What is adenoid surgery?
The adenoids sit at the back of the nose, where the nasal passage turns down into the throat. They are lymphoid tissue — part of the immune system in early childhood — and they normally enlarge in the pre-school years and then shrink again.
While they are large, they occupy space that air needs. They also sit next to the openings of the Eustachian tubes, the channels that ventilate the middle ear. Adenoidectomy is the operation that removes them.
There is no external incision. The operation is performed through the open mouth, and nothing is visible afterwards.
What symptoms do enlarged adenoids cause?
| Symptom | Why it happens |
|---|---|
| Mouth breathing, especially at night | The back of the nose is blocked |
| Snoring, restless sleep, pauses in breathing | Airflow is obstructed during sleep |
| Nasal-sounding speech | Sound resonance in the nose is reduced |
| Glue ear, dulled hearing | The Eustachian tube openings are obstructed |
| Recurrent ear infections | Poor ventilation of the middle ear |
| Persistent runny or blocked nose | Impaired drainage |
Many of these overlap with allergy, with a deviated septum in older children, and with enlarged turbinates. Examination — including a look at the back of the nose with an endoscope where the child tolerates it — is what separates them.
When is surgery considered?
Adenoidectomy is considered when symptoms are persistent, are affecting sleep, hearing, speech or school performance, and have not settled with time or with medical treatment.
It is not the automatic answer to a snoring child. The assessment covers:
- how long the symptoms have been present and whether they are improving on their own;
- sleep — snoring, witnessed pauses in breathing, restlessness, daytime tiredness or behaviour changes;
- hearing — a hearing test where glue ear is suspected;
- whether the tonsils are also involved, in which case tonsil surgery may be combined;
- other causes — allergic rhinitis in particular, which is treated medically first.
What does the evidence show?
For obstructive sleep-disordered breathing in children, the Childhood Adenotonsillectomy Trial randomised children to early adenotonsillectomy or to watchful waiting with supportive care, and reported improvements in several outcome measures in the surgical group.
Professional guidance for tonsil surgery in children, published as a clinical practice guideline by the American Academy of Otolaryngology–Head and Neck Surgery, also addresses the assessment of obstructive sleep-disordered breathing and the role of surgery in it.
The practical message from both is the same: surgery helps children who are properly selected. Selection is the work.
How is the operation performed?
- Anaesthesia. General anaesthesia, with the child asleep throughout.
- Access. The mouth is held open; the adenoid is reached behind the soft palate. Nothing is cut externally.
- Removal. The adenoid tissue is removed with a curette, a suction diathermy device or a microdebrider, depending on the anatomy.
- Haemostasis. Bleeding points are sealed.
- Recovery. The child wakes in the recovery area. Many are discharged the same day; some stay one night, particularly younger children or those with significant sleep apnoea.
What does recovery look like?
| Period | What is usual |
|---|---|
| Day 1 | Sore throat, earache, nasal blockage, nasal-sounding voice |
| Days 2–4 | Bad breath and a blocked or crusty nose as the area heals |
| Days 5–7 | Discomfort settling; most children back to school |
| Weeks 2–3 | Nasal breathing steadily improves as swelling resolves |
| Weeks 4–6 | Full benefit generally apparent |
Practical advice usually includes plenty of fluids, regular simple painkillers as prescribed, soft food in the first days, and avoiding crowded places and swimming for a short period. Specific instructions are given after the operation.
What are the risks?
- Bleeding, usually minor, occasionally requiring a return to theatre.
- Infection, uncommon.
- Anaesthetic risks, discussed by the anaesthetist beforehand.
- Temporary change in voice quality as resonance changes — usually settles.
- Velopharyngeal insufficiency — a nasal-sounding voice or fluid escaping into the nose when drinking. Uncommon and usually temporary, but more of a concern in children with a submucous cleft palate, which is checked for before surgery.
- Regrowth of adenoid tissue, uncommon.
- Persisting symptoms where another cause, such as allergy, is also contributing.
This list is not exhaustive. Risks specific to your child are discussed at consultation and again during the informed consent conversation with you as parent or guardian.
What affects the price?
The extent of the operation, whether tonsil surgery is combined, the anaesthesia, and whether an overnight stay is planned. No prices are published on this site and no figure can be given before examination. See the Medical Disclaimer.
What should families travelling to Izmir know?
Children's surgery needs a little more planning than adult surgery. Bring any previous hearing tests, sleep assessments and records of past infections — they materially affect the decision.
Because the recovery involves a week of tenderness and a small risk of bleeding, families are advised to stay in Izmir for the first several days rather than travelling immediately. The exact timetable is agreed after examination. Consent is taken from a parent or legal guardian, and consultations are held in Turkish, English, Bulgarian and Russian.