Your child needs an operation called an adenoidectomy to take out their adenoids.
Your child also has obstructive sleep apnea (OSA). This means your child will need to be closely watched after the operation. Your child may also have to stay in hospital longer than the other children having an adenoidectomy.
This page explains what to expect while your child is in the hospital and how to take care of your child at home.
What are adenoids?
Adenoids are lumps of tissue, up behind the nose. Adenoids cannot be seen when looking in the mouth.
Sometimes, adenoids become enlarged and can cause breathing problems.
What is obstructive sleep apnea?
Sleep apnea means that your child goes through long pauses between breaths while sleeping. The obstructive part of OSA means that the pauses are caused by an obstruction or blockage. OSA can occur when the adenoids have become large enough to cause some blockage of your child's air passages.
Removing enlarged adenoids
Your child may have had enlarged adenoids since birth, or their adenoids may have grown too large from repeated infections. The enlarged adenoids are interfering with your child's breathing, especially at night when they are sleeping. Taking out the adenoids will improve breathing. If your child often has ear infections, an adenoidectomy may help them have fewer ear infections.
An otolaryngologist will do the operation. An otolaryngologist is a doctor who specializes in problems of the ears, nose and throat.
Before the operation
Several hours before the operation, your child will need to stop eating and drinking. A member of the health-care team will tell you when your child must stop eating and drinking.
Write this information down here:
The date and time of the operation:
When your child must stop eating:
When your child must stop drinking clear fluids:
Other things to remember:
Surgery to remove the adenoids
The doctor will give your child a special sleep medicine called a general anaesthetic. This will make sure your child sleeps through the operation and does not feel any pain.
While your child is asleep, the doctor will take out the adenoids through your child's mouth. Your child will not get stitches. The operation will take between 20 and 45 minutes.
You will be able to see your child when they are fully awake
A volunteer from the Surgical Waiting Room will bring you to see your child.
After the operation
After the operation, your child will be taken to the recovery room, also called the Post Anaesthetic Care Unit (PACU). This is where your child will wake up. Your child will stay in the PACU for about one hour. Then your child will be taken to an inpatient room on the otolaryngology unit. Your child will stay in this room overnight. Your child will be closely monitored by a nurse and will be connected to a machine that monitors their heart rate, breathing rate and oxygen levels.
Your child will be closely monitored overnight
- An electronic monitor will be attached to your child to help the nurse watch your child's breathing.
- Your child will be encouraged to take fluids by mouth. Your child will start with sips of clear fluids (fluids you can see through), ice chips or freezies. Once your child can take sips, they can then drink liquids from a cup.
- Your child's temperature and vital signs will be taken regularly.
- Your child will still have an IV in their arm. It may be needed for fluids or medication.
- Your child will be given pain medication if needed.
- The nursing staff will watch your child for vomiting or bleeding.
- The nurses will notify the otolaryngologist if there are any complications.
- When your child is fully awake, they may get up with help to use the washroom.
- Your child may throw up thick liquid that is a brownish colour, if they have swallowed some blood during or after the operation. This is normal. If your child keeps throwing up, they will be given medication through the IV to help settle their upset stomach.
One parent may stay overnight with your child.
Managing your child's pain after the operation
If your child has pain after the operation, they will be given pain medication by a liquid to swallow. Pain after adenoid surgery can last for a few days. Pain medication should be given for the first 72 hours on a schedule, then gradually spread out until it is no longer needed. .
Most children go home in the morning
Your child will be seen by the otolaryngology doctors the afternoon of the operation and early the next morning. If your child is drinking and had no problems overnight, they should be able to go home in the morning.
Caring for your child at home
Pain
You may give your child medication for pain.
You may receive a prescription for pain medication before you leave the hospital. Follow the dosage instructions given to you by the pharmacist. Although these prescription pain medications can be beneficial, they may have potentially serious complications if not used properly.
When using these medications, if you notice any changes in either breathing or level of drowsiness that concern you, stop the medication and seek medical attention. If your child is unresponsive, call 911 immediately.
Do not give your child over-the-counter medication that may have a sedative effect (makes people sleepy) while giving the prescription for pain medication. Examples of these medications are decongestants and antihistamines. Discuss these medications with your pharmacist.
You may give your child acetaminophen and/or ibuprofen if they have pain. Give the dose printed on the bottle for your child's weight.
Diet
It is very important that your child have lots to drink after the operation. Let your child drink as much liquid as they want. When your child can drink liquids without throwing up, they may eat soft foods. Then they can progress to a regular diet.
Mouth care
Your child can rinse their mouth with water or brush their teeth gently. Do not let your child gargle.
Teach your child to sneeze with their mouth open. Do not let your child blow their nose for at least one week after the operation. They should dab their nose with a tissue if it is dripping.
To help your child breathe more comfortably, you can use a machine called a humidifier. This machine makes the air moist with a cool mist. Put it at your child's bedside.
Your child's voice may sound as if they are talking through their nose. This is normal. It may last for a few weeks or up to three months, if the adenoids were very large.
Activity
- Your child should limit their activity for about two or three days after the operation. Ask your otolaryngologist when it will be okay for your child to play contact sports again.
- Your child may shower or bathe as usual.
- Your child should stay away from crowds and people with infections and colds.
- Your child may return to school or day care five days after the operation. You should not let your child go on long trips out of town for two weeks.
Your child may need a follow-up appointment
If your otolaryngologist has requested to see your child again in the clinic, the clinic will make an appointment for your child.
Reasons to call the health-care team
Please call your child's otolaryngologist, the otolaryngology clinic nurse or your child's primary care provider if your child has any of the following signs after going home.
- fever of 38.5°C (101.3°F) or higher
- vomiting (throwing up) that does not stop
- pain that gets worse
- refusing to drink
- fresh blood in the nose or mouth
If your child is bleeding, having trouble breathing, or if you have additional concerns, take your child to the closest emergency department.
Write down contact information here:
Otolaryngologist's name and number:
Otolaryngology clinic number:
Family doctor's name and number: