Surgery to remove the adenoids
Surgery to remove the adenoids is the most common surgical intervention in young children. But before talking about the operation itself, it is necessary to understand what adenoids are and in what cases they should be deleted.
What are adenoids
Adenoids are a nasopharyngeal tonsil, one of eight tonsils that are part of the immune system. Adenoids consist of lymphoid tissue and actively fight infection that enters the body through the nasopharynx.
Up to 7 years of age, adenoids in a child can greatly increase, interfering with nasal breathing. Especially often suffer from adenoids kids aged 3-4 years.
How is the disease manifested
The child often begins to get sick with common colds. Each time with another cold, the adenoids increase slightly, and when the disease passes, they decrease again. But if a child gets cold often, then in a short period of time the adenoids do not have time to return to normal and gradually swell more and more. As a result:
the child does not breathe through the nose, which is especially noticeable when he sleeps;
in a dream he snores and snores, and sometimes (in severe cases) he has breath-holdings – the so-called obstructive apnea;
he is tormented by a constant runny nose;
he is nasal;
from the nose all the time;
the child often has a headache;
his hearing is deteriorating;
sometimes it is difficult for him to swallow food.
All this suggests that the child has adenoiditis – inflammation of the nasopharyngeal tonsil.
How to detect adenoids
When parents go to the ENT doctor with the symptoms described above, the doctor examines the child’s nasopharynx with mirrors or an endoscope. This is necessary, since with a simple visual inspection the adenoids are not visible. When using the endoscope, the doctor as well as the parents see the entire nasopharynx on the monitor. This procedure, of course, is not too pleasant, but it is absolutely harmless and necessary to make the correct diagnosis. The only restriction is that such an examination should be carried out if the child is not sick at that moment, otherwise the picture will be false. Children also perform ear impedancemetry or audiometry to evaluate the performance of the auditory tubes.
Having diagnosed, the doctor offers parents either a conservative treatment or an operation: adenectomy — complete removal of the adenoids or adenomotomy — partial removal.
Indications and contraindications for surgery to remove adenoids
Usually an operation is prescribed if:
conservative methods of treatment during the year did not produce results and adenoiditis in a child develops 4 times a year or more;
breathing through the nose of a child is seriously impaired, sleep apnea with breath holding 10 seconds or more appears;
the child suffers from exudative otitis and his hearing is reduced;
there is a suspicion of tissue malignancy;
swollen tonsils cause maxillofacial anomalies.
The operation is contraindicated in case of serious cardiovascular diseases, blood clotting diseases, bronchial asthma and severe allergies. In addition, it is impossible to remove adenoids during acute infectious diseases and exacerbations of chronic diseases. In this case, you must wait 2 months after recovery. Relative contraindication – age up to 3 years. So babies surgery is carried out only for health reasons.
Classic adenoid surgery
The operation is performed in the morning on an empty stomach, usually under local anesthesia – with freezing of the mucous membrane of the pharynx. The adenoids are removed with a pointed loop (Beckmann’s knife): the tongue is pressed with a spatula to the lower palate, the loop is inserted into the mouth and the surgeon cuts off adenoid tissue with one movement. To prevent re-growth of the adenoids and reduce blood loss, the surface of the adenoids is treated with a hot loop — electrical coagulation is carried out.
Bleeding after surgery, as a rule, not much or no.
On the first day after the operation, the child should not be given solid food in order not to irritate the oral mucosa.
Laser removal of adenoids
With the help of a laser, the adenoids are either evaporated or cut off. In the first case, this is the so-called vaporization – burning the surface of the fabric with hot steam. The placement is indicated for the removal of small adenoids. Large adenoids coagulate – cut off with a focused laser beam.
As a rule, during vaporization, the adenoids are not completely removed, and they grow back, so you have to do the operation several times. When using the loop, the adenoids are cut off entirely, which minimizes the likelihood of their re-growth.
If the doctor recommends surgery, you should heed his advice. And remember that adenoids are removed, not because the child is often sick, but because, expanding, they do not allow the baby to breathe through the nose and cause such complications as apnea, sinusitis, otitis, sinusitis.