Adenoidectomy in children: Postoperative care and complications
- Anna H Messner, MD
Anna H Messner, MD
- Section Editor — Pediatric Otolaryngology
- Professor of Otolaryngology/Head & Neck Surgery and Pediatrics
- Stanford University
Adenoidectomy is a common pediatric surgical procedure that is performed alone or in conjunction with tonsillectomy . 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".)
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 . (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 . 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.
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- POSTOPERATIVE CARE
- Postoperative hemorrhage
- Velopharyngeal insufficiency
- Temporomandibular joint dysfunction
- Nasopharyngeal stenosis
- Atlantoaxial rotary subluxation (Grisel syndrome)
- Other causes of neck pain and torticollis
- Regrowth of adenoids with recurrence of symptoms