenoidectomy is typically a short and safe surgical procedure performed under general anesthesia. The main steps of the procedure include:

• Preparation: The patient undergoes a general health check-up before surgery. Both children and adults are evaluated for anesthesia suitability.
• Removal of Adenoids: The surgeon usually removes the adenoid tissue by scraping it from inside the mouth. This method is widely used and highly effective worldwide. However, for the past 10 years, I have been removing adenoid tissue under direct vision using an endoscope. The endoscope used in this method provides great advantage in identifying the exact location of the adenoids and allows for their removal (using a microdebrider) without damaging surrounding tissues. No incisions are made during the procedure, which significantly speeds up the recovery process.
• Control of Bleeding: Bleeding during adenoidectomy is usually minimal. The surgeon stops any bleeding if necessary.

The procedure takes approximately 30 minutes, and most patients are discharged on the same day. Recovery is generally faster in children, who can return to normal activities within a few days. Recovery in adults may take a little longer.

Post-Adenoidectomy Care: What Should Be Considered?

The post-surgery period is important for both children and adults. To ensure smooth recovery, attention should be paid to the following:

• Diet: Soft and warm foods should be preferred during the first few days. Hot and spicy foods should be avoided.
• Fluid Intake: Drinking plenty of fluids helps keep the throat moist and speeds up recovery.
• Pain Management: Mild throat pain is common. Pain relievers recommended by the doctor can be used.
• Rest: Rest is especially important for children during the first few days after surgery. Physical activities should be avoided.
• Infection Risk: If symptoms of infection (high fever, severe pain) arise after surgery, the doctor should be consulted immediately.

Benefits of Adenoidectomy

Adenoidectomy is an effective surgical intervention that improves quality of life. Both in children and adults, it provides the following benefits:

• Easier breathing,
• Reduction in snoring and sleep apnea,
• Prevention of ear infections,
• Better quality of sleep,
• Increased overall health and energy levels.
• Improved appetite.

In children, there can be significant improvements in speech, language development, and school performance after surgery. Adults feel an increase in energy and productivity in their daily lives.

Misconceptions About Adenoidectomy

There are several misconceptions about adenoidectomy in society. Here are some commonly misunderstood facts:

• “Removing the adenoids harms the immune system.”
  The role of adenoids in the immune system is limited to childhood. Their removal does not affect the body’s overall immunity.
• “The surgery is very risky.”
  Adenoidectomy is a very safe procedure when performed by experienced surgeons.
• “Adenoid problems don’t occur in adults.”
  Although rare, adenoid problems can occur in adults and may need to be treated.

Conclusion: The Right Step for a Healthy Life

Adenoidectomy is an important surgical intervention that opens the doors to healthy breathing and a quality life, particularly for children and sometimes for adults. If you are experiencing nasal congestion, snoring, recurrent infections, or sleep problems, it is essential to consult an ENT specialist.