ENT SURGERY
Adenotonsillectomy
Adenotonsillectomy is one of the most commonly performed ENT procedures in the world. It is most frequently performed in children but is also performed in adults when both structures are causing significant symptoms. At Royal Eye & Ear Hospital, our ENT specialist performs adenotonsillectomy with the care, skill and child-friendly approach that gives patients and families complete confidence.
What Is Adenotonsillectomy
Adenotonsillectomy is the surgical removal of both the tonsils and the adenoids in a single procedure. The tonsils are two pads of lymphoid tissue at the back of the throat. The adenoids are a similar mass of lymphoid tissue sitting behind the nasal passages, above the throat. Both are part of the immune system. Both can become chronically enlarged or infected — causing overlapping and often compounding symptoms.
When both structures are causing problems, removing them together is more efficient than two separate procedures. One anaesthetic. One recovery. One definitive resolution of all symptoms related to both structures.
How It Works
Adenotonsillectomy involves Five precise steps:
- General anaesthesia — You or your child are completely asleep throughout. Nothing is felt during the procedure.
- Tonsil removal — A small retractor holds the mouth open. The surgeon dissects and removes both tonsils completely, including their capsules, through the mouth. No external cuts.
- Adenoid removal — Using a curette, microdebrider or diathermy through the mouth and back of the nose, the adenoid tissue is removed from behind the nasal passage. Again, no external cuts.
- Haemostasis — All bleeding points are carefully controlled. Thorough haemostasis of both surgical sites is confirmed before closure.
- Closure — No stitches required. Both wounds heal naturally. The procedure is complete.
The procedure takes 45-60 minutes. Same-day discharge in most cases.
Why Choose Royal Eye & Ear Hospital for Adenotonsillectomy?
Adenotonsillectomy requires careful patient selection, thorough pre-operative assessment and the skill to safely perform two ENT procedures simultaneously — particularly in young children with smaller airways.
- 🏥 Dedicated ENT Specialists We are a specialist eye and ear hospital. Adenotonsillectomy is a core part of our ENT surgical programme — performed routinely and with the consistent clinical standards this combined procedure demands.
- Experienced Surgical Team Our ENT surgeons are experienced in combined adenotonsillectomy across all age groups — from young children to adults. Safe, precise technique at both surgical sites minimises bleeding risk and ensures optimal outcomes.
- 📍 Conveniently Located in Nairobi Based on 3rd Parklands Avenue, we serve patients from Westlands, Parklands, Gigiri, Muthaiga, and across the greater Nairobi region.
- 💊Same-Day Discharge Adenotonsillectomy is performed as a day procedure in most cases. Patients go home the same day once comfortable, awake and able to drink.
- 🔬 Combined Procedures Available Adenotonsillectomy can be combined with grommet insertion when glue ear or recurrent ear infections are also present — addressing all contributing ENT problems in a single anaesthetic episode.
Benefits of Adenotonsillectomy
One Operation
Both sources of the problem are removed simultaneously.
Transforms Sleep
Removing both restores free, unobstructed breathing during sleep.
Clears Nasal Breathing
Mouth breathing, dry mouth, bad breath and nasal speech all resolve.
Ends Recurring Infections
Recurrent tonsillitis and recurring ear infections linked to adenoid obstruction of the Eustachian tube both improve significantly after adenotonsillectomy.
Improves Speech
Restoring clear nasal breathing and normal sleep gives children the auditory and cognitive environment they need to develop normally.
Supports Growth
Growth hormone is released primarily during deep sleep. Children with obstructive sleep apnoea from enlarged tonsils and adenoids are often deprived of the deep sleep they need.
What to Expect After Adenotonsillectomy
Timeline:
Day 1
Both throat and nasal areas will be sore. The patient wakes groggy. Cool fluids are offered in recovery before going home. Some bloody nasal discharge and a blocked nose are normal in the first day or two from the adenoid site.
Days 1-3
Throat pain and nasal congestion are at their most noticeable. Give pain medication regularly as prescribed — do not wait for the pain to peak. Encourage cool fluids and soft foods. Rest at home completely.
Days 4-7
Pain typically peaks around days 4-5 as healing scabs form in the throat. Continue all pain medication as directed. Hydration is critical — dehydration is a leading cause of hospital readmission after adenotonsillectomy. Keep the patient drinking even when swallowing is uncomfortable.
Week 2
Significant improvement in comfort. Most children return to school after 10-14 days once pain is manageable and eating and drinking are normal. Adults typically return to desk-based work in the same timeframe.
