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Should my child have his adenoids removed?

Many parents struggle with decisions about adenoid removal and how to make the right choice for their child. We asked Dr. David Brown, an ear, nose and throat specialist at C.S. Mott Children’s Hospital, to fill us in on the procedure and why it is recommended for some children. 

Adenoids are located in the nasal pharynx, and may interfere with both sinus and ear drainage if enlarged.

Adenoids are located in the nasal pharynx, and may interfere with both sinus and ear drainage if enlarged.

Making decisions about your child’s healthcare can be difficult. This is particularly true for surgical procedures, no matter how safe and routine they have proven to be. Adenoid removal is most often a case in which a doctor might make a recommendation, and the parents make the ultimate decision. To help you with your decision, it is important to be informed about what the adenoids are, what happens during removal and how it may benefit your child.

What and where?

When I discuss adenoid removal with parents, we typically start by discussing exactly what and where adenoids are. Adenoids are made of lymphatic tissue, a type of tissue present throughout the gastrointestinal tract. They have a small part in promoting immunity, but children normally have enough outside of the adenoids to support their immune system. Adenoids are found in the back of the nose in a place called the nasal pharynx. It is difficult to see without special equipment, so it cannot be examined by most general pediatricians.

Why?

It can be difficult to see the connection between adenoids and the symptoms your child has. Adenoid removal is often recommended for children who have chronic nose drainage or sinus infection, chronic ear aches or multiple sets of tubes, or breathing problems like sleep apnea.  When adenoids are swollen or infected, they can inhibit normal breathing, leading children to mouth breathing. They can also block natural nasal drainage, leading to sinus infections and frequent yellow-green build up. If a child is on a second set of ear tubes, it may be helpful to remove the adenoids. Ear tubes are meant to help promote normal draining of the middle ear, and enlarged adenoids can get in the way of this drainage. Additionally, if problem adenoids are not removed, they can harbor infection and their biofilms, or areas of bacteria growth, can reduce the effectiveness of antibiotics.

How?

Once you feel comfortable with what the adenoids are and the benefits of removal, the next step for many parents making a decision about adenoidectomy for their child is to understand how the procedure is performed. For most healthy children, this is an outpatient procedure. It is a little more involved than some outpatient procedures, however, since it requires anesthesia and a breathing tube. The removal is all completed through the mouth, using a mirror tool to view the adenoid area. Different surgeons prefer different tools which may involve suction, scraping or electric heat to remove the tissue and reduce bleeding. The procedure itself takes only five minutes.

Then what?

Most often, children do very well after the removal, only taking basic amounts of ibuprofen or acetaminophen to reduce pain for a few days if necessary. Because of the location of the adenoids, children will often complain of either a head or ear ache, or occasionally both, not knowing exactly where the sensation is coming from. Some children do not complain of any pain. Due to its location, the wound from the removal is allowed to naturally close and may take a few weeks to fully heal. As it heals, children may experience smelly breath. Additionally, adenoids may continue to grow in children until around age five to seven. If a child has adenoid removal at a very young age, there is a chance that their symptoms related to infected or swollen adenoids will return as adenoids grow. Finally, surgeons may adjust the process to only remove part of the adenoid due to potential complications with the soft palette if necessary. In certain cases, a full removal of the adenoids would leave too large of a gap around the soft palette, resulting in difficulty with eating or speaking normally. A partial removal usually removes this risk, but on rare occasions follow up therapy is required. For many children, the benefits of adenoid removal are palpable, offering a quick relief of their sinus or ear symptoms and very few or no side effects.

Is it right for us?

Almost always, I tell families that adenoid removal is their option. There is rarely a time when adenoid removal is a necessity. At the same time, there are few side effects and only very rare occasions where the removal could be detrimental, namely for children who have preexisting conditions such as cleft palate or Down Syndrome. Understandably, parents of children who make fine candidates for removal are worried about anesthesia and tracheal tubes. Today, however, we know more about small child anesthesia and there are fewer risks associated with the procedure.

In my time as an otolaryngologist, families who have chosen adenoid removal for their child were typically very pleased. Those who have decided against it often reconsider at a later date.  Of course, it is still a choice in most cases, and it is important to do what is best for your family and your child’s health.

