Adenoidectomy in Singapore

Adenoidectomy is a commonly performed surgical procedure aimed at removing the adenoid glands, which are located at the back of the nasal cavity.

These glands can enlarge or become chronically infected, resulting in a variety of health problems such as difficulty breathing, recurring infections, and sleep disturbances. The procedure is particularly common in children and is intended to improve overall respiratory health and quality of life.

Dr Gan Eng Cern

Ear, nose and throat specialist

MBBS

MRCS (Edin)

mmed (orl)

FAMS

Adenoidectomy for Blocked Nose in Singapore

Benefits Techniques Preparation Procedure Recovery Risks FAQ

Indications for Adenoidectomy

Adenoidectomy may be recommended when conservative treatments fail to provide sufficient relief for the following conditions:

Chronic Nasal Obstruction: Enlarged adenoids significantly block the nasal airway, resulting in persistent mouth breathing, nasal congestion, and disrupted sleep patterns.
Recurrent Upper Respiratory Infections: Frequent infections of the nose, sinuses, or throat that persist despite ongoing medical treatment and management.
Chronic Otitis Media: Persistent middle ear infections or fluid accumulation that can lead to hearing difficulties and long-term ear health complications.
Sleep-Disordered Breathing: Enlarged adenoids contributing to conditions like sleep apnoea or habitual, disruptive snoring, impacting sleep quality and overall well-being.

Benefits of Adenoidectomy

Adenoidectomy provides significant improvements in quality of life and health, including:

Improved Breathing: The removal of enlarged adenoids clears obstructed nasal airways, allowing for easier and more consistent breathing.
Fewer Infections: The procedure significantly reduces the frequency of upper respiratory tract infections and chronic ear infections, improving long-term health.
Enhanced Sleep Quality: Patients experience more restful sleep with fewer interruptions, as well as a decrease in snoring and other sleep disturbances.
Improved Ear Health: Adenoidectomy helps resolve persistent ear problems, such as chronic otitis media, and reduces the likelihood of hearing impairment over time.

Types of Surgical Techniques

Adenoidectomy can be performed using several approaches, each tailored to specific needs.

Conventional Curettage

This traditional method involves using a curved surgical tool called an adenoid curette to manually remove adenoid tissue. The surgeon scrapes the tissue under direct visualisation, often assisted by a mirror or endoscope. This approach is effective in ensuring complete removal and provides good control over the surgical field.

Powered Adenoidectomy

This technique employs a microdebrider, a powered surgical instrument that simultaneously cuts and suctions the adenoid tissue. It allows for precise removal with minimal bleeding and typically results in a faster recovery.

Coblation Technology

This method uses radiofrequency energy at lower temperatures to gently remove adenoid tissue. Coblation minimises damage to surrounding structures, reduces bleeding, and is associated with less post-operative pain.

Preparing for Surgery

Medical Evaluation: Before adenoidectomy, a medical evaluation is conducted, including a review of medical history and a physical examination. The ENT surgeon assesses adenoid size using a visual examination or imaging of the back of the nasal cavity. Blood tests may be done to check clotting function and overall health.
Medication Adjustments: Blood-thinning medications must be stopped 1-2 weeks before surgery. The surgeon reviews all current medications and supplements. Patients receive specific instructions about which medicines to continue or pause.
Pre-Operative Guidelines: No food or drink is allowed for 6-8 hours before surgery. Patients should wear comfortable clothing without metal fasteners. Remove all jewelery, contact lenses, and dental appliances before the procedure.

Step-by-Step Procedure

Anaesthesia Administration

General anaesthesia is administered to ensure the patient remains unconscious and pain-free during the procedure.

Surgical Access

The surgeon places a mouth gag to keep the oral cavity open. The soft palate is retracted to expose the adenoid region. Direct visualisation confirms that surgical instruments are properly positioned.

Adenoid Removal

The adenoid tissue is carefully removed using the selected surgical instrument. The surgeon ensures complete removal while preserving nearby structures. Bleeding is managed with suction and cautery as needed.

