Pharyngeal tonsils are masses of lymphoid tissue embedded in the mucosa of the nasopharynx posterior wall, part of Waldeyer's lymphatic system and the body’s defence mechanism. When increased in size, these tonsils are called adenoids and can occupy various parts of the pharyngeal cavity.
In some people, excessive growth can cause nasopharyngeal blockade, which increases the risk of recurrent infections and various cardio-respiratory complications.
Often adenoidectomy is performed at the same time as  tonsillectomy. Tonsils serve as immuno-protective agents but in some people and especially children who have large tonsils, these glands may act with less or no effectiveness at all and cause frequent throat and ear infections or even obstruct breathing.

Surgeons recommends adenoidectomy when the adenoids obstruct the airway, snore in excess, have trouble breathing in the nose, have sleep apnoea.
Adenoidectomy is recommended if the adenoids interfere with the patient’s daily life, should they persist despite treatment with antibiotics if they have more than 5 relapses per year, or 3 or more relapses per year during a period of 2 years.
It is common for the adenoids to shrink as the child reaches puberty, and adenoidectomy is rarely needed after becoming an adolescent.
Tonsillectomy is advisable when tonsillitis crises become so frequent or severe that the patient's general health is affected or daily activities, hearing or breathing are hindered.
The specific guidelines for surgery are five or more tonsillitis episodes in any one year, or three or more episodes per year over a period of two years, or severe tonsillitis or tonsillitis not responding to antibiotics.

The surgeon holds the patient's mouth open to make the tonsils visible. The glands are distended from the back of the throat and are removed. Bleeding  is then monitored- often the cut heals on its own with no need for sutures.

The doctor will indicate requirements, specific to each patient.

The most common complication is bleeding, which if severe may require the patient to return to the operating theatre.
Any surgery involves risks, but dehydration can occur (due to lack of fluid intake), fever, difficulty breathing (swelling of the tissues of the throat), reactions to medications, respiratory problems, infection, swallowing or injury to the uvula (soft palate).

During the recovery period, the patient may suffer from nasal congestion, nasal drainage and sore throat.
After surgery, there is a reduction in but not a complete removal of the incidence of throat infection. During the recovery period, it is recommended to eat soft, easy to swallow foods and to drink a lot of cold liquids. During the first two weeks after surgery, the patient may go through mood swings.

Complete recovery may take two weeks. Sore throat and ear pain is commonplace in the first days after surgery.