Learn more about the medical services offered by ear, nose and throat specialists at Mott, or call 877-475-MOTT (877-475-6688) to speak with a Mott Patient Advisor.


About Mott Children’s Hospital

University of Michigan C.S. Mott Children’s Hospital is consistently ranked one of the best hospitals in the country. It was nationally ranked in all ten pediatric specialties in U.S. News Media Group’s “America’s Best Children’s Hospitals,” including #3 in the country for heart and heart surgery. In November, the hospital moves to a new state-of-the-art facility that will be home to cutting-edge specialty services for newborns, children and women.

 

61 thoughts on “Should my child have his adenoids removed?

  1. avatar
    David L Smith on said:

    Excellent information provided in a very easy but concise manner. thank you very much.
    P.S. I didn’t see a way to forward the info which would be extremely helpful.

  2. avatar
    Chynna Wertz on said:

    My son is having the surgery in a couple of days due to sleep apnea, trouble spekaing and chronic nasal infection. This information that you have given is very helpful. Im still scared about the surgery but that is going to always be there because it is just a parents way of trying to coop. Lol.

    • avatar
      Terri Tope on said:

      My son is 4 and is going to get the procedure on the 4th, and I too am very concerned. He is getting it for chronic snoring and trouble with pronunciations/speaking. How old was your son? How do you feel about the outcome of the surgury? Did it help with his speech? How old was your son at the time? After reading this information, were you afraid because of the information they present regarding full removal possibly causing difficulty eating or speaking properly? I have so many questions, but I will just leave with this for now. I would appreciate any information.

      • avatar
        michelle on said:

        My son was 9. My concern was chances of death with any operation that wasn’t needed for life threatening reasons. It’s so hard to make decisions for your child and put them through this. The recovery was very tough, but the outcome was AMAZING for my son! I tried everything before making this the last resort. You will know in your heart what is needed when your ready.

      • avatar
        Robert Babbitt on said:

        Our son is scheduled to have his Tonsils removed here shortly and have some concerns after reading that there have been some deaths from this procedure. The Professionals were sighting reasons for difficulty in breathing and swallowing. How did your child do after his procedure?

  3. My child having 4 yrs now, born with a cleft palate in his soft palate, repaired at the age of 1. Now that he has fluid in his ear and ENT suggest to remove adenoid. However his cleft palate operated doctor suggest not to completely remove the adenoid (keep the center portion of the adenoid and remove only both sides)., but ENT doesnot agree on this. Can you suggest what approach could be the best for the child.
    Mat

  4. avatar
    jackie on said:

    My son just had his removed yesterday. It was a long day but it went very well! So, if you have to have this done for your child, don’t worry :) I explained everything to him the week before to prepare him for every step. He didn’t get anxious or cry the entire time. The procedure went very fast. He slept in the recovery room (every child wakes up differently though) and was so quiet..just looked around and saw us there and went back to sleep. We were sent back to our room in pediatrics and he watched some tv and had slushie and then he wanted pudding! He didnt complain of any pain. They told us pain meds for 2-4 days and soft food diet..however he wanted mcdonalds so we went there. He ate an ENTIRE kids meal with no problems. I gave him the meds every 3 hours as told. He went to bed @730pm (got meds) and didnt get meds again until 730am and he didnt complain of any pain or seem in pain at all. SO please dont stress out about this like I did!!!!

    • avatar
      michelle on said:

      Thanks for the feedback. Still very scared though. It’s tough to ease a mama’s worries when it comes to her babies! I know if it were surgery for me,I’d be ok. ;) Glad to hear the recovery is going well for you!

    • Thank you very much for posting about your experience! My daughter is 5 and having hers removed tomorrow due to chronic sinus/ear infection pluse she has mild asthma. Although everything I read said it would be ok there is nothing like hearing/reading it first hand. Of course us parents will always worry and surgery is never what we want to hear but your post is very helpful. Glad to read your son’s recovery went well.

