Adenotomy

Adenotomy is a surgical procedure to remove hypertrophied pharyngeal tonsils (adenoid vegetation). Intervention is aimed at restoring nasal breathing, drainage function of auditory tubes, and eliminating the source of chronic infection in nasopharynx.

This surgery is one of the most common routine procedures in paediatric otolaryngology. Modern approaches to adenotomy are based on the principles of complete removal of lymphoid tissue under visual monitoring, which minimises the risk of recurrence and complications.

Indications and methods of administration

The surgery is done for specific indications, the main ones being obstructive sleep apnea syndrome (OSAS), recurring middle ear infections with hearing loss and persistent nasal breathing problems that don’t respond to conservative treatment.

The “gold standard” today is endoscopic adenotomy performed under general anaesthesia. Visual control allows the surgeon to completely remove adenoid tissue using a microdebrider (shaver) or cold plasma ablation (coblation), which significantly increases the safety and effectiveness of the procedure compared to the outdated method of blind curettage.

Clinical Significance

The clinical significance of adenotomy lies in the dramatic improvement in the child’s quality of life: restored physiological nasal breathing, normalised sleep, as well as reducing the frequency of respiratory and ear diseases. A successful surgery prevents the development of complications of chronic hypoxia and the formation of an “adenoid” type of face.

Despite the high safety of modern techniques, complications are possible. The main ones are post-surgical bleeding (early or delayed) and, in rare cases, the development of palatopharyngeal insufficiency (nasal speech, food entering the nose), especially in patients with hidden palate abnormalities.