Effects of adenoidectomy and adenotonsillectomy on the components of Waldeyer ring


  • Vikram K. Bhat Karnataka Institute of Medical Sciences, HUBLI
  • Deekshith Shetty Karnataka Institute of Medical Sciences Hubli
  • Preetham H. Nagaiah Karnataka Institute of Medical Sciences Hubli




Adenoidectomy, Adenotonsillectomy, Waldeyer ring


Background: The consolidated effects of adenoidectomy alone and adenotonsillectomy on the Waldeyer ring need to be studied in children.

Methods: This was a clinical trial with a sample size of 100 in each of the two arms [Group A: adenoidectomy alone, Group B: adenotonsillectomy].  

Results: It was found that the association between adenoid recurrence (Risk 3 times) and palatine tonsil hypertrophy (Risk 11 times) in Group A patients at 3 and 6 months was extremely significant. Whereas lingual tonsil hypertrophy was found to be highly associated with Group B.

Conclusions: If adenoidectomy alone is performed, there are high chances of hypertrophy of palatine tonsils, lateral pharyngeal bands and a high risk of adenoid recurrence. If adenoidectomy and tonsillectomy are performed together there is some chance of lingual tonsil hypertrophy. Hence it would be prudent to perform both the surgeries simultaneously in most children for better control of chronic infections and obstructive sleep apnoea symptoms.

Author Biographies

Vikram K. Bhat, Karnataka Institute of Medical Sciences, HUBLI

Senior Associate Professor and Unit chief in ent

Deekshith Shetty, Karnataka Institute of Medical Sciences Hubli

Resident in ENT


Guttman D, Shvero J. Lingual tonsil hypertrophy in patients with a history of palatine tonsillectomy. Medical Connections. 2014;9:43-6.

Duval M, Chung JC, Vaccani JP. A case-controlled study of repeated adenoidectomy in children. JAMA Otolaryngol Head Neck Surg. 2013;139(1):32-6.

Ozmen S, Ozmen O. Failure rate of adenoidectomy and reasons of failure in the short term. Int J Otolaryngol Head & Neck Surgery. 2012;1:14-7.

Lesinskas E, Duigolas M. The incidence of adenoidal regrowth after adenoidectomy and its effect on persistent nasal symptoms. Eur Arch Otorhinolaryngol. 2009;266:469-73.

Monroy A, Behar P, Brodsky L. Revision adenoidectomy: A retrospective study. Int J Pediatr Otorhinolaryngol. 2008;72(5):565–70.

Joshua B, Bahar G, Sulkes J, Shpitzer T, Raveh E, Tikua P. Adenoidectomy long term follow up. Otorhinolaryngol Head Neck Surg. 2006;135(4):576-80.

Emerick KS, Cunningham MJ. Tubal tonsil hypertrophy: a cause of recurrent symptoms after adenoidectomy. Arch Otolaryngol Head Neck Surg. 2006;132(2):153-6.

Kay DJ, Bryson PC, Casselbrant M. Rates and risk factors for subsequent tonsillectomy after prior adenoidectomy: A regression analysis. Arch Otolaryngol Head Neck Surg. 2005;131(3):252-5.

Farrel J, Lowry M, Isaacson G. Do adenoids regrow after excision? Otolaryngol Head Neck Surg. 2000;123(5):576-81.

Tolczynski B, Yorkton, Sask. The recurrence of adenoids. Canada Med Association J. 1955;72:672-3.






Original Research Articles