  5. avatar
    Casey on said:

    This was a great article. Thank you! My daughter just turned 2 and is likely to get hers out – as of today, her allergist, pediatrician, and an ENT are going to discuss it and let me know… has constant sinus infections to be so little and after 21 days of a heavy-duty antibiotic, x-rays show her adenoids are quite enlarged… My husband read a few other articles that seemed a little scary for a parent and said we need to try to talk them out of it – after reading this, we feel a little better and most definitely want what is best for her. It’s just hard to think about anesthesia and a breathing tube!!! Thank you to the other parents posting as well for some encouragement. :) We will go ahead with it if the consensus between the experts is that she needs to have them removed.

  6. avatar
    Ramesh on said:

    Many thanks to Rebecca for contributing his value time for very clear explanation. Appreciated.
    My son 4 years old having frequent cold (once in every month) and some times breathing through mouth and snoaring, while go to general pediatric, they does not aware of this instead they gave general medication, but one day he got ear pain that time ENT specialist suggested to check adenoid growth, same confirmed through x-ray, but doctor advised to go for nasal spray application daily and monitor for a month, if it fails then only surgery for adenoid removal. now we are in observation period. I wish cure without surgery.

  7. avatar
    Angela on said:

    My little one just turned 2 yesterday, and we already have our surgery date scheduled for the end of this month. As baby she has had several ear infections, went for a first pair of ear tubes last august, they only lasted till March, and as soon as they came out ear infections came back. The last time she had ear infections was back in May, haven’t had one since then, but after taking her to do an audio test, she failed because of the fluid that is currently there. I have taken her to two ENT, and both have agreed that she needs another set of ear tubes; however, she has been clear now for two months and both also agreed that she will need to get part of her adeniods removed, so my question to them is now; no ear infections for almost two months now should we still have the adenoids removed? Honestly I don’t want her to go through that, the same day under the same anesthesia she is having a dermoyd eye sys remove, ear tubes and now the adenoids, my heart tells me to postpone the adenoids procedure, honestly I don’t know what to do. What would you do? her adenoids aren’t infected, they are some enlarged, that’s what the doctor said without having x-rays done, so how can they tell without getting x-rays done.

  8. avatar
    Jan Smith on said:

    Great info, my daughter had hers removed last week and sleeps like a champ now, breathes through her nose instead of her mouth at night, eats better, etc..,. I was very nervous about putting her to sleep but she was perfectly fine. No complaints, wouldn’t even know she had an operation. The only side effect was bad breath, which is no biggie! And the procedure only took 20 minutes (not counting recovery, when they let them slowly wake up). No regrets, glad we did it.

    • avatar
      michelle on said:

      Thanks Jan! I did make a date for my son to have the tonsils and adenoids both removed because I believe it can/will help. How was the pain? How long before she would swallow without worrying about it hurting? Did she have the adenoids out too? May I ask how old she is?

      • avatar
        Jan Smith on said:

        My daughter is 4 and she only had her adenoids taken out. She maybe said once that her throat hurt, that was it. Just a little Tylenol did the trick!

  9. avatar
    michelle martin on said:

    My son had adenoids and tonsils removed yesterday. There were no x-rays ahead of time to view the adenoids but once inside the doctor said they were larger than his tonsils,which were quite impressive by themselves.He said he would be shocked if this didn’t improve his quality of life greatly.There is a chance he may not even need the Zertec allergy meds we have been giving him most of his life. (he’s 9)
    They had a hard time waking him after surgery and I said either he didn’t do well on the anesthesia or he’s making of for 9 years of lost sleep. I noticed in recovery he was sleeping without snoring for the first time ever! His airways were unobstructed.THAT is very encouraging.He did throw up blood in recovery. They said they can’t stop it all from draining down in his stomach.
    Overall the surgery was quick,but we were at the hospital 9 hours! Take stuff with you to drink and eat, it’s a long day. Each kiddo is different and mine was groggy for a long time. He slept for about 4 hours in recovery.
    Today at home it’s ROUGH!! He’s very sore and crying some. The sherbet and ice packs on his neck help with pain some,(along with meds)but not enough to comfort him so he can sleep yet. I’m a very busy mommy today taking care of him!

