Many parents are faced with adenoid growth, but few understand what this term means. Moms and dads have even more questions when a doctor recommends removing adenoids. Of course, any operation in childhood is a serious test for the baby's body and for the nervous system of the parents. But sometimes surgery is the only right choice.
Pediatrician, neonatologist
The final decision - to agree to an operation or to continue conservative therapy - is made by the parents. They must understand what they are dealing with, what to expect from the operation and when they can postpone, and when they should immediately run to the doctor. Moreover, there are clear indications for the operation.
What are adenoids
In the oral cavity and nasopharynx, there are accumulations of lymphoid tissue - tonsils. The pharyngeal lymphatic ring consists of 6 tonsils, the main function of which is protective. Being in the path of inhaled air, the tonsils protect the body from infectious agents.
It happens that frequent colds lead to a decrease in the function of lymphoid tissue, and the amygdala itself grows. The most famous tonsils are palatine, and their inflammation is called tonsillitis, or tonsillitis. To detect enlarged palatine tonsils, no special examination is required. To make a diagnosis, the pediatrician just needs to look into the child's mouth.
The situation with the adenoids is more complicated, because the adenoids are the growth of the only tonsil, which is located in the nasopharynx. It is impossible to see the pathological condition of the pharyngeal tonsil without special mirrors. But the symptoms of adenoids are very specific, parents themselves can suspect the disease.
How to identify adenoids in children?
It is not difficult to guess about the growth of the pharyngeal tonsil, it is enough to be attentive to the child and know the main symptoms of adenoids in children.
The enlarged amygdala interferes with the free flow of air, it becomes difficult for the baby to breathe through the nose. Congestion can manifest itself against the background of a cold, profuse serous discharge or without catarrhal manifestations.
- Runny nose.
The disease leads to a deterioration in the condition of the nasal mucosa, palatine arches, nasal concha. Often there are rhinitis, sinusitis, which are difficult to cure.
- Sleep disturbance.
Insufficient oxygen supply affects the quality of sleep, the baby does not sleep well, often he has nightmares. In the morning, the baby wakes up irritated and capricious, the general condition of the child is disturbed. Snoring occurs, breathing changes, there are attacks of suffocation associated with the retraction of the root of the tongue.
- Voice change.
Often, parents pay attention to the change in the child's voice, the baby begins to nasal.
- Decreased hearing.
The overgrown lymphoid tissue closes the opening of the auditory tube, and the baby's hearing deteriorates. There is pain in the ear, appear.
- Adenoiditis.
In the event that an infection is layered on the overgrown tissue, adenoiditis occurs. Inflammation of the adenoids leads to an increase in body temperature, an increase in lymph nodes, and intoxication.
- Face change.
With a long course of the process, the development of the bone tissue of the face is disturbed, the lower jaw is lengthened, the bite is disturbed. The child gets used to keeping his mouth open, there is an "adenoid" type of face. With early treatment, these changes can be reversed. If treatment is not prescribed on time, the child remains with the consequences of adenoids forever.
- Chronic hypoxia.
The baby is constantly in conditions of a lack of oxygen, this affects the general condition, well-being of the child. Children often have anemia and problems with appetite.
- Deterioration of the general condition of the child.
The constant lack of oxygen is manifested by increased fatigue, in younger children, the pace of development slows down.
The degree of adenoids in children
Examining the child, the doctor pays attention to how much the pharyngeal tonsil is enlarged and indicates the degree of adenoids in the diagnosis.
- Grade 1 adenoids.
The pharyngeal tonsil is moderately enlarged, during the day the child does not feel discomfort. The first manifestations occur at night, when signs of respiratory failure appear.
- Grade 2 adenoids.
The amygdala is significantly enlarged, covering 2/3 of the height of the nasal passages. The manifestations of the disease increase, breathing is impaired day and night, snoring appears. The child often keeps his mouth open.
- Grade 3 adenoids.
The overgrown formation closes almost completely the flow of air into the nasopharynx. The baby breathes with his mouth open, air enters only through the oral cavity.
According to Dr. Komarovsky, the degree of proliferation of the pharyngeal tonsil plays an indirect role in deciding on the operation. There are cases when adenoids of the first degree lead to severe complications. Sometimes babies with third-degree adenoids have only mild breathing difficulties.
Do you need an operation?
A significant increase in the amygdala leads to severe complications that affect the health and quality of life of the child. But is it possible to remove adenoids in a child or can conservative therapy be managed?
All over the world there are clear indications for the removal of adenoids in children.
The indications for the removal of adenoids in children are as follows.
- Difficulty nasal breathing.
- Sleep disturbances, changes in breathing at night, shortness of breath, snoring.
- Hearing impairment, repeated episodes of otitis media.
- Sinusitis, frequent exacerbations of the disease.
- Changes in the bones of the facial skull, "adenoid" type of face.
When deciding whether to remove adenoids in a child, they pay attention to the child's breathing. If the baby has episodes of shortness of breath, it becomes dangerous to postpone the intervention.
The otolaryngologist will help you choose the right treatment, taking into account the child's age, clinical condition, visual examination of the adenoids. Examining the adenoids and deciding whether it is worth removing the adenoids for the child, the doctor assesses the condition of the pharyngeal tonsil.
If, when examining the tonsil, the doctor pays attention to swelling, the presence of pus and mucus, signs of inflammation, then the operation should be postponed. Return to this question should be after the disappearance of signs of inflammation.
When is the best time to remove adenoids from a child?
To achieve good results, you need to carefully choose the time to remove the adenoids in the baby's nose. This operation is performed as planned, which means that you need to choose a time when the child is not sick. You should not agree to the intervention if the crumbs show signs of rhinitis, exacerbation of chronic diseases.
Since children are sick for a long time, it can be difficult to choose the right moment for the operation. Often the period of absolute health of the crumbs falls on the summer months.
Doctors say summer is not the best time for surgery, as hot weather increases the risk of infection and bleeding. The optimal period for the removal of adenoids is considered to be the end of summer and the beginning of autumn.
At what age are adenoids removed in children?
The effectiveness of the operation is greatly influenced by the age of the child. You should not perform the operation on a child under 2 years old, since the pharyngeal tonsil contains lymphoid tissue, forms the body's immune defense.
The nasopharyngeal tonsil reaches its maximum size at the age of 3 to 7 years. It is at this age that repeated episodes of the disease are possible.
In children over 7 years of age, the activity of lymphoid tissue is significantly reduced, and the risk of the disease returning is reduced.
If the doctor has identified serious indications for surgery, then age is not a contraindication to the intervention. It is dangerous to postpone surgery in the hope of preventing tissue overgrowth. Inadequate therapy for adenoids can lead to hearing loss, skeletal deformity, chronic sinusitis, and otitis media.
