Discharge Instructions: Adenoidectomy

Important information following surgery:

We believe all children have a right to the best pain management that can be safely provided. The goal is to recognize pain and treat it successfully with medicines and comfort measures. Your child will likely have pain after surgery. Your child may not be pain free, but we will help each child to be as comfortable as possible.

Patient instructions following surgery:

Pain and discomfort

• Mild throat, neck pain and headaches are common after surgery and may last 10-12 days.

• Signs of pain include crying, touching the head, throat or neck, drooling, refusing to drink. 

• Give ibuprofen (Motrin®) every 6 hours you may also give acetaminophen (Tylenol®) every 4 hours as ordered by your surgeon

• Do not give your child any aspirin products.

• Give the medicine with food or milk to prevent stomach upset.

• Encourage frequent chewing for 2 days after surgery to decrease throat and jaw pain.

• Apply heat and gently massage the back of neck. Have your child turn their head side to side 10 times every 2 hours while awake. Contact the office if your child develops a head tilt or can't turn their head side to side.

Bleeding 

• When the adenoid scab falls off, your child may bleed from the mouth or nose.

• This is uncommon. If you see blood, call ENT immediately. 

Diet

• Encourage your child to drink often. Jell-O, pudding, yogurt, ice cream and popsicles count as drinks.

• There are NO food restrictions. 

Activity

• Closely supervise your child for 24 hours immediately after surgery. Patients over 16 years may not drive for 24 hours. 

• There are no activity restrictions after 24 hours. Your child may return to school or daycare and resume their normal routine as soon as they are eating and drinking normally and have minimal pain.

• Keep head elevated on 2 pillows for the first 2 nights of recovery.

• Your child can shower or bathe.

Nasal congestion and cough

• Encourage your child to drink a lot, including water, juice, or milk.

• Use normal saline nasal spray in the nose every 2 to 3 hours as needed while awake. 

• A cool mist humidifier can be used while sleeping.

Bad breath

• Your child will have bad breath for about 2 weeks.

• Encourage your child to brush their teeth and tongue at least 2 times a day.

• Use normal saline spray in the nose every 2 to 3 hours as needed while awake.

Voice change

• Your child’s voice may change after surgery. It may have a “nasal” sound. The voice usually returns to normal within 12 weeks after surgery.

• Liquid may come from your child’s nose after they drink. Encourage small sips or use a straw. This problem usually goes away within 12 weeks after surgery.

Follow-up appointment

• The ENT department will contact you by letter 4-8 weeks after surgery to check on your child’s progress.

• A follow-up appointment is not required unless you or your surgeon request one. 

Suggested shopping list

• Soft chewing gum or chewy candy

• Crunchy foods including pretzels, chips, cheese doodles, crackers

• Ibuprofen (Motrin) liquid or tablets

• Normal saline nasal spray (any brand)

Call 911 if your child has difficulty breathing.

Call your CHOP ENT team with questions, concerns or if your child:

• Has bleeding from the nose or mouth or has bright red blood in vomit. Call ENT immediately.

• Does not feel any better 45 minutes after pain medicine

• Drinks very little or refuses to drink 

• Urinates less than twice a day

• Has no tears with crying

• Vomits 2 times in one day 

• Has a temperature of 102ºF (38.8°C) or higher by mouth or rectum that lasts more than 24 hours after they have had acetaminophen or ibuprofen. 

• Has severe bad breath

• Has severe neck pain, a stiff neck, or head is tilted to the side and cannot straighten after receiving pain medicine. 

Division of Otolaryngology (Ear, Nose and Throat)

215-590-3440

7 days per week/24 hours

Reviewed February 2024 by Christie Alminde R.N. CPN