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  11. avatar
    michelle on said:

    Ok so I went through with the surgery for my son. Both T and A. I found out after surgery that the adenoids were much larger and more of a problem than the tonsils. Anyway, I just wanted to say the recovery is HARD! It took a solid week before feeling good,and another to eat well, BUT I’d do it all over again! My son sleeps soundly now with not even a sound! His airways are free! Amazing night and day difference. He is also OFF all the allergy meds he had been taking for years! It was a blessing for us to have this done!

  12. avatar
    Patience on said:

    Thanks to all of you who contributed with your comments.My son is only 1 and the day to have his adenoids removed is only 3 days away and i was so nervous just to picture him being operated,but after reading what some of you wrote,i’m a bit relieved and i just cant wait to see my son sleeping without any snoring and any disturbances,and also breathing through his nose

    • My little one gor hers removed just a couple months ago when she turned two, hers was significantly enlarged, but I knew that before surgery cause I demanded some xrays prior. She has been sleeping good, eats better and when she was out of the or she was ready to eat, no pain, no cry, no bad breath, God was by her side each second, and He will be with your little one to. Little babies do so much better in the OR than us the parents while we wait for the whole thing to be done and be back with them and have them wrapped in our arms once again. Blessings!!!!

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  15. avatar
    Barbara on said:

    My daughter is having surgery tomorrow and am super worried, but i have to do it for better health, and now after reading this am kinda relieved, my girl is 2 years and 7 months but can not speak well, snores at night and breathes through the mouth during the day and night, does not eat because of pain, so i guess after the surgery her health will improve, but am super worried, everyone reading this please pray for me and my daughter for the surgery to go well tomorrow.

    • avatar
      Michelle on said:

      Prayers for you and your daughter tonight & tomorrow Barbara. It’s so hard to make the tough decisions for our kids. You sound like you already know this could improve her quality of life considerably though. Once that is determined you can keep focused on the end result and get yourself through the worrying by staying focused. My son is a totally different person. I don’t have stock in the Kleenex business any longer,I don’t wear ear plugs at night,and he doesn’t have dark circles under his eyes anymore.Oh and he is meeting 100% of his goals in school now. (bonus) You should notice the difference the very first time she sleeps. <3

  16. avatar
    Dallori on said:

    I’m glad I saw this website. My son is 8 months old and is scheduled for surgery on Dec.23. He has had 4 ear infections in the last 5 months. I am very concerned about surgrry on him because he is not 1 yet. My husband and I decided to get the tubes first then look at the adenoids after he turns 1. What do you all think about that???

    • avatar
      Michelle on said:

      Hi me again. :) My son also had a surgery at 10 days old,so I know that fear all too well. I didn’t have a choice in that one,it was necessary,however it was easier that time. I say “easier” because he was kept sedated, the hospital monitored him and he was in the hospital overnight for observation. Also he wasn’t old enough to talk to me about all his fears. (THAT made me feel the worst before surgery, thinking I forced it upon him.) I’d ask if the hospital would keep him overnight or longer?! They would be more qualified to see signs or symptoms of anything wrong afterwards,when someone is so tiny and can’t communicate things as easily. If they are going to keep him and you can get enough trust in them to do it,I think getting it done sooner rather than later would be ideal. Why go through all the other stuff just to possibly have this done later anyway? I’ve heard stories of that happening to other kiddos. Some still need it later. :(

  17. My son is 6 and had adenoids removed and put ear tubes 6 months ago. The surgeon suggested to remove his tonsils too. But it was not that big at that time therefore we did not remove the tonsils. Big mistakes!! Now his tonsils is getting bigger and need to remove. My son needs to undergo surgery again soon. I am so sad he needs to go through this procedure again. His recovery was tough. Solid one week liquid diet and also on pain killer. My son was underweight and very weak. Therefore, I was so scare to go through all three surgeries together. He lost weight after surgery but he catches up later on. The recovery is totally depending on the method the surgeon uses, child’s physical condition, and how willing they want to eat. If they eat sooner, the recovery is faster. My son was constantly congested, mouth breathing, and loud snoring. If your child is in same condition, it is worth to do it. Their life will be changed after that. I will have my son’s tonsils removed in nest month. I chose the doctor who uses coblation method. the advantages are less pain, faster healing and less post operative care.