Full recovery
Children mostly have no pain or mild pain 14 days after adenotonsillectomy. Most patients reach full recovery within two weeks. Nasal breathing improvements and sleep improvements are often noticed even before full recovery is complete.
Recovery Do's and Dont's:
Do’s:
✅ Give pain medication regularly and on schedule — essential for managing recovery
✅ Encourage constant cool fluids — hydration is the most important recovery action
✅ Offer soft, cool foods — ice cream, yoghurt, smooth soups, mashed foods
✅ Rest at home for at least one to two weeks
✅ Attend the follow-up appointment without exception
✅ Monitor for any signs of bleeding and seek emergency care immediately if present
Don’ts:
❌ Do not give aspirin — it significantly increases bleeding risk
❌ Do not allow hard, sharp or scratchy foods — crisps, toast, crackers, nuts
❌ Do not allow strenuous exercise or rough play for two weeks
❌ Do not return to school or work until eating normally and off strong pain relief
❌ Do not ignore bright red bleeding from the mouth or nose — seek emergency care immediately
❌ Do not smoke around a recovering patient — smoke severely delays healing
RESULTS
What Results Can You Expect?
1
Transformed Sleep
The most dramatic and immediate result.
2
Quality of life
Surgery delivers measurable, objective improvements
3
Clear Nasal Breathing
Breathe freely through your nose after adenoid removal.
4
End of Recurring Infections
Recurrent tonsillitis and adenoid-related ear infections both reduce dramatically.
Risks & Considerations of Adenotonsillectomy⚠️
Adenotonsillectomy is a safe and commonly performed procedure. At Royal Eye & Ear Hospital our ENT surgeon takes every precaution to minimise risk. All surgical procedures carry some risk and patients and parents should be aware of the following.
1
Post-Operative Bleeding
The most important risk. Bleeding complications prevalence is approximately 4.1% after adenotonsillectomy. Bleeding can occur at any time from surgery up to 21 days afterward. Bright red blood from the mouth or nose requires immediate emergency assessment. Avoid aspirin, ibuprofen and strenuous activity during recovery to minimise this risk.
2
Dehydration
Pain on swallowing makes drinking difficult. Patients who do not maintain adequate fluid intake become dehydrated — the leading cause of hospital readmission after adenotonsillectomy. Consistent fluid intake throughout recovery, even when swallowing is uncomfortable, is essential.
3
Pain
Throat pain is expected for 10-14 days after adenotonsillectomy. Pain peaks around days 4-5. Regular prescribed pain relief manages it effectively. Nasal discomfort from the adenoid site is milder and shorter-lived than throat pain.
Patient outcome note: Your surgeon will discuss all risks clearly before surgery. For children and adults with significant combined tonsillar and adenoid disease, the benefits of adenotonsillectomy consistently and substantially outweigh these manageable risks.
Frequently Asked Questions About Adenotonsillectomy
Adenotonsillectomy removes both the tonsils and adenoids in one procedure. Tonsillectomy removes only the tonsils. Adenoidectomy removes only the adenoids. When both structures are enlarged and causing symptoms, adenotonsillectomy is the most efficient approach — one anaesthetic, one recovery, complete resolution of all related symptoms in a single episode.
Adenotonsillectomy can be performed in children from around 2-3 years of age when symptoms are severe enough to justify surgery. It is most commonly performed in school-age children. There is no upper age limit — adults also undergo the procedure when both structures are causing significant symptoms. Your surgeon will assess suitability at consultation.
No. Both structures are only a small part of the body’s immune defence system. Removing them does not meaningfully weaken immunity. Children who suffer from chronic infection are typically healthier after removal because the source of repeated infection has been eliminated.
Adenoid tissue can regrow — particularly in very young children. This is uncommon and if regrowth causes significant symptoms, a second procedure can be performed. Tonsils do not regrow after complete removal.
Our happy customers
We’ve helped thousands of patients
Here is what they say…
Codey Joyner
UrbanAcres, LLC
“My move was way less stressful than expected! Movely packed everything, stored it for a week, and moved it all to my new home just as promised!”
Eren Hill
H&H Legal Partners
“Movely provided a very professional service when we moved offices last month. They were easy to work with and moved everything on time.”
Emanuel Sadler
SavvyMarket
Best experience ever! I desperately needed a mover to help with a last minute relocation, and Movely was so helpful in making it a seamless process!”
Ready to Restore Your Vision?
Don’t let cataracts rob you of your independence. Our specialist team at Royal Eye & Ear Hospital is ready to help you see clearly again.
Royal Eye & Ear Hospital © 2026 All Rights Reserved.