Treatment of adenoids in children
One of the reasons for the appearance of adenoids is infections of bacterial and viral origin. Proper rational treatment of a respiratory infection contributes to the regression of an enlarged tonsil. If the child is sick for a long time and often, the amygdala simply does not have time to return to its normal size.
The treatment of adenoids must be approached comprehensively. Doctors recommend taking medications in combination with physiotherapy. Vasoconstrictor drops, antimicrobial agents are often prescribed. From physiotherapeutic procedures, UFO, UHF, electrophoresis are recommended.
In the case of adenoiditis of allergic etiology, the use of antihistamines has a good result. With the help of antiallergic drugs, edema decreases, the amygdala takes on its normal size.
If the adenoids have grown significantly and interfere with normal life, the question of surgical treatment of the disease is being resolved. As with any operation, there are certain contraindications to the removal of adenoids (adenotomy).
Contraindications to adenotomy
- Infectious diseases.
Acute adenoiditis, tonsillitis, rhinitis, or exacerbation of any chronic disease require a delay in surgery.
- Epidemics of infectious diseases.
You should not carry out the operation in the midst of infectious diseases, flu. It is advisable to wait for a better time for the procedure.
- Less than 1 month after vaccination.
For an adenotomy, it is better to choose the time when the child's body is ready to fully resist the increased load on the immune system. The period after vaccination is not the best time for any surgical intervention.
- Oncological diseases.
Any malignant disease, especially blood disease, is a serious contraindication to surgical treatment.
- Allergic diseases.
It is necessary to postpone the intervention if the baby has any manifestations of allergies.
Methods for removing adenoids in children
Choosing surgical treatment, parents must decide on the method of removing the lymphoid tissue. Nowadays, in addition to traditional surgery, there are other ways to carry out an intervention to remove the adenoids. An otolaryngologist can help with the choice, who will suggest the best way for the child.
This operation usually takes place under local anesthesia. With a special ring-shaped scalpel, the doctor grabs the overgrown tissue and cuts it off. The duration of the intervention is short - up to 10 minutes, but the disadvantages of this method are obvious.
Cons of the method:
- excision occurs almost blindly, therefore, high accuracy and professionalism of the operating doctor is required;
- severe pain syndrome;
- the risk of bleeding;
- since the anesthesia of the operation is performed under local anesthesia, the risks of psychological trauma are high.
Plus of the method:
- low price, the method is available to absolutely everyone at any age.
Endoscopic removal of adenoids in children
Removal of adenoids in children using an endoscope is a modern method that allows you to effectively get rid of the problem.
The advantages of the method are as follows.
- General anesthesia.
During the intervention, the baby sleeps and does not feel pain, quickly forgets about the operation. Modern methods of anesthesia have a short effect, after a few hours there is no trace of anesthesia.
- High-precision method.
During the operation, the doctor has the opportunity to monitor the intervention, eliminate tissue bleeding. The risk of incomplete removal of adenoids decreases, the frequency of relapses and repeated growths decreases.
- Fast discharge from the hospital.
In the absence of complications, the child is discharged home 3-5 days after the procedure.
Flaws:
- high cost of the operation.
Laser removal of adenoids
A special laser scalpel is used for this operation. When exposed to a scalpel, heating and tissue destruction occurs.
The advantages are as follows.
- Accuracy.
Even small growths can be removed.
- Disinfection.
The laser also has disinfecting properties, destroys pathogenic microbes, which is the prevention of infectious complications.
- Minimal risk of bleeding.
The laser instantly "closes" the vessels at the incision site, no additional funds are required to prevent bleeding.
- Painlessness.
The laser beam instantly destroys the nerve cells at the incision site, so there is no severe pain.
- Fast recovery.
Already in a day, the child can begin his usual activities, and after 2-4 weeks, the amygdala is completely healed.
Flaws:
- if the overgrowth is pronounced, laser treatment may not be enough. In such cases, resort to classical or endoscopic removal;
- the cost of the operation.
Cryotherapy of adenoids in children
Cryotherapy, or removal of adenoids with liquid nitrogen, is a modern, almost painless way to get rid of small growths. The operation for children is simple. In a sitting position, a special tube is inserted into the child's mouth and the adenoids are removed.
The advantages of the method are as follows.
- Painlessness, bloodlessness.
Liquid nitrogen freezes nerve cells and clogs blood vessels, so children can easily tolerate surgery.
- Short duration of the procedure.
The duration of exposure to liquid nitrogen is 2-3 seconds, the manipulation is repeated several times with an interval of 1-2 minutes.
- Fast checkout.
After the manipulation, the doctor examines the child's mucous membrane and lets him go home. Complete healing of the tonsil lasts 2-4 weeks.
Minuses:
- inability to operate on large adenoids;
- the cost of the operation.
Recovery period
How quickly the child will return to normal after the operation depends on the type of operation, the size of the adenoids and the resistance of the child's body. All patients are given recommendations, thanks to which the healing process is faster.
- Compliance with the regime.
If the operation is performed classically or endoscopically, you need to stay in bed on the first day after the procedure. Walking is allowed a few days after the operation, and visiting kindergarten or school - at least a week later. It is worth limiting physical activity within 2 weeks after the intervention.
- Personal hygiene.
Do not forget about daily brushing your teeth 2 times a day. Supplement oral and throat hygiene by rinsing with a disinfectant solution after meals. Rinsing the nasal passages with saline is allowed 2-3 days after the intervention.
- Avoiding temperature extremes.
If the operation took place in the cold season, you should avoid the child's stay in the cold for a long time. Heat inhalations, swimming pools, saunas, baths are prohibited.
- Diet.
Avoid foods that can injure the delicate mucous membrane after surgery. It is recommended to take only warm, liquid, soft food. Mild soups, cereals, stewed vegetables are perfect. Some experts recommend eating cold food and ice cream on the 2-3rd day after treatment. This promotes early healing of wounds.
Conclusion
Adenoids are a very common disease among frequently ill children. The question of whether it is necessary to remove the adenoids and how best to do it arises among many parents. Whether surgical treatment is necessary or whether it is possible to dispense with the use of drugs is decided by the otolaryngologist individually in each case.
(3 estimates, average: 5,00 out of 5)Graduated from Lugansk State Medical University with a degree in Pediatrics in 2010, graduated from an internship in Neonatology in 2017, in 2017 she was assigned category 2 in Neonatology. I work in the Lugansk Republican Perinatal Center, previously - a department for newborns in the Rovenka maternity hospital. I specialize in nursing premature babies.
All materials on the site were prepared by specialists in the field of surgery, anatomy and specialized disciplines.
All recommendations are indicative and cannot be applied without consulting your doctor.
Adenotomy is one of the most frequent surgical interventions in ENT practice, which does not lose its relevance even with the appearance of a mass of other methods of treating pathology. The operation eliminates the symptoms of adenoiditis, prevents the dangerous consequences of the disease and significantly improves the quality of life of patients.