  18. avatar
    Stella on said:

    Am so scared ,my son is 11months and we are scheduled for surgery on 30th Jan 2014 ,by then he will be 1week to celebrating his birthday.This information is very helpful and i trust In GOd that all will be well.

    • avatar
      Gina Poe on said:

      Be SURE to give your baby adequate antioxidants in the last meal before the surgery and the first meal post surgery to protect his brain from the oxidative side effects of anesthesia which can be particularly harmful in children under age 3. Just a handful of blueberries will suffice. Antioxidants exist naturally in many fruits and vegetables. Just take care of that one thing and your son will be just fine. Do not worry. Both my sons had adenotonsillectomies at age 3 and they are better off for it. Pat yourself on the back for discovering the problem and fixing it so early. Well done!

  19. All 3 of my kids had their tonsils and adenoids out when they were 2.5 years old. Best decision ever! Easy recoveries too. Only bad thing is my oldest is now 10 and we recently discovered his adenoids have grown back. I didn’t know that could happen! He is scheduled to have them removed this June. We’ve tried everything from nasal sprays to allergy meds to help with the mouth breathing, snoring, and overall misery of not being able to breathe through his nose! But then we realized he had a total blockage-only a fingernail space of room to breathe they had grown back too much. We saw the same doctor who did his surgery at 2.5 and they were fully removed the first time, we have the post-op records for proof. Just be sure if you have adenoids removed to keep watch as they get older! It’s rare I’m sure but I wish he didn’t have to suffer or go through the surgery again :(

  20. I have a big problem with my daughter’s five years old and suffering from chronic snoring and I have decided that after I read this article to go out to the nearest doctor, and I will write later what he told me the doctor

  21. avatar
    Shannon Ouellette on said:

    I am still debating weather to have his adenoids removed, he is in line for tubes, and just now did a different doctor advise to have the adenoids out. Then my Mom said get rid of the tonsils too. Im not sure ??? HIs symptoms are..

    -Mouth breathing
    -constant running nose
    -smell in his nose
    -Snot yellow, green ( smells horrible)
    -Heavy breather but I dont really notice loud snoring, he sleeps loud but not snore.

    He had back to back ear infections starting around 12mo-until about a month ago when I started giving his sinus rinses (the gunk that came out was incredible) He doesnt like them of course and crys and begs when he see’s the bottle, I to hold him down and half of the water pushes snot out and the chokes/swallows the other half. dont have this problem my sinus rinses come out the other side. None goes down my throat. ?? My husband chokes on his too, but he has a deviated septum. The doctor said since the nasil rinses his ears are beautiful!!! But there is still stagnant fluid in his ears. Just NOT swollen and infected. He still gets sick fever and I assume its his ears bit just viral infections no ear infections since the nasil rinses started.

    Even with a nasil rinse every other night, he still has all symptoms listed above minus ear infections.

    SO what do I do ? Defiantly gettting tubes his speech is very delayed, hes 2.5 and just started really talking 5 months ago, and still has major pronunciations problems. DO I do the adenoids too ? I have not gotten xray I dont want the radiation. HIs tonsils are not swollen so far.

    any thoughts?

    • avatar
      michelle on said:

      Shannon, If you’re doing the tonsils already, do the adenoids at the same time. That’s just my opinion, because I think it’s easier to have one recovery over two. If you find you need them out later, that’s going to be rough to go through all of that stuff again.
      My son didn’t have x-rays either, but when the doc got in there he said they were even bigger than the tonsils. It was a smart move on the doc’s part to suggest I do both.
      My son was sick all the time before surgery, and now he rarely gets even the sniffles. For us it was an amazing difference. Good luck with everything, what ever you decide.

  22. avatar
    hamid on said:

    my son is undergoing adenoid surgery tomorrow, he is five and a half years old and was having serious breathing problems while sleeping, headaches, fever and problems with diet too.Medical specialist referred him to ENT specialist who had x-ray and blood test and suggested a surgery for adenoid and tonsils removal. noticed serious attitude problems in him and lack of concentration while studying too. finally we decided to under go surgery to improve his health and resolve other issues.

