adenotonsillectomy

An adenotonsillectomy is a surgical procedure that removes both the adenoids (pharyngeal tonsils) and the palatine tonsils. The surgery is performed under general anesthesia and is most common in children, though it is also done in adults in certain cases. The adenoids lie behind the nasal cavity in the upper throat; the tonsils are located at the back of the throat on each side.

Indications for the procedure include recurrent or chronic throat infections, recurrenttonsillitis, and obstructive sleep-disordered breathing or nasal/airway obstruction due to enlarged adenoids and/or tonsils. It can also be indicated for persistent middle-ear effusion or Eustachian tube dysfunction when medical therapy has failed. Contraindications include active infection at the time of surgery, uncorrected bleeding disorders, and certain severe medical conditions that increase anesthesia risk.

The procedure generally combines two operations: tonsillectomy (removal of the tonsils) and adenoidectomy (removal of the adenoids). Techniques vary and may include cold dissection, electrocautery, or coblation. Most cases are performed as a day surgery, with the patient going home the same day after a period of observation.

Recovery typically lasts about one to two weeks. Pain relief is managed with analgesics, and patients are advised to maintain hydration, eat soft foods, and avoid strenuous activity during healing. Most children experience relief from airway obstruction and infection frequency; however, some may continue to have problems related to allergies, nasal obstruction, or recurrent infections.

Complications are uncommon but can include postoperative bleeding, dehydration, infection, or rarely injury to surrounding structures. Anesthesia-related risks, though small, are also considered. See also adenoidectomy and tonsillectomy.