Often, adenotomy is performed in childhood, the predominant age of patients is babies from 3 years old and preschool children. It is at this age that adenoiditis is most widespread, because the child is actively in contact with the external environment and other people, meets new infections and develops immunity to them.
The pharyngeal tonsil is part of the Valdeyer-Pirogov lymphoid ring, which is designed to contain the infection below the pharynx. The protective function can turn into a serious pathology when the lymphatic tissue begins to grow disproportionately more than is required for local immunity.
An enlarged amygdala creates a mechanical obstruction in the pharynx, which is manifested by impaired breathing, and also serves as a hotbed of constant reproduction of all kinds of microbes. The initial degrees of adenoiditis are treated conservatively, although the symptoms of the disease are already there. The lack of effect from therapy and the progression of pathology leads patients to a surgeon.
Indications for removal of adenoids
In itself, an increase in the pharyngeal tonsil is not a reason for surgery. Specialists will do everything possible to help the patient in a conservative way, because the operation is an injury and a certain risk. However, it happens that you cannot do without it, then the ENT weighs all the pros and cons, talks with the parents, if we are talking about a small patient, and appoints the date of the intervention.
Many parents know that the lymphoid pharyngeal ring is the most important barrier to infection, therefore they are afraid that after the operation the child will lose this protection and will become sick more often. Doctors explain to them that the abnormally overgrown lymphoid tissue not only does not fulfill its direct role, but also supports chronic inflammation, prevents the child from growing and developing correctly, creates the risk of dangerous complications, therefore, in these cases, one cannot hesitate or hesitate, and the only way is to save the child from suffering will be surgical intervention.
The indications for adenotomy are:
- Grade 3 adenoids;
- Frequent recurrent respiratory infections that do not respond well to conservative therapy and cause the progression of adenoiditis;
- Recurrent otitis media and hearing loss in one or both ears;
- Violations of speech and physical development in a child;
- Difficulty breathing with sleep apnea;
- Changes in the bite and the formation of a specific "adenoid" face.
degree of adenoiditis
The main reason for the intervention is the third degree of adenoiditis, entailing difficulty in breathing through the nose, and constantly exacerbating infections of the upper respiratory tract and ENT organs. In a small child, the correct physical development is disturbed, the face acquires characteristic features, which it will be almost impossible to correct later. In addition to physical suffering, the patient experiences psycho-emotional anxiety, lacks sleep due to the impossibility of normal breathing, and intellectual development suffers.
Difficulty nasal breathing and frequent infections of the ENT organs are considered the main symptoms of severe adenoiditis. The child breathes through the mouth, because of which the skin of the lips becomes dry and cracked, and the face becomes puffy and stretched. Attention is drawn to the constantly open mouth, and at night the parents hear with concern how hard it is for the baby to breathe. There may be episodes of nocturnal respiratory arrests, when the amygdala completely blocks the airways with its volume.
It is important that the surgery to remove the adenoids is performed before there are irreversible changes and serious complications of a seemingly small problem limited to the pharynx. Late treatment and, moreover, its absence can cause disability, therefore, it is unacceptable to ignore the pathology.
The best age for adenotomy in children is 3-7 years. Unreasonable postponement of the operation leads to serious consequences:
- Persistent hearing loss;
- Chronic otitis media;
- Changes in the facial skeleton;
- Dental problems - malocclusion, caries, violation of the eruption of permanent teeth;
- Bronchial asthma;
- Glomerulopathy.
Adenotomy, although much less common, is also performed in adult patients. The reason may be:
- Nocturnal snoring and trouble breathing during sleep;
- Frequent respiratory infections with diagnosed adenoiditis;
- Recurrent sinusitis, otitis media.
Contraindications to the removal of adenoids have also been identified. Among them:
- Age up to two years;
- Acute infectious pathology (flu, chickenpox, intestinal infections, etc.) until it is completely cured;
- Congenital malformations of the facial skeleton and anomalies in the structure of blood vessels;
- Vaccination less than a month ago;
- Malignant tumors;
- Severe bleeding disorders.
Preparing for surgery
When the question of the need for surgery is resolved, the patient or his parents begin to search for a suitable hospital. Difficulties in choosing usually do not arise, because surgical removal of tonsils is carried out in all ENT departments of public hospitals. The intervention is not very difficult, but the surgeon must be sufficiently qualified and experienced, especially when working with young children.
Preparation for surgery to remove adenoids includes standard laboratory tests - general and biochemical for blood, coagulation studies, determination of group and Rh-affiliation, urinalysis, blood for HIV, syphilis and hepatitis. Adult patients are assigned an ECG, children are examined by a pediatrician, who, together with an otorhinolaryngologist, decides on the safety of the operation.
Adenotomy can be performed on an outpatient or inpatient basis, but most often hospitalization is not required. On the eve of the operation, the patient is allowed to have dinner at least 12 hours before the intervention, after which food and drink are completely excluded, because anesthesia can be general, and the child may vomit against the background of anesthesia. In female patients, surgery is not prescribed during menstruation due to the risk of bleeding.
Features of anesthesia
The method of pain relief is one of the most important and crucial stages of treatment, it is determined by the age of the patient. If we are talking about a child under seven years old, then general anesthesia is indicated, for older children and adults, adenotomy is done under local anesthesia, although in each case the doctor is suitable individually.
Operation under general anesthesia for a small child has an important advantage: the absence of operational stress, as in the case when the baby sees everything that happens in the operating room, without even feeling pain. The anesthesiologist chooses drugs for anesthesia individually, but most modern drugs are safe, low-toxic, and anesthesia is similar to normal sleep. Currently, Esmeron, Dormikum, Diprivan, etc. are used in pediatrics.
General anesthesia is preferable for children 3-4 years old, in whom the effect of being present at the operation can cause severe fear and anxiety. It is easier to negotiate, explain and reassure older patients who have not even reached the age of seven, so local anesthesia can be performed for preschool children.
If planned local anesthesia,
then a sedative drug is preliminarily injected, and the nasopharynx is irrigated with a lidocaine solution so that further injecting of the anesthetic is not painful. To achieve a good level of pain relief, lidocaine or novocaine is used, which is injected directly into the tonsil area. The advantage of such anesthesia is the absence of a period of "recovery" from anesthesia and the toxic effect of drugs.
In the case of local anesthesia, the patient is conscious, he sees and hears everything, therefore fear and anxiety are not uncommon even in adults. To minimize stress, the doctor before the adenotomy tells the patient in detail about the upcoming operation and tries to calm him down as much as possible, especially if the latter is a child. On the part of the parents, psychological support and attention are also of no small importance, which will help to transfer the operation as calmly as possible.
To date, in addition to the classical adenotomy, other methods of removing the pharyngeal tonsil using physical factors have been developed - laser, coblation, radio wave coagulation. The use of endoscopic techniques makes the treatment more effective and safer.