  23. avatar
    Jenna Hoskin on said:

    My son had adenoids removed and grommets inserted three weeks ago as he was getting chronic ear and throat infections. I was also really worried about the surgery and anaesthetic but it all went very smoothly and he has been so great ever since! Recovery was so fast and I’m very happy with the decision. I just wish I’d done it earlier. My son is two and a half.

  24. avatar
    Shelena Dawn Wall-carpinteyro on said:

    My son just turned 2 last week and today we seen the ear nose and throut dr. He just looked in his throut with a light and did a hearing test and told me he needs his adenoids removed. The only problem my son has is he wakes up choking and coughing at least once a week. He said its because his adenoids are to big but i realy dont know how he would know that when he cant see them threw the mouth or ears and with no xray. He schedualed surgery for him next wednsday but i am afraid of the possability of something going wrong with anistesia so i am thinking about canceling it tomarrow…

  25. avatar
    Shelena on said:

    My son just turned 2 last week and today we seen the ear nose and throut dr. He just looked in his throut with a light and did a hearing test and told me he needs his adenoids removed. The only problem my son has is he wakes up choking and coughing at least once a week. He said its because his adenoids are to big but i realy dont know how he would know that when he cant see them threw the mouth or ears and with no xray. He schedualed surgery for him next wednsday but i am afraid of the possability of something going wrong with anistesia so i am thinking about canceling it tomarrow…

  26. avatar
    Sarah on said:

    My step-daughter is 4 and a half, and her doctor just suggested getting her second round of tubes as well as removing her adenoids. She breathes heavily through her mouth with a constant stuffy nose, has had multiple ear infections, and speaks like a child just learning to speak beacuse she can’t hear very well. I read that the adenoids begin to shrink in size after age 5, would that mean these problems can begin to naturally rectify themselves with her adenoids not being enlarged? Her problems began at age 2, which is why she has trouble communicating properly like a child her age should. Would anyone suggest waiting it out or would both surgeries be more beneficial? Her first round of tubes did absolutely nothing and I have a hard time spending even more money on surgeries that aren’t necessary and are painful for our daughter if they won’t even help her ear infections, breathe, and speak.

  27. avatar
    sarahawallace on said:

    My step-daughter is 4, and her doctor just suggested getting her second round of tubes as well as removing her adenoids. She breathes heavily through her mouth with a constant stuffy nose, has had multiple ear infections, and speaks like a child just learning to speak beacuse she can’t hear very well. I read that the adenoids begin to shrink in size after age 5, would that mean these problems can begin to naturally rectify themselves with her adenoids not being enlarged? Her problems began at age 2, which is why she has trouble communicating properly like a child her age should. Would anyone suggest waiting it out or would both surgeries be more beneficial? Her first round of tubes did absolutely nothing and I have a hard time spending even more money on surgeries that aren’t necessary and are painful for our daughter if they won’t even help her ear infections, breathe, and speak.

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  29. avatar
    Renata Gulnaz on said:

    Hi, actually, I was not so familiar with adenoids until I saw this article. Anyway, thanks for providing useful information about this. After a thorough reading, I found out that adenoids are lumps of tissue most likely seen in the neck or some other parts of the body. And an adenoids glands have been taken out by removal through a surgery. Other method maybe a radio frequency. However, how true is it that there are cases in which adenoid tissue may grow back? I just hope this is considered a rare case.

  30. avatar
    Veronica on said:

    My 3 year old son had his tonsils and abenoids removed on 9/18/2014 due to sleep apnea he seems to be breathing heavier while he’s sleeping. Why?

  31. My step-daughter is 4 and a half, and her doctor just suggested getting her second round of tubes as well as removing her adenoids. She breathes heavily through her mouth with a constant stuffy nose, has had multiple ear infections, and speaks like a child just learning to speak beacuse she can’t hear very well. I read that the adenoids begin to shrink in size after age 5, would that mean these problems can begin to naturally rectify themselves with her adenoids not being enlarged

    • I wish I had this information when my son was younger. He was a mouth breather and had allergies. He ended up having surgery as an adult. I think recovery is much harder when you are an adult. We never thought to have him checked out as a child. He did have frequent ear infections up to about age 3. Then he outgrew them.

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