Completion and Inspection

The surgical area is carefully checked to ensure all adenoid tissue has been removed. Any bleeding is controlled, and the area is cleaned. The mouth gag is removed, and the patient is prepared for recovery.

Post-Surgical Care and Recovery

Immediate Post-operative Care: Patients are observed in the recovery room for 2-4 hours to ensure their condition stabilises after surgery. Once the patient is fully awake and alert, they may be given ice chips or small sips of water to soothe the throat and ensure they can swallow comfortably.
Recovery Process: Most patients can return home the same day after their clinic visit, provided there are no complications. A soft food diet is recommended for the first 1-2 weeks to minimise throat irritation and promote healing. Common symptoms such as mild throat pain and bad breath may last for 7-10 days but gradually improve as the throat heals. Strenuous activities should be avoided until approved by the surgeon, but most normal activities can be resumed within a week.
Follow-up Care: A follow-up appointment is typically scheduled 1-2 weeks after the procedure to monitor the healing process. During this visit, the surgeon examines the surgical site, addresses any lingering discomfort and ensures that recovery is on track.

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Potential Risks and Complications

Adenoidectomy complications include post-operative bleeding, which typically occurs within the first 24 hours. Infection risks are minimal but may require antibiotics if they develop. Voice changes may occur temporarily. Rare complications include anaesthetic reactions or injury to surrounding structures. Velopharyngeal insufficiency, in which air escapes through the nose while speaking, can occur but usually resolves on its own.

For Singaporeans & Singapore Permanent Residents

Medisave & Insurance Shield Plan approved

Your ENT procedure may be eligible for Medisave claims, with the claimable amount varying based on the procedure’s complexity. For additional options, including the use of your insurance or Integrated Shield Plan, reach out to our friendly clinic staff today for assistance.

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Frequently Asked Questions (FAQ)

Will adenoids recur after surgery?

It is uncommon for adenoids to recur significantly after removal. In rare cases, small amounts of remaining tissue may enlarge, especially in young children, but this usually does not cause problems.

How long does the surgery take?

The procedure itself usually takes 20-30 minutes. Including the time needed for anaesthesia and preparation, the entire process in the operating room typically lasts 45-60 minutes.

Can adenoidectomy impact the immune system?

Removing the adenoids does not compromise the immune system. The body has multiple mechanisms and components that continue to provide effective protection against infections and maintain overall immunity.

Dr Gan Eng Cern

Ear, nose and throat specialist

MBBS

MRCS (Edin)

mmed (orl)

FAMS

With over 15 years of experience, Dr Gan specialises in the comprehensive management of a broad range of conditions related to the ear, nose and throat (ENT), and head and neck.

Dr. Gan has contributed to the academic field as a Senior Clinical Lecturer at the Yong Loo Lin School of Medicine, National University of Singapore. He is recognised for his extensive research work, with numerous contributions to reputable international ENT journals. Dr Gan is also highly sought after as a speaker and has shared his surgical knowledge as a surgical dissection teacher at various prominent ENT conferences and courses.

2020 – Reader’s Choice Gold Award for Best ENT Specialist (Expat Living Singapore)
2016 – Best Educator Award (Eastern Health Alliance)
2016 – “Wow” Award (Patient Compliment)

2014 – Eastern Health Alliance Caring Award – Silver
2014 – 19th Yahya Cohen Memorial Lectureship (awarded by the College of Surgeons, Academy of Medicine Singapore for best scientific surgical paper)
2012 – Human Manpower Development Award (Ministry of Health, Singapore)
2007 – Singhealth Best Doctor Award

Qualifications

MBBS – Bachelor of Science, Bachelor of Medicine, Bachelor of Surgery (University of New South Wales, Sydney, Australia)
MRCS (Edin) – Member of the Royal College of Surgeons Edinburgh, United Kingdom
MMed (ORL) – Master of Medicine in ENT (National University of Singapore)
FAMS – Fellow of the Academy of Medicine Singapore

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