Classical surgery to remove adenoids
classic adenotomy
Classical adenotomy is performed using a special instrument - Beckmann's adenotome. The patient, as a rule, sits, and the adenotome is inserted into the oral cavity to the amygdala behind the soft palate, which is raised by the laryngeal speculum. The adenoids must completely enter the adenotome ring, after which they are excised with one quick movement of the surgeon's hand and withdrawn out through the mouth. Bleeding stops by itself or the vessels coagulate. In case of severe bleeding, the area of operation is treated with hemostatics.
The operation is usually performed under local anesthesia and takes a few minutes. Children who have received a sedative and who are prepared for the procedure by their parents and a doctor tolerate it well, so many specialists prefer local anesthesia.
After removing the tonsil, the child is sent to the ward with one of the parents, and if the postoperative period is favorable, he can be sent home on the same day.
The advantage of the method the possibility of its use on an outpatient basis and under local anesthesia is considered. A significant disadvantage is that the surgeon acts blindly, if it is not possible to use the endoscope, because of this, there is a high probability of leaving the lymphoid tissue with subsequent relapse.Others disadvantages possible soreness during manipulation is considered, as well as a higher risk of dangerous complications - the ingress of removed tissues into the respiratory tract, infectious complications (pneumonia, meningitis), injuries of the lower jaw, pathology of the hearing organs. The psychological trauma that can be inflicted on a child cannot be ignored either. It has been established that the level of anxiety may increase in children, neurosis may develop, therefore, nevertheless, most doctors agree on the advisability of general anesthesia.
Endoscopic adenotomy
Endoscopic removal of adenoids is one of the most modern and promising methods of treating pathology. The use of endoscopic technique allows you to carefully examine the pharyngeal area, safely and radically remove the pharyngeal tonsil.
The operation is performed under general anesthesia. The endoscope is inserted through one of the nasal passages, the surgeon examines the pharyngeal wall, after which he excises the adenoid tissue with an adenotome, forceps, microdebrider, and laser. Some specialists supplement endoscopic control with visual, introducing a laryngeal speculum through the oral cavity.
Endoscopy makes it possible to most completely remove the overgrown lymphoid tissue, and in case of relapse, it is simply irreplaceable. Endoscopic removal of adenoids is especially indicated when the proliferation occurs not in the lumen of the pharynx, but along its surface. The operation is longer than the classical adenotomy, but also more accurate, because the surgeon acts on purpose. The excised tissue is removed more often through the nasal passage, free from the endoscope, but possibly through the oral cavity.
endoscopic adenotomy
An option for endoscopic removal of adenoids is shaver Technics, when the tissue is excised with a special device - a shaver (microdebrider). This device is a micro-cutter with a rotating head, placed in a hollow tube. The cutter blade cuts off hypertrophied tissues, crushes them, and then the amygdala is aspirated into a special container, which eliminates the risk of getting it into the respiratory tract.
The advantage of the shaver technique- low invasiveness, that is, the healthy tissue of the pharynx is not damaged, the risk of bleeding is minimal, there are no scars, while endoscopic control makes it possible to completely excise the amygdala, preventing relapse. The method is considered one of the most modern and effective.
Too narrow nasal passages in a small child, through which it is impossible to enter the instrumentation, may become a limitation to the removal of the tonsil with a microdebrider. In addition, not every hospital can afford the necessary expensive equipment, so more often this method is offered by private clinics.
Video: endoscopic adenotomy
The use of physical energy in the treatment of adenoiditis
The most common methods of excision of the pharyngeal tonsil using physical energy are the use of a laser, radio waves, and electrocoagulation.
laser treatment
Laser removal of adenoids consists in the effect on the tissue of radiation, which causes a local increase in temperature, evaporation of water from cells (vaporization) and the destruction of hypertrophic growths. The method is not accompanied by bleeding, this is its plus, but there are also significant disadvantages:
- The inability to control the depth of exposure, because of which there is a risk of damage to healthy tissues;
- The operation is lengthy;
- The need for the availability of appropriate equipment and highly qualified personnel.
Radio wave treatment carried out by the Surgitron apparatus. The pharyngeal tonsil is removed with a nozzle that generates radio waves, while the vessels are coagulated. The undoubted advantage of the method is the low probability of bleeding and low blood loss during surgery.
Plasma coagulators and coblation systems also used by some clinics. These methods can significantly reduce the pain that occurs in the postoperative period, and are also practically bloodless, therefore, are indicated for patients with blood coagulation disorders.
Coblation is exposure to "cold" plasma, when tissues are destroyed or coagulated without burns. Advantages - high accuracy and efficiency, safety, short recovery period. Among the disadvantages are the high cost of equipment and training of surgeons, recurrence of adenoiditis, and the likelihood of cicatricial changes in the tissues of the pharynx.
As you can see, there are many ways to get rid of the pharyngeal tonsil, and choosing a specific one is not an easy task. Each patient needs an individual approach, taking into account age, anatomical features of the structure of the pharynx and nose, psycho-emotional background, concomitant pathology.
Postoperative period
As a rule, the postoperative period is easy, complications can be considered a rarity with a correctly selected operating technique. On the first day, a rise in temperature is possible, which is knocked down by the usual antipyretic drugs - paracetamol, ibufen.
Some children complain of sore throats and difficulty breathing through the nose, which are caused by swelling of the mucous membranes and trauma during surgery. These symptoms do not require specific treatment (except for nasal drops) and disappear within the first few days.
The patient does not eat for the first 2 hours, and for the next 7-10 days he adheres to the diet, since nutrition plays a significant role in the restoration of tissues of the nasopharynx. A few days after the operation, soft, mashed food, mashed potatoes, cereals are recommended. The child can be given special baby food for babies, which will not injure the pharyngeal mucosa. By the end of the first week, the menu expands, you can add pasta, omelet, soufflé from meat and fish. It is important that the food is not hard, too hot or too cold or too chunky.
In the postoperative period, carbonated drinks, concentrated juice or compote, crackers, hard biscuits, spices, salty and spicy dishes are strongly not recommended, which enhance local blood circulation with the risk of bleeding and can injure the mucous membrane of the pharynx.
- bath, sauna, hot bath are excluded for the entire recovery period (up to a month);
- going in for sports - not earlier than in a month, while the usual activity remains at the usual level;
- it is advisable to protect the operated person from contact with potential carriers of a respiratory infection; the child is not taken to kindergarten or school for about 2 weeks.
Medical therapy in the postoperative period is not needed, only nasal drops, narrowing the vessels and providing a local disinfecting effect (protargol, xylin), are shown, but always under the supervision of a doctor.
Many parents are faced with the fact that after treatment, the child continues to breathe through the mouth, out of habit, because nothing prevents nasal breathing. This problem is fought with special breathing exercises.
Complications include bleeding, purulent processes in the pharynx, acute inflammation in the ear, recurrence of adenoiditis. Adequate anesthesia, endoscopic control, and antibiotic protection can reduce the risk of complications to a minimum in any of the surgery options.
Removal of the adenoids is one of the methods of treatment of pathological proliferation of the nasopharyngeal tonsil. It is prescribed if the child is diagnosed with complications caused by adenoids (impaired nasal breathing, hearing loss, chronic inflammation of the nasopharynx), and drug therapy does not bring a positive result.
Removal of adenoids, which is carried out in a child, regardless of his age group, is a radical method of treating a nasopharyngeal disease called adenotomy.
Therapeutic manipulations of this type are a full-fledged surgical operation, which is aimed at excising excessively enlarged lymphoid tissue. It is of it that the nasopharyngeal tonsil consists, which has undergone hyperplasia and disrupted the normal air circulation in the upper respiratory tract.
The table below shows the types of surgical intervention, as well as the specifics of its implementation:
Removal of adenoids in a child occurs at stages 3 and 4 of adenoiditis
| A kind of adenotomy | Characteristics of surgical treatment |
| Full | Provides for a complete resection of the pharyngeal tonsil, which has undergone pathological effects and greatly increased in size. The decision on complete excision of the adenoids is made by the otolaryngologist based on the results of the examination. Lymphoid tissue is completely excised if it is severely altered by a chronic inflammatory process, is a source of chronic infection and no longer performs its physiological functions. |
| Partial | Only part of the tonsil is surgically removed. The use of this type of adenotomy is advisable if there are no signs of inflammation of the lymphoid tissue, and its hyperplasia is not significant. Partial removal of the nasopharyngeal tonsil minimizes trauma to the soft tissues, preserves the functionality of the lymphoid tissue and ensures rapid postoperative recovery. |
| Classical adenotomy | During the removal of the nasopharyngeal tonsils, a special surgical instrument is used - adenotome knife. The main disadvantages of this type of removal of adenoids are the narrow field of view, as well as profuse bleeding, which opens immediately after cutting off the lymphoid tissue. Due to this, the wound healing time increases, which can last from 7 to 10 days. |
| Laser | A modern method of removing adenoids. Allows you to get rid of sick nasopharyngeal tonsils with a laser, which quickly excises hyperplastic tissue, but there is no large blood loss. Laser removal of adenoids is highly accurate and minimizes trauma to the peripheral tissues, as well as to the nasopharyngeal mucosa. The rehabilitation period is 2-3 days. |
| Endoscopic | One of the most common and effective techniques for performing adenotomy. In the process of carrying out surgical procedures, an adenotome knife and an endoscope are used. The doctor performing the treatment sees the object of surgery and removes exclusively lymphoid tissue, which disrupts air circulation in the nasopharyngeal cavity. |
| Coblation | This type of adenotomy involves the use of a cold plasma apparatus. Medical equipment of this type allows painless excision of the nasopharyngeal tonsils, avoiding bleeding, cauterizing the operated area and ensuring the fastest possible recovery of the body. |
The cost of removing the adenoids depends on the type of surgery being performed. Conventional surgical intervention without the use of expensive medical equipment, as well as with the use of an endoscope, is carried out free of charge in public health institutions.
Innovative methods of excision of the nasopharyngeal tonsils using a cold plasma and laser instrument are carried out in private clinics, and the average cost of this type of medical services is 3000-4000 rubles.
Advantages and disadvantages of removing adenoids in a child
Removal of adenoids in a child is a surgical intervention on the tonsils of the nasopharynx, which involves damage to the soft tissues and mucous membranes located in the circumference. 
The advantages of surgical removal of the adenoids are as follows the results that can be achieved after surgical procedures:
- nasal breathing is restored, which was completely or partially absent before;
- a deep and full sleep returns to the child, since before that he could not sleep normally due to a constantly stuffy nose;
- a violation of the bite and the development of the lower jaw is prevented, because with adenoids, breathing is possible only through the mouth, which remains constantly open (there is an incorrect formation of the zygomatic-orbital joints);
- the child is less likely to have colds and infectious diseases of the nasopharynx;
- the risk of developing concomitant diseases of the upper respiratory tract in the form of sinusitis, sinusitis, frontal sinusitis, which are often diagnosed in children with not removed adenoids, is reduced;
- snoring disappears, which occurs in every 2nd child with hyperplasia of the nasopharyngeal tonsils;
- timely removal of adenoids prevents otitis media and hearing loss;
- normal speech and diction develops, the child stops talking in the nose.
The advantages in the surgical treatment of adenoids are much greater than the potential disadvantages.
The disadvantages of surgery are the following risks:
- adenoids consist entirely of lymphoid tissue, participate in the synthesis of special cells - lymphocytes, which are necessary to ensure local immunity (their removal will make the nasopharynx more vulnerable to dangerous bacterial and viral microorganisms);
- about 25% of operations to remove the nasopharyngeal tonsils end in a relapse of the disease, which comes back again after a prolonged cold, SARS, flu;
- a focus of chronic infection may develop in the nasopharynx, which will lead to the frequent and unreasonable appearance of a runny nose, purulent discharge;
- the child will receive psychological stress caused by the type of blood, surgical instruments (the consciousness of children 3-5 years old is not yet ready for the fact that manipulations will be performed deep in their oral cavity, which will lead to the release of blood, pain and restrictions on food intake);
- there is always a risk of bacterial infection, which can lead to complications, cause the formation of abscesses, cause a prolonged inflammatory process;
- damage to receptors, nerve endings and loss of smell (the child simply ceases to distinguish smells).
All the pros and cons of surgical removal of the adenoids are explained to the child's parents before the appointment of the date of surgery. Excision of the nasopharyngeal tonsils using a laser or cold plasma instrumentation minimizes all of the above disadvantages and risks.
Indications for the removal of adenoids in a child
Removal of adenoids in a child is a radical method of treatment, the need for which is determined exclusively by an otolaryngologist. 
Surgical excision of enlarged tonsils of the nasopharynx is indicated if the child has the following signs of pathology:
- there is no breathing through the nose, the child tries to inhale, but the lymphoid tissue blocks the lumen of the respiratory canal;
- the child is always with an open mouth;
- at night, the baby is worried about strong snoring, which can be heard throughout the room;
- the child often suffers from colds and infectious diseases, suffers from chronic rhinitis;
- concomitant complications of adenoid developed in the form of sinusitis, sinusitis, frontal sinusitis;
- drug treatment does not bring a positive therapeutic result;
- the child's hearing began to decline, speech and diction were disturbed, he began to sing;
- there was a risk of developing dental problems associated with a constantly open mouth, drying out of the mucous membrane of the gums, palate, inner surface of the cheeks and tongue, and the formation of an irregular bite.
Parents who believe that their child does not need surgery to remove enlarged adenoids have the right to refuse surgery. They are provided with a form of a document in which they indicate that they have been explained the need for surgical treatment of the child, as well as the consequences of the lack of appropriate therapy.
