This article is for educational purposes only. It should not be used as a template for consenting patients. The person obtaining consent should have clear knowledge of the procedure and the potential risks and complications. Always refer to your local or national guidelines, and the applicable and appropriate law in your jurisdiction governing patient consent.
Overview of Procedure
An adenoidectomy is an operation to remove or reduce the adenoid tissue, the lymphoid tissue present in the nasopharynx. This is mainly performed for recurrent tonsillitis.
The procedure is performed transorally. It can be completed by curettage, before being packed, or by a combination of suction and coblation diathermy, all under direct vision using a mirror.
Figure 1 – The lingual and palatine tonsils
Complications
Intraoperative
| Complication | Description of Complication | Potential Ways to Reduce Risk |
| Haemorrhage | Damage to any of the surrounding structures and blood vessels, occurs in <2% cases | Ensure adequate haemostasis throughout every step of the procedure |
| Injury to the gums, lips, teeth, tongue, and jaw | In order to obtain good exposure, the jaw is typically suspended using a special mouth gag | |
| Anaesthetic risks | Includes damage to the teeth, throat and larynx, reaction to medications, nausea and vomiting, cardiovascular, and respiratory complications. | Forms a part of the anaesthetist assessment before the operation |
Early
| Complication | Description of Complication | Potential Ways to Reduce Risk |
| Pain | Often only a mild sore throat, will typically pass within a few days | |
| Bleeding | This can occur immediately after surgery or up to 2 weeks after. Whilst often minor, in severe cases may require a return to theatre and / or blood transfusion | |
| Infection | Due to the open tissue bed, infection is common; can result in delayed bleeding | |
| Palatal insufficiency | After adenoidectomy, the soft palate has to close a larger gap during speech and swallowing; this leads to leakage of food or fluids through the nose | This usually improves, however if not the patient may need further surgery or speech therapy |
| Change in voice | Large adenoids tend to cause muffling of the voice; when the adenoids are removed, the quality of the voice changes, this may last for a few days |
Late
| Complication | Description of Complication | Potential Ways to Reduce Risk |
| Regrowth | Can occur in 5-10% of cases | Ensure meticulous dissection of the lymphoid tissue during the procedure |
| Eustachian Tube damage | Can lead to pain, hearing loss, and dizziness |