Removal of adenoids

Adenoids are small glands in the back of the nasopharynx that play an important role in the body's immune system. However, when they cause a number of health problems, an adenotomy may be required – removal of the adenoids.

What is an adenotomy

Adenoids (growths of the nasopharyngeal tonsil) are an accumulation of lymphoid tissue located in the nasopharynx. They are part of the body's immune system and help protect against infections. However, when adenoids increase in size or become inflamed, they can cause a number of problems: difficulty breathing through the nose, chronic runny nose, recurring ear infections, hearing disorders.

An adenotomy is a surgical procedure in which adenoids are removed. It is usually performed under general anesthesia and takes about 30 minutes. This is a safe and effective operation that can significantly improve the patient's quality of life. Most often, adenoids are removed in childhood – from 3 to 12 years old. After puberty, adenoid vegetation usually atrophies. In some cases, this does not happen – then the operation can be performed on an adult.

Indications for surgery

By itself, hypertrophy of the nasopharyngeal tonsils is not a reason for their removal. Surgical treatment is indicated in cases where the patient has one or more concomitant symptoms:

• Recurrent otitis media. Enlarged adenoids can block the Eustachian tube, leading to frequent ear infections.

• Chronic rhinitis. Enlarged adenoids can cause a persistent runny nose and make it difficult to breathe normally through the nose.

• Sleep problems, including sleep apnea. Overgrowths of the pharyngeal tonsil can block the airway during sleep, causing respiratory arrest.

• Hearing disorders.

• Speech problems or delayed speech development as a result of hearing disorders.

• Sinusitis. Enlarged adenoids or tonsils can block the openings in the sinuses, leading to infection.

The decision to delete is made by the doctor based on the patient's general health, symptoms, and reaction to other treatments. In some cases, conservative tactics are not justified, as they can lead to worsening of symptoms and irreversible changes in the middle ear and paranasal sinuses.

Contraindications

Despite the fact that adenotomy is a common and relatively safe procedure, there are certain contraindications for its implementation. Here are some of them:

• Age less than 3 years. In children of this age, the immune system is not yet fully formed, so adenoids play an important role in fighting infections. An adenotomy can only be performed if there are serious indications.

• Abnormalities in the structure of the face or throat. In some cases, an adenotomy can cause problems with speech or swallowing.

• Serious heart or lung diseases. These conditions can increase the risk of complications during surgery or anesthesia.

• Immunodeficiency conditions.

• Allergy to anesthesia.

• Blood clotting disorders.

Relative contraindications are infectious diseases, chronic diseases in the acute stage. The operation will also have to be postponed if the child has recently undergone another surgical procedure, an infectious disease, or has been vaccinated.

The doctor should carefully assess the patient's health before performing an adenotomy to minimize the risk of complications. In some cases, it may be necessary to consult with other specialists.

Preparation for an adenotomy

Proper preparation helps to minimize the risk of complications and speed up the recovery process after surgery. Before the procedure, the patient undergoes a medical examination to exclude contraindications. Standard preoperative examinations include:

• laboratory tests: general blood count, coagulogram, general urinalysis and others, depending on the patient's state of health;

• pharyngeal and nasal swabs to detect pathogenic microflora;

• ECG;

• visit to the dentist for oral sanitation;

• consultation with an anesthesiologist to select the most appropriate type of anesthesia;

• consultation with a pediatrician or therapist, as well as other specialists in the presence of chronic diseases (for example, an allergist, pulmonologist).

Children are advised not to visit crowded places 7-10 days before surgery to eliminate the risk of infectious diseases. You need to come to the procedure on an empty stomach. It is usually recommended not to eat or drink for 6-8 hours before surgery.

An adenotomy can be performed in various ways. The method is chosen by the doctor depending on the patient's medical history, taking into account the location and degree of development of the adenoid tissue, as well as the features of the anatomy of the nasopharynx. In the EMC clinic, surgeons use both the classic adenotomy method and more modern approaches using a Shaver (microdebridor).

During the operation, the patient is in a state of drug-induced sleep. The surgeon gets access to the adenoids through the oropharynx. The manipulations are performed under full visual control – for this we use different types of endoscopes, a surgical microscope or mirror optics. This allows the surgeon to achieve maximum control over the process.

After removal of the adenoids or tonsils, in some cases, coagulation is performed – this helps prevent possible postoperative bleeding and provides reliable prevention of complications. Thanks to modern methods and technologies, the result is predictable and the process is safe.

Rehabilitation

After the operation is completed, the patient is transferred to the ward, where he recovers from anesthesia. In the EMC clinic, children see their parents immediately after waking up from a drug-induced sleep, which reduces the child's stress level. Doctors monitor the patient's condition for 6-8 hours. Then, if there are no complications, the patient can go home.

Recommendations after adenotomy include:

• Limitation of physical activity. Maximum rest is recommended for the patient for the first few days after surgery.

• A gentle diet. You need to monitor your diet, avoid hot and spicy foods, as well as foods that cause allergies. Warm semi-liquid meals are recommended for the first few days.

• Exclusion of thermal procedures (hot baths, steam baths).

• Taking medications. Usually, patients are prescribed a short course of antibiotics to prevent the development of infection.

Tissue swelling may persist during the first week. Full recovery usually takes 10-14 days. Following the doctor's recommendations helps speed up the rehabilitation process and reduce the risk of complications.

Result of the operation

Adenotomy usually leads to a significant improvement in the patient's quality of life. First of all, this is due to the restoration of normal nasal breathing. Sleep gets better, snoring disappears. The frequency of colds and otitis media decreases, and hearing improves, since adenoids are often the cause of impaired ventilation of the auditory tubes.

Question-answer

Do I need to remove the adenoids?

It is important to separate hypertrophy (enlargement) of the adenoids and adenoiditis (inflammation). Medications can help with inflammation, but they cannot reduce hypertrophied tissue. In this case, