Our Summary

This research paper looks at why some children still have breathing problems after having their adenoids removed, a common surgery to relieve blocked airways. The study discovered that in 18% of the patients, standard surgery wasn’t able to completely clear the nasopharynx (the area behind the nose where adenoids are located). The researchers found that the average length of the soft palate (the back part of the roof of the mouth) in these cases was longer than average. This suggests that a longer soft palate might affect the success of the surgery. The authors suggest that surgeons should consider the length of the soft palate while performing the surgery, and perhaps use an endoscope (a long, thin, flexible tube with a light and camera on the end) to better check their work in these cases.

FAQs

  1. Why do some children still have breathing problems even after having their adenoids removed?
  2. What role does the length of the soft palate play in the success of adenoidectomy?
  3. What do the authors suggest surgeons should consider during the surgery to increase its success rate?

Doctor’s Tip

A doctor might advise a patient undergoing adenoidectomy to discuss the length of their soft palate with their surgeon before the procedure to ensure the best possible outcome. Additionally, patients should follow all post-operative care instructions carefully to promote proper healing and reduce the risk of complications.

Suitable For

Patients who are typically recommended adenoidectomy include:

  1. Children who suffer from chronic or recurrent ear infections, sinus infections, or tonsillitis that are not responding to other treatments.
  2. Children who have difficulty breathing through their nose due to enlarged adenoids, leading to mouth breathing, snoring, or sleep apnea.
  3. Children who have frequent nasal congestion or a persistent runny nose due to enlarged adenoids.
  4. Children who have difficulty swallowing or speaking due to enlarged adenoids blocking the back of the throat.
  5. Children who have been diagnosed with a condition such as adenoid hypertrophy, which is an abnormal growth of the adenoid tissue.

Timeline

Before adenoidectomy:

  • Patient experiences symptoms such as difficulty breathing, snoring, nasal congestion, and recurrent ear infections.
  • Patient undergoes a thorough examination by an ear, nose, and throat (ENT) specialist, including a physical examination and possibly imaging tests such as a CT scan.
  • Surgery is scheduled and patient receives pre-operative instructions, including fasting before the procedure.

After adenoidectomy:

  • Patient undergoes the adenoidectomy procedure, which typically takes about 30 minutes and is done under general anesthesia.
  • Patient may experience some pain, sore throat, and nasal congestion in the days following the surgery.
  • Patient is discharged home the same day and instructed to rest and avoid strenuous activities.
  • Follow-up appointments are scheduled to monitor healing and ensure proper recovery.
  • Patient may experience improvement in symptoms such as breathing difficulties, snoring, and ear infections in the weeks and months following the surgery.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with adenoidectomy surgery?
  2. How long is the recovery time after adenoidectomy surgery?
  3. Will the surgery completely alleviate my breathing problems, or is there a chance that they may persist?
  4. How will you determine if my adenoids need to be removed, and are there any alternative treatment options?
  5. Will the length of my soft palate be taken into consideration during the surgery, and how might this affect the outcome?
  6. Will you be using an endoscope during the surgery to ensure that the adenoids are completely removed?
  7. How soon after the surgery can I expect to see improvement in my breathing symptoms?
  8. Are there any specific post-operative care instructions or restrictions that I should follow?
  9. What is the likelihood of the adenoids regrowing after they have been removed?
  10. Are there any long-term effects or considerations that I should be aware of following adenoidectomy surgery?

Reference

Authors: Pagella F, Lizzio R, Pusateri A, Ugolini S, Maiorano E, Mirabella R, De Silvestri A, Tinelli G, Matti E. Journal: Int J Pediatr Otorhinolaryngol. 2021 Jan;140:110493. doi: 10.1016/j.ijporl.2020.110493. Epub 2020 Nov 11. PMID: 33199030