Adenotomy in Children: What Parents Need to Know Before Surgery

A mother brought her five-year-old son to the ENT doctor because “the child is congested again, third ear infection in six months.” Endoscopy revealed grade III adenoids — the pharyngeal tonsil was blocking over 70% of the nasopharynx. The boy had been breathing through his mouth for two years, snoring every night, and nobody realized the problem wasn’t a runny nose but overgrown lymphoid tissue.

What Are Adenoids

Adenoids (pharyngeal tonsil) are lymphoid tissue in the upper nasopharynx. In children aged 2–7, they’re most active as part of immune system development. The problem begins when the tissue enlarges enough to block normal nasal breathing. Three grades: I — up to one-third blocked, II — half blocked with frequent ear infections, III — over two-thirds blocked with constant mouth breathing and hearing loss.

Warning Signs for Parents

Constant mouth breathing even without a cold. Snoring every night. Three or more ear infections per year. Reduced hearing. Nasal voice. Restless sleep with breathing pauses. Frequent respiratory infections progressing to sinusitis or bronchitis. If several of these sound familiar, it’s time for an ENT evaluation with endoscopic examination.

When to Operate vs. When to Wait

Conservative treatment works for grades I–II without complications. But grade III adenoids, recurrent ear infections threatening hearing, or diagnosed sleep apnea make surgery the safer choice. A common myth: “the child will outgrow it.” While adenoid tissue does regress after age 7–8, by then chronic hearing loss or bite deformation from mouth breathing may already be permanent.

How Modern Adenotomy Works

Today’s adenotomy is an endoscopic procedure under general anesthesia. The surgeon sees the nasopharynx on screen via a camera and removes tissue precisely. Duration: 20–30 minutes. General anesthesia in pediatric ENT surgery is the standard — it ensures stillness, pain control, and comfort.

Recovery

Days 1–5: mild throat discomfort, possible low-grade fever. Nasal breathing improves immediately, though swelling may persist for a week or two. Soft warm diet, no physical activity for 2 weeks. Most children return to normal within 5–7 days. Parents notice the main change: the child finally sleeps quietly and breathes through the nose.

At the ENT center at S-Clinic in Chernivtsi, adenotomy is performed endoscopically under general anesthesia with an in-house recovery ward. Book a consultation online.