Clinical Reference Systems: Pediatric Advisor 10.0

What are adenoids?

The adenoids are small pads of tissue found behind the back of the nose above the throat. They cannot be seen by looking in the mouth. Adenoids can become very large and block the eustachian tubes (the tubes from the middle ears to the back of the nose) and cause ear infections. Large adenoids can also block the nasal airway causing your child to breathe through his mouth and snore at night. Adenoids can become infected and carry germs (bacteria).

Why should the adenoids be removed?

• Blocked-up nose: Very large adenoids can block the nasal passages. This causes snoring and keeps your child from being able to breathe through his nose. Severe blocking may lead to more serious problems (such as apnea and heart problems). Removing the adenoids lets the child breathe normally through the nose.
• Recurring ear infections: Very large adenoids can block the eustachian tubes and lead to ear infections or the failure of ear infections to clear. If a child has surgery to place PE (pressure-equalizing) tubes in the eardrums at the same time the adenoids are taken out, it can help prevent recurring ear infections.

How long will it take to recover?

Most children are back to normal within 24 hours after surgery. Some children take a few days to recover. More snoring or nasal congestion is normal and is caused by temporary swelling in the back of the nose. Bad breath is also normal and is caused by the scabs that form after surgery. The snoring, congestion, and bad breath should be gone within 10 to 14 days after surgery. There should be no bleeding from the mouth or nose after surgery.

Discharge Instructions After Surgery

1. Pain Medicines

   Most children have little pain after the operation. Most of the pain will be toward the back of the neck. Your child may have a sore throat or headache for a few days. Give regular doses of pain medicine (any acetaminophen medicine, such as Tylenol) 4 to 5 times a day for a week. If your child has severe pain, use the prescription pain medicine as labeled. DO NOT USE ASPIRIN OR IBUPROFEN because these medicines increase the chance of bleeding. You can use cool compresses or ice packs on your child's neck to help your child feel more comfortable. You can also have your child suck on ice chips or chew gum.

2. Fever Medicines

   A fever between 99ƒF (37.5ƒC) and 101ƒF (38.4ƒC) is normal for a few days after surgery and can be treated with acetaminophen.

3. Diet

   Begin giving your child cool, clear liquids as soon as she wants to drink. Popsicles are also good. Gradually add foods that your child feels like eating until the diet is back to normal.

   Your child may feel sick to her stomach, throw up, or feel tired and cranky. This should get better within a few hours. Occasionally, nausea and vomiting are caused by the codeine in the prescibed pain medicine.

4. Activity

   It is best for your child to rest at home for the first 1 to 2 days after surgery. Normal activities can start as soon as your child feels up to it. There is no rule for the right time to go back to school, but a guideline is 2 to 4 days. Your child should not play rough or play contact sports until 14 days after the surgery.

5. Other Medicines
   • For pain or fever over 102ƒF (39ƒC) give ______________________
   • __________________________________________________________
   • __________________________________________________________

6. Additional Instructions
   • __________________________________________________________
   • __________________________________________________________
   • __________________________________________________________

7. Follow-Up Appointment After Discharge

   Your child needs to be rechecked and has an appointment on ______________ at ________ o'clock with _______________________.

Call Your Ear, Nose, and Throat (ENT) Doctor Immediately If:

• There is any bleeding from the mouth or nose.
• Your child's fever goes over 102ƒF (39ƒC).
• There are any signs of dehydration.
• Your child has been vomiting more than 12 hours.

Call Your ENT Doctor During Office Hours If:

• Your child's fever lasts more than 3 days.
• You have other concerns or questions.