Status: Individual prior approval
Effective date: 1 April 2026
Next review date: 1 April 2028
Adenoids are small lumps of tissue at the back of the nose, above the roof of the mouth. Adenoids are part of the immune system, which only children have. They start to grow from birth and are at their largest when a child is around three to five years of age. Adenoids tend to shrink by adulthood and will often have disappeared.
Adenoidectomy is the surgical removal of adenoids. Adjuvant Adenoidectomy is adenoidectomy performed alongside another ENT procedure (e.g., grommets).
Essex ICB commissions adjuvant adenoidectomy on a restricted basis.
Individual prior approval-Adjuvant adenoidectomy for glue ear (OME/AOM)
Adjuvant adenoidectomy for the treatment of glue ear should only be offered to children under 12 years of age when one or more of the following clinical criteria are met:
- The child has persistent and/or frequent nasal obstruction contributed to by adenoidal hypertrophy, or
- The child is undergoing re‑insertion of grommets due to recurrence of previously surgically treated otitis media with effusion (OME), or
- The child is undergoing grommet surgery for treatment of recurrent acute otitis media (AOM).
Not routinely funded: Adjuvant adenoidectomy is not routinely funded in children under 12 undergoing initial grommet insertion for the treatment of OME.
Adenoidectomy is routinely funded in the following circumstances:
- As part of treatment for obstructive sleep apnoea or sleep disordered breathing in children (e.g. as part of adenotonsillectomy)
- As part of the treatment of chronic rhinosinusitis in children
- For persistent nasal obstruction in children and adults with adenoidal hypertrophy
- In preparation for speech surgery in conjunction with the cleft surgery team.
Patients not meeting the above criteria will not be funded unless there are clinically exceptional circumstances.
Individual funding requests should only be made where the patient demonstrates clinical exceptionality.
Further information on applying for funding in exceptional clinical circumstances can be found on the ICB’s website.
See also: SRP-054 Grommets (OME thresholds; observation; audiology requirements).
See also: SRP-103 Tonsillectomy/Adenoidectomy for Recurrent Tonsillitis (shared decision-making and OSA indications)
References:
Removal of adenoids for treatment of glue ear
NICE NG233: Otitis media with effusion in under 12s (Aug 30, 2023) — diagnostic, observation and surgical management standards. [nice.org.uk]
NHS Evidence-Based Interventions (EBI): Tonsillectomy for recurrent tonsillitis (Published Jan 2019; last reviewed Sep 2024) [ebi.aomrc.org.uk]
NICE IPG328: Removing adenoids using heat and suction — technique guidance for suction diathermy adenoidectomy. [nice.org.uk]
ENT-UK Commissioning Guide: Tonsillectomy (Jan 2021) — pathway considerations for adenotonsillectomy in paediatric OSA