Official reprint from UpToDate®
www.uptodate.com ©2016 UpToDate®

Adenoidectomy in children: Postoperative care and complications

Anna H Messner, MD
Section Editor
Glenn C Isaacson, MD, FAAP
Deputy Editor
Carrie Armsby, MD, MPH


Adenoidectomy is a common pediatric surgical procedure that is performed alone or in conjunction with tonsillectomy [1]. This topic reviews the postoperative care and complications in children who have undergone adenoidectomy alone. Postoperative issues in children who have undergone tonsillectomy with or without adenoidectomy are discussed in greater detail separately. The indications, contraindications, and preoperative and intraoperative care for both procedures in children are also reviewed elsewhere. (See "Tonsillectomy (with or without adenoidectomy) in children: Postoperative care and complications" and "Tonsillectomy and/or adenoidectomy in children: Indications and contraindications" and "Tonsillectomy and/or adenoidectomy in children: Preoperative evaluation and care".)

Tonsillectomy in adults is discussed in detail separately. (See "Tonsillectomy in adults: Indications" and "Tonsillectomy in adults".)


The recovery following adenoidectomy is remarkably easy compared with the recovery following tonsillectomy alone or tonsillectomy with adenoidectomy. Patients who undergo adenoidectomy alone are typically discharged home the same day as surgery. Exceptions include the presence of underlying comorbid conditions or if the child is <2 years of age and has obstructive sleep apnea (OSA), which is associated with increased risk of perioperative respiratory compromise [2]. (See "Management of obstructive sleep apnea in children", section on 'Surgical therapy'.)

Pharyngeal pain from the surgical site and endotracheal intubation typically only requires nonnarcotic analgesics, such as acetaminophen or ibuprofen, on an as-needed basis. A minority of patients may also have neck pain that may last for several days to a few weeks [3]. Occasionally a child will complain of ear pain after surgery. The ear pain is referred from the pharynx and is treated with over-the-counter pain medications.

Many children will have significant halitosis that can last up to two weeks after surgery. The bad breath is a normal side effect of the surgery and resolves spontaneously.


Subscribers log in here

To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information or to purchase a personal subscription, click below on the option that best describes you:
Literature review current through: Sep 2016. | This topic last updated: Feb 18, 2016.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2016 UpToDate, Inc.
  1. Duval M, Chung JC, Vaccani JP. A case-control study of repeated adenoidectomy in children. JAMA Otolaryngol Head Neck Surg 2013; 139:32.
  2. Brigance JS, Miyamoto RC, Schilt P, et al. Surgical management of obstructive sleep apnea in infants and young toddlers. Otolaryngol Head Neck Surg 2009; 140:912.
  3. Henry LR, Gal TJ, Mair EA. Does increased electrocautery during adenoidectomy lead to neck pain? Otolaryngol Head Neck Surg 2005; 133:556.
  4. Baker LL, Bower CM, Glasier CM. Atlanto-axial subluxation and cervical osteomyelitis: two unusual complications of adenoidectomy. Ann Otol Rhinol Laryngol 1996; 105:295.
  5. Isaacson G, Parke WW. Meningitis after adenoidectomy: an anatomic explanation. Ann Otol Rhinol Laryngol 1996; 105:684.
  6. Tomkinson A, Harrison W, Owens D, et al. Postoperative hemorrhage following adenoidectomy. Laryngoscope 2012; 122:1246.
  7. Thomas K, Boeger D, Buentzel J, et al. Pediatric adenoidectomy: a population-based regional study on epidemiology and outcome. Int J Pediatr Otorhinolaryngol 2013; 77:1716.
  8. MRC Multicentre Otitis Media Study Group. Adjuvant adenoidectomy in persistent bilateral otitis media with effusion: hearing and revision surgery outcomes through 2 years in the TARGET randomised trial. Clin Otolaryngol 2012; 37:107.
  9. Witzel MA, Rich RH, Margar-Bacal F, Cox C. Velopharyngeal insufficiency after adenoidectomy: an 8-year review. Int J Pediatr Otorhinolaryngol 1986; 11:15.
  10. Maryn Y, Van Lierde K, De Bodt M, Van Cauwenberge P. The effects of adenoidectomy and tonsillectomy on speech and nasal resonance. Folia Phoniatr Logop 2004; 56:182.
  11. Stewart KJ, Ahmad T, Razzell RE, Watson AC. Altered speech following adenoidectomy: a 20 year experience. Br J Plast Surg 2002; 55:469.
  12. Milczuk HA. Effects of oropharyngeal surgery on velopharyngeal competence. Curr Opin Otolaryngol Head Neck Surg 2012; 20:522.
  13. Pulkkinen J, Ranta R, Heliövaara A, Haapanen ML. Craniofacial characteristics and velopharyngeal function in cleft lip/palate children with and without adenoidectomy. Eur Arch Otorhinolaryngol 2002; 259:100.
  14. Perkins JA, Sie K, Gray S. Presence of 22q11 deletion in postadenoidectomy velopharyngeal insufficiency. Arch Otolaryngol Head Neck Surg 2000; 126:645.
  15. Khami M, Tan S, Glicksman JT, Husein M. Incidence and Risk Factors of Velopharyngeal Insufficiency Postadenotonsillectomy. Otolaryngol Head Neck Surg 2015; 153:1051.
  16. Ford LC, Sulprizio SL, Rasgon BM. Otolaryngological manifestations of velocardiofacial syndrome: a retrospective review of 35 patients. Laryngoscope 2000; 110:362.
  17. Saunders NC, Hartley BE, Sell D, Sommerlad B. Velopharyngeal insufficiency following adenoidectomy. Clin Otolaryngol Allied Sci 2004; 29:686.
  18. Fernandes DB, Grobbelaar AO, Hudson DA, Lentin R. Velopharyngeal incompetence after adenotonsillectomy in non-cleft patients. Br J Oral Maxillofac Surg 1996; 34:364.
  19. Tweedie DJ, Skilbeck CJ, Wyatt ME, Cochrane LA. Partial adenoidectomy by suction diathermy in children with cleft palate, to avoid velopharyngeal insufficiency. Int J Pediatr Otorhinolaryngol 2009; 73:1594.
  20. Stern Y, Segal K, Yaniv E. Endoscopic adenoidectomy in children with submucosal cleft palate. Int J Pediatr Otorhinolaryngol 2006; 70:1871.
  21. Finkelstein Y, Wexler DB, Nachmani A, Ophir D. Endoscopic partial adenoidectomy for children with submucous cleft palate. Cleft Palate Craniofac J 2002; 39:479.
  22. Murray N, Fitzpatrick P, Guarisco JL. Powered partial adenoidectomy. Arch Otolaryngol Head Neck Surg 2002; 128:792.
  23. Koltai PJ, Chan J, Younes A. Power-assisted adenoidectomy: total and partial resection. Laryngoscope 2002; 112:29.
  24. Mathew R, Asimacopoulos E, Walker D, et al. Analysis of clinical negligence claims following tonsillectomy in England 1995 to 2010. Ann Otol Rhinol Laryngol 2012; 121:337.
  25. Hydri AS, Malik SM. Reduced mouth opening following tonsillectomy in children: myth or reality. J Coll Physicians Surg Pak 2010; 20:781.
  26. Wan DC, Kumar A, Head CS, et al. Amelioration of acquired nasopharyngeal stenosis, with bilateral Z-pharyngoplasty. Ann Plast Surg 2010; 64:747.
  27. Giannoni C, Sulek M, Friedman EM, Duncan NO 3rd. Acquired nasopharyngeal stenosis: a warning and review. Arch Otolaryngol Head Neck Surg 1998; 124:163.
  28. Richter GT, Bower CM. Cervical complications following routine tonsillectomy and adenoidectomy. Curr Opin Otolaryngol Head Neck Surg 2006; 14:375.
  29. Bocciolini C, Dall'Olio D, Cunsolo E, et al. Grisel's syndrome: a rare complication following adenoidectomy. Acta Otorhinolaryngol Ital 2005; 25:245.
  30. Kraft M, Tschopp K. Evaluation of persistent torticollis following adenoidectomy. J Laryngol Otol 2001; 115:669.
  31. Tschopp K. Monopolar electrocautery in adenoidectomy as a possible risk factor for Grisel's syndrome. Laryngoscope 2002; 112:1445.
  32. Liapi A, Dhanasekar G, Turner NO. Role of revision adenoidectomy in paediatric otolaryngological practice. J Laryngol Otol 2006; 120:219.
  33. Buchinsky FJ, Lowry MA, Isaacson G. Do adenoids regrow after excision? Otolaryngol Head Neck Surg 2000; 123:576.
  34. Dearking AC, Lahr BD, Kuchena A, Orvidas LJ. Factors associated with revision adenoidectomy. Otolaryngol Head Neck Surg 2012; 146:984.
  35. Monroy A, Behar P, Brodsky L. Revision adenoidectomy--a retrospective study. Int J Pediatr Otorhinolaryngol 2008; 72:565.
  36. Lesinskas E, Drigotas M. The incidence of adenoidal regrowth after adenoidectomy and its effect on persistent nasal symptoms. Eur Arch Otorhinolaryngol 2009; 266:469.
  37. Greenfeld M, Tauman R, DeRowe A, Sivan Y. Obstructive sleep apnea syndrome due to adenotonsillar hypertrophy in infants. Int J Pediatr Otorhinolaryngol 2003; 67:1055.
  38. Emerick KS, Cunningham MJ. Tubal tonsil hypertrophy: a cause of recurrent symptoms after adenoidectomy. Arch Otolaryngol Head Neck Surg 2006; 132:153.