Removal Of Adenoids In Children: How Is It Removed, Is It Worth Doing?

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Removal of adenoids in children

The proliferation of adenoid tissue, or enlargement of the tonsils, is an ENT pathology that is most common in children. The consequences of the proliferation of tonsil tissue are shortness of breath, frequent respiratory diseases and chronic inflammation in the nasopharynx. The tonsils are a kind of protective barrier against infection, preventing it from entering the upper respiratory tract. Even in a hypertrophied state, they perform their functions.

Reasons for enlarged tonsils:

• Bacterial infections;
• Viral infections;
• Immunity disorders.

Despite the important function of the tonsils, their excessive enlargement will sooner or later become the reason for the removal of the glands.

Possible consequences of overgrowth of adenoids:

• Delayed development of a child due to chronic oxygen starvation (chronic hypoxia), is expressed in a decrease in attention, memory, speech development delay;
• Changing the shape and size of the facial skeleton;
• Prerequisites for frequent viral or bacterial infections.

Medical treatment of adenoids is not as effective as surgery.

Content:

• Indications for the removal of adenoids in children
• Contraindications to surgery
• Types of surgery
• Postoperative care
• How much does adenoid removal cost?

Indications for the removal of adenoids in children

There must be good reasons for the appointment of surgery to remove adenoids. The indications for removal do not depend on age. If the operation is required immediately, it is carried out, despite the fact that the child has not yet turned 6-7 years old - the age when the tissue of the tonsils is no longer subject to age-related changes. It is believed that if the adenoids are removed too early, before the child's 6-7 years of age, there is a risk of facing the need to remove the tonsils again.

Important indications for removal:

• the child snores while sleeping at night;
• he has no nasal breathing;
• a history of lung disease, when pathologies of the respiratory tract threaten to worsen the child's condition;
• recurrent otitis media, provoked by impaired ventilation of the auditory tube and ear cavity.

Video on the topic "Doctor Komarovsky on indications for the removal of adenoids":

Contraindications to surgery

Adenotomy is not performed in children under the age of 3 years, during an epidemic of respiratory diseases, in the first 4-5 weeks after vaccination.

Contraindications to tonsil removal:

• Anomalies of the soft or hard palate;
• History of blood diseases;
• Diseases of the heart and blood vessels;
• Acute infectious disease in a child during preparation for surgery.

If the condition of a child suffering from heart disease worsens due to the proliferation of adenoids, they are removed in a specialized hospital.

Types of surgery

Before the operation of adenotomy, drug treatment is performed. Its goal is to prepare the child for surgery, to prevent relapse. The otolaryngologist informs parents about the available methods for removing tonsils, analyzes their pros and cons. As a result, the safest method and the least likelihood of relapses and complications are chosen.

• Traditional adenotomy. This conservative method of removing tonsils is carried out under local anesthesia using a special scalpel. Removal is carried out without visual control, which is a significant disadvantage of this method. This increases the risk of incomplete removal of the hypertrophied tonsil, the appearance of a relapse of the disease. In addition, the child is awake and may interfere with the operation.
• Endoscopic adenotomy. This method is considered the safest and most effective way to remove tonsils. The operation is carried out under the control of an endoscope; the adenoids are removed through the nose under general anesthesia. Removal is carried out in full, the risk of recurrence is minimal or completely absent. During the operation, the child is immersed in medication sleep and does not experience physical or emotional discomfort.
• Laser removal of tonsils. The intervention is performed under general anesthesia as an adjunct to endoscopic adenotomy. The laser does not remove the tissue, but burns it, reducing it in size. After laser removal of adenoids, relapses are extremely rare. This intervention is painless and low-traumatic. Since the laser beam has antibacterial and anti-inflammatory effects, the procedure does not cause complications.

• Cold plasma surgery (coblation). An innovative operation to remove tonsils using a cold plasma coblator is performed under general anesthesia. It is painless, carried out in a short time without damaging healthy tissue. There is no blood loss with coblation.
• Cryotherapy Exposure to the tonsils with liquid nitrogen vapor is carried out for 15 minutes. To do this, a cryo-nebulizer tube is inserted into the child's nasal passage and nitrogen vapor is supplied. To obtain a visible effect, at least 4-5 procedures are required. A break of 1-3 months is maintained between them. The procedure is safe, does not cause discomfort to the child. Cryotherapy helps to restore hypertrophied lymphoid tissue.

Postoperative care

Adenotomy, carried out with all safety measures taken into account, passes without postoperative complications. When using methods that do not exclude blood loss, the child may vomit due to blood clots entering the digestive tract. After 20-24 hours, this reaction will disappear.

Possible consequences:

• Recurrence of adenoids;
• Pain syndrome;
• Hyperthermia within 2 days after surgery;
• Purulent otitis media due to infection;
• Injuries to the nasopharynx due to the low qualification of the surgeon or poor-quality equipment.

Proper care of the child after surgery is of great importance. To minimize complications, you need to follow the recommendations:

• Limit physical activity for the child for 2 weeks;
• Remove solid food from the diet;
• Avoid being in a stuffy room;
• Do not be exposed to solar insolation;
• Do not swim in hot water.

After the operation, the child is prescribed rinsing with astringent solutions, instillation of vasoconstrictor drops into the nose.

How much does adenoid removal cost?

The average cost of an operation in Moscow in a private clinic for the removal of adenoids using the classical method is 20,000 rubles, an endoscopic adenotomy costs 30,000 rubles. This price does not include the cost of anesthesia and preoperative consultation with an otolaryngologist.

Since the adenoids were formed anatomically, their excessive proliferation cannot be stopped with medication. Therefore, in the later stages of the pathological process, adenotomy becomes the most correct solution. The operation performed by a qualified surgeon will effectively get rid of the problem that threatens the health of the child.

The author of the article: Lazarev Oleg Vladimirovich | ENT

Education: In 2009, he received a diploma in the specialty "General Medicine" at the Petrozavodsk State University. After completing an internship at the Murmansk Regional Clinical Hospital, he received a diploma in Otorhinolaryngology (2010)