Contraindications to the removal of adenoids in a child
Removal of adenoids in a child is not a complicated surgical operation, which is well tolerated and also has a minimum number of complications. Despite this, there are a number of restrictions on its implementation.
It is contraindicated to remove adenoids in the following cases:
In the process of examining the child and preparing him for the operation, the attending physician may discover other grounds that completely exclude the surgical intervention, or that require temporary therapy.
What examinations need to be done before removing adenoids in a child
Before scheduling a date for removal of the nasopharyngeal tonsils, the child must pass the following tests and undergo an instrumental examination of the body:
In addition to the above types of examination, the child undergoes a general analysis of blood and urine. Before prescribing a diagnosis, the attending physician palpates the nasopharynx and performs anterior rhinoscopy by examining the surface of the adenoids through the nasal openings.
Preparing to remove adenoids from a child
Before carrying out a surgical operation, it is necessary to observe a number of rules that will ensure the normal passage of the process of removing the adenoids and minimize the risk of complications.
The following preparatory steps are performed:
Removal of adenoids in a child is not a difficult surgical operation, but it requires the right psychological attitude and moral endurance. Especially if the surgery is performed in a traditional surgical way without using an endoscope.
This method of surgical treatment of adenoids is still used in district hospitals with a poor material and technical base, where there are no endoscopic devices. Parents need to set the child up for the fact that the operation will be quick, and that it is extremely necessary for his health.
Procedure for removing adenoids in a child
Excision of the nasopharyngeal tonsils can be performed in several ways. The procedure for removing adenoids depends on what kind of surgical intervention was chosen by the attending physician and the parents of the baby.
Surgical method
This method of removing overgrown lymphoid tissue involves the following procedure:
The child is transferred to the ward of the surgical department, where he receives further medical treatment aimed at preventing bacterial infection and speedy healing of the nasopharynx.
Laser removal
A modern and almost painless method of surgical therapy, which is carried out as follows:
Immediately after completing the surgical procedures using this method, the baby can go home. If the treatment procedure went without complications, there is no bleeding, then hospitalization is not required.
Endoscopic
This method of removing adenoids is used more often than all other methods of surgical intervention.
In order to rid the baby of adenoids, the surgeon performs the following steps:
- The child receives local or general anesthesia.
- The oral cavity is fixed in an open position so that the doctor has unhindered access to the lymphoid tissue.
- A probe of the endoscopic apparatus is inserted into the nasal opening, which transmits a video image in real time and allows the doctor to see the adenoids on a computer monitor.
- Removal of the nasopharyngeal tonsils is carried out through the mouth using surgical instruments.
Immediately after the completion of the therapeutic manipulations, the child is transferred to the general therapy ward. A good field of view and modern equipment allow for rapid excision of lymphoid tissue with minimal trauma to the nasopharyngeal mucosa.
Adenotomy using the coblation method is performed in exactly the same way as laser removal of the nasopharyngeal tonsils, but only using a cold plasma device.
Recovery after removal of adenoids in a child
If the surgical operation was performed without violating the treatment protocol, there were no complications and the peripheral tissues, nerve endings were not affected, then a special course of restorative rehabilitation is not required. The child should not eat anything in the first 2 hours after removal of the adenoids. 
After the specified time, you can use broth, puree and other liquid food. Stale foods, rough, fibrous, salty, pickled, sour, spicy foods are completely excluded from the diet.
In the next 5 days after the operation, it is recommended to rinse the mouth and larynx with a weakly concentrated antiseptic solution. To prepare it, you need to take 1 tsp. table salt without a slide and dissolve it in 0.5 liters of warm water.
With the prepared solution, the child should perform daily rinsing of the mouth and throat. The duration of the treatment procedure is 3-5 minutes. 2 times a day after brushing your teeth. Children under the age of 5 who do not yet have sufficient oral care skills are treated with an antiseptic throat treatment with a Lugol solution. The procedure is performed once a day for 5 days.
How long will the result last after removal of the adenoids in a child
Adenoid hyperplasia is not a recurrent disease. With the complete removal of the lymphoid tissue, a long-term therapeutic result is provided, excluding the re-formation of growths. Partial excision of the adenoids while preserving part of the tonsils increases the risk of tissue overgrowth and blockage of the airway.
In this case, the child may again face the problem of breathing through the nose. The likelihood of a relapse of the disease is unlikely, and re-formation of adenoids is rare.
The only exceptions are cases of violation of the treatment protocol, mistakes made during the operation, the preservation of most of the hyperplastic tissue of the nasopharyngeal tonsils. To avoid recurrence of the disease, it is recommended during the year at least 1 time per month. visit a pediatric otolaryngologist.
Possible complications after removal of adenoids in a child
Complications arising after removal of adenoids in children of all age groups are associated with the characteristics of the postoperative period.
In the first 2-3 days after surgery, the following complications may occur:
In the event that, after removing the adenoids, the child has the above complications, then you should immediately contact the attending otolaryngologist or surgeon performing the operation.
Adenotomy is not a dangerous operation that must be performed on time. Severely enlarged tissue of the nasopharyngeal tonsils is more difficult to remove. Operating a child in the early stages of adenoid formation guarantees the restoration of nasal breathing, rapid healing of the nasopharynx and the absence of negative consequences.
Article formatting: Mila Friedan
Video about adenotomy
Review of the child after adenotomy:
Adenoids are enlarged nasopharyngeal tonsils, which lead to difficulty in nasal breathing, hearing loss, and physical and mental retardation. Normally, the tonsils serve as a protective organ, protecting the body from the penetration of infections, but frequent infectious diseases lead to repeated inflammation of the lymphoid tissue, as a result of which it grows in the form of adenoids.
Most often, children aged 3 to 7 years get sick as a result of frequent ARVI and other infectious diseases (measles, scarlet fever).
Adenoids may also be accompanied by such symptoms as dry cough, fever, night snoring, mucous, yellow-green nasal discharge.
Surgical intervention is necessary only if all conservative methods have not yielded a positive result. The most effective way to treat adenoids is to remove them.
Inflammation of the adenoids can occur in three forms of the disease: acute, chronic and subacute
What is the operation
The most common method for removing adenoids is adenotomy. It is one of the shortest operations, lasting about 5 minutes under local or general anesthesia.
Unfortunately, the operation cannot be 100% safe, as complications may arise:
- the consequences of anesthesia;
- damage to the palate, bleeding.
It is not advisable to perform the operation during the peak seasons of viral infections, when the immune system is weakened. The best time for an operation is summer.
The operation can be performed on patients of any age. Recovery is quick, the patient leaves the hospital the same day. After removal of the adenoids, it is recommended to maintain a diet that excludes spicy, hot, cold and solid foods for several days.
Indications for removal of adenoids
The main indications for surgery are not the size of the adenoids, but the symptoms that inflamed nasopharyngeal tonsils lead to.
Adenoid growths leads to disruption of many functions in the body. A chronic focus of infection is formed, while immunity decreases.
Indications for the removal of adenoids in children:
- Decreased hearing. The nasopharyngeal tonsils block the passage of the Eustachian tube, thus obstructing the passage of air into the middle ear. The eardrum loses its mobility, hearing impairment occurs.
- Chronic adenoiditis. Inflamed adenoids are a favorable environment for various viruses and bacteria.
- Frequent otitis media. Due to the growth of adenoids, dysfunctions of the middle ear occur, and favorable conditions for viruses and bacteria appear.
- Violation of speech.
- Deterioration in mental and physical activity.
- Wrong bite, formation of an "adenoid face".
- Adenoid cough.
- Respiratory tract diseases (bronchitis, pharyngitis, tracheitis, pneumonia). With inflamed nasopharyngeal tonsils, mucus and pus are constantly formed, which drain into the lower parts of the respiratory system. Thus, they cause inflammation that leads to respiratory infections.
- Frequent ARVI.
- Lack of results of conservative treatment methods.
Methods for removing adenoids
Instrumental removal method - Adenotomy
Adenotomy is performed using a special ring-shaped knife called adenotome. It is injected into the nasopharynx area and when the adenoid tissue enters the ring, it is cut off with one movement of the hand. After that, the adenoid is cut off. The operation takes about 5 minutes. The bleeding stops within a few minutes.
It is performed under local anesthesia on an outpatient basis. A hospital stay is not required. Among the disadvantages of such an operation, it can be noted that the doctor operates in the blind, without seeing the nasopharyngeal cavity. Very often, small areas of lymphoid tissue remain, which lead to repeated proliferation of the adenoids in the future.
Radio wave removal of adenoids
The operation is performed using the Surgitron device, which has a special attachment for removing adenoids - radio wave adenotomas. With the help of this nozzle, the entire adenoid is cut off at once, as in the case of adenotomy, and the radio wave cauterizes the vessels, thus reducing bleeding. Among the advantages of the operation:
- reduction of blood loss during surgery;
- reducing the risk of postoperative bleeding.
Laser treatment is the best achievement in surgery. The operation takes place under the influence of laser radiation. There is an increase in the temperature in the tissues and, thus, the evaporation of liquid from it. Among the disadvantages of the method:
- longer operation;
- heating of adjacent healthy tissues occurs.
Children under 7 years old are operated under general anesthesia, over 7 years old - under local anesthesia.
Removal with a shaver (microdebrider)
Microdebrider is a tool with a rotating head and a blade at the end. The tool crushes the adenoid, which is then placed in the suction reservoir. Microdebrider allows you to completely remove adenoids without damaging the mucous membrane, that is, without bleeding. The operation is performed under anesthesia with endoscopic control. This method is one of the most effective, in which there is practically no risk of re-growth.
Children under 7 years old are operated under general anesthesia, and over 7 years old - under local anesthesia.
Preparing for surgery
Removal of the adenoids is not an urgent operation. You need to prepare for it, conduct a complete examination of the child:
- general and biochemical blood test;
- Analysis of urine;
- a blood test for infections such as hepatitis, HIV;
- coagulogram;
- examination by a pediatrician.
On the day before the operation, you should not eat or even drink water. The day before, you should refrain from having dinner after 6 pm.
Anesthesia when removing adenoids
Local anesthesia
Possible for children over 7 years old:
- the use of a sedative drug;
- applying an anesthetic solution to the nasopharynx (10% lidocaine solution);
- the introduction of a less concentrated solution of anesthetic into the adenoid tissue (2% lidocaine).
During the operation, the child is awake.
In children aged 2 to 7 years, the operation to remove the adenoids is performed under general anesthesia, which does not cause psychological trauma to the child and completely relieves pain. For a quick return to consciousness for general anesthesia, it is better to use propofol or some other modern inhalation anesthetic.
Complications after surgery
The most common complication is bleeding. Most often, it occurs within three hours after the operation, so this is the amount of time the child should be under the supervision of a doctor.
Rarely, acute otitis media occurs, as blood can enter the auditory tube. Sometimes in the first 2 days after the operation, the temperature rises to 38 degrees.
Sniffing has long been synonymous with childhood. Children get sick a lot, especially with colds. Frequent inflammatory diseases in the nasopharynx lead to the appearance of adenoids.
With the progression of the disease, the only way to treat it is to promptly remove the overgrown tissue. This often scares both the child and his mom and dad. How is the removal of adenoids in children interested in many parents.
Adenoids are a pathologically enlarged nasopharyngeal tonsil, which causes difficulty breathing, hearing impairment and other disorders.
The amygdala is located in the fornix of the nasopharynx and is not visible to the naked eye. It can only be examined by an otolaryngologist using a special mirror.
The nasopharyngeal tonsil is part of the so-called lymphadenoid pharyngeal ring, which surrounds the entrance to the respiratory and digestive tract. It performs a protective function and belongs to the immune system.
With adenoid growths, nasal breathing is blocked. The child is increasingly breathing through the mouth.Because of this, the body's defense mechanisms do not fulfill their function, the air is not sufficiently filtered and viruses and microbes penetrate into the respiratory tract.
Therefore, more and more inflammatory diseases occur: tonsillitis, bronchitis, sinusitis and others. The risk of developing pneumonia increases. Inflammatory processes in the nasopharynx often cause otitis media (inflammation of the middle ear) in children.
Adenoids can develop in children from 1 to 14 years old, but children from 3 to 7 years old most often suffer.
Due to adenoid growths, such problems appear:
- The voice becomes nasal, the child speaks as if through the nose;
- A chronic rhinitis appears with difficult, often purulent, discharge;
- Due to the constant inflammatory process and weakening of the immune system, the child is often sick, it is difficult to recover, complications arise with acute respiratory infections;
- Starts snoring in sleep;
- Hearing may decrease;
- There are frequent headaches, pallor of the skin, absent-mindedness.
There are three stages of adenoid growths:
- initial stage... The nasopharyngeal tonsil is slightly enlarged and slightly obstructs the nasal passage;
- Second stage... The adenoids cover more than half of the nasal passage;
- Third stage... The overgrown adenoid tissue almost completely blocks the nasal passage.
In the early stages, conservative treatment may be prescribed to stop tissue overgrowth. These are usually special drops, rinsing the nose and nasopharynx with medicinal solutions, homeopathic remedies, and so on.
If it does not help and the proliferation of adenoid tissue continues, then it is removed surgically.
Reasons and indications for surgery. Possible consequences
Not always with adenoids, an operation is prescribed to remove them. The reasons for surgery are:
Adenoids of the third degree, when they overlap the lumen of the nasopharynx by more than 2/3;
When the adenoid growths of the excretory fistula of the Eustachian tubes are closed and, as a result, the accumulation of mucus in the middle ear. This leads to hearing loss and the occurrence of frequent otitis media, including purulent ones.
Possible complications
Parents are often afraid to undergo surgery due to possible complications. However, adenotomy (surgery to remove the adenoids) is not considered a difficult or dangerous procedure. Modern techniques make it as effective and painless as possible.
However, sometimes the following consequences arise:
- An increase in temperature above 38 degrees for more than 48 hours may indicate the occurrence of an infectious inflammation;
- Incessant bleeding from the nasopharynx. It occurs if the tissue of the adenoids is not completely removed. Additional cleaning or laser cauterization is required;
- Damage to adjacent mucous tissue, leading in the future to the development of atrophic epipharyngitis;
- Relapses of the disease.
To avoid possible complications, it is necessary to carefully approach the choice of a specialist who will perform the operation and the method of removing adenoids in children.
To operate or not?
Parents often have doubts and do not want to have their child operated on. Of course, surgery is stressful for the child. But it should be borne in mind that there is no other alternative to get rid of the adenoids.
If the adenoid tissue has already grown, then it will not be able to decrease in any way and it is necessary to remove it promptly. It is impossible to cure grade 3 adenoids with drugs.
Sometimes parents confuse adenoid growths and adenoiditis. Adenoiditis occurs as a result of inflammation of the adenoid tissue. It can be treated and the inflammation will go away. However, overgrown adenoids cannot be treated this way.
The operation is not prescribed unless absolutely necessary. If the adenoids do not cause serious violations, then they try to stop their growth conservatively. In case of ineffectiveness of treatment and further growth of pathology, surgery cannot be avoided.
Therefore, if surgical intervention is necessary, then you should not postpone it in order to avoid irreversible consequences for the child's health.
Is the removal painful? What pain reliever is used?
Some parents who underwent removal of adenoids in childhood remember it as an unpleasant and painful procedure. They refuse to subject their child to it. But it is worth noting that in those days this operation was carried out without anesthesia. Therefore, the memories remained sad.
Expert opinion
Smirnova Luiza Dmitrievna - medical worker
Private Clinic Pediatrician Assistant
Ask your doctor about pain relief before surgery. In all modern hospitals, local or general anesthesia is used for adenotomy. General anesthesia is most preferred for children. After the injection, the child falls asleep, and when he wakes up, the operation is over.
This form of anesthesia has a number of contraindications. Therefore, local anesthesia is sometimes used. It provides enough pain relief, but the child may be intimidated by the sight of instruments or blood. So with local anesthesia, an additional injection of a sedative is given.
If an operation is necessary, and there is no possibility of anesthesia, then the operation is performed without anesthesia. Adenoids do not have nerve endings, so their removal, although an unpleasant procedure, is not too painful.
Types of operations
Most often, surgery to remove the adenoids (adenotomy) means the surgical excision of tissue with a special instrument.
However, there are other methods of removing adenoids in children.
In modern medicine, the following main methods are distinguished:
- Endoscopic removal;
- Laser excision of adenoids;
- Excision of adenoid tissue with a radio wave apparatus.
During the operation, complete or partial removal of the adenoids is performed.
Endoscopic removal is a surgical procedure guided by an endoscope.
During a surgical operation, a doctor can use various instruments: a conventional adenotome, electrocoagulation, a microdebrider (shaver), a plasma knife, and others.
However, regardless of the technique used, the essence of the operation lies in the excision and removal of the adenoid tissue from the nasopharynx. An endoscope is used for imaging.
Laser removal of adenoids is used for small tissue growths. This procedure is less traumatic, however, more often several sessions are needed.
With large growths of the adenoids, it is advisable to perform surgical excision followed by laser cauterization.
When using a radio wave apparatus to remove adenoids under the action of a high frequency current, a kind of tissue evaporation occurs, and the adenoids are reduced.
The advantages of radio wave surgery are minimal trauma, bloodlessness, and accelerated wound healing.
Why is their absence dangerous? Dangers of untimely deletion
An increase in adenoids is most often accompanied by an increase in the palatine tonsils. This can lead to the fact that it becomes difficult to breathe not only through the nose, but also through the mouth. Especially often the child suffocates at night.
If the adenoids are not removed in a timely manner, then due to the constantly open mouth, the upper jaw becomes underdeveloped, teeth begin to grow incorrectly, and the jaw is deformed.
The worst thing is that if a deformation occurs, then the process is irreversible, even when the operation is taken into account. Therefore, do not delay the treatment of adenoids.
Another common complication of adenoids is hearing loss and the onset of hearing loss. However, this violation is reversible. After removal of the adenoids, hearing is restored.
Many are afraid to remove the adenoids, because they are afraid that the child's body will lose a kind of "protective barrier" and become ill even more often than before removal.
Among the mothers who agreed to the operation, the child has some who are not happy with the result, and even think that it has become worse. In order to weigh the pros and cons of the operation, consult your doctor.
It's good if you already have one verified, if not, see a doctor you trust.
Remember that with a strong overgrowth of the adenoids, surgery is required.
Preparing for surgery
It is necessary to prepare for the operation, first of all, psychologically. It is important that parents are calm themselves. It is necessary to explain to the child the need for the procedure, to tell what awaits him, but so that he is not afraid. You can promise your baby ice cream after the procedure.
When planning an adenotomy, the doctor will prescribe the necessary tests and examinations. On the eve of the operation, medications may be prescribed to improve blood clotting.
On the day when surgery is scheduled, you must not feed or drink the baby two hours before the procedure. This is especially important if anesthesia is expected. Otherwise, vomiting may occur.
Postoperative recovery
The operation itself does not last long, 5-10 minutes.
The child will recover from anesthesia for some time. If everything went well, then 2-3 hours after the baby came to his senses, he is allowed to go home.
After adenotomy, cold has a calming effect on the nasopharyngeal mucosa, relieves swelling, and stops bleeding.
But if it is difficult for a child to swallow or does not feel well after anesthesia, there is no need to insist.
On the first day after surgery, you may experience coughing up blood or vomiting blood. This is due to blood entering the stomach during the operation.
Are you for or against deletion?
AgainstPer
The wounds on the mucous membrane have not yet healed and may bleed a little, especially if irritated.
After the operation, on the first day, the temperature may rise, and weakness is present.
In the first days, the child is instructed to rest more, not to walk on the street, avoid exertion, and engage in breathing exercises.
To normalize the function of nasal breathing, vasoconstrictor drops are prescribed for 5 days.
Recovery of nasal breathing and hearing usually occurs within 7-10 days after surgery.
Relapses - secondary appearance
Sometimes relapses occur after removal of the adenoids in children. Re-growth of adenoid tissue is possible if
- The lymphoid tissue was not completely removed;
- Operation for a child under 3 years old;
- The presence of factors that cause adenoid growths (allergies, heredity, frequent diseases).
Such cases do not happen often and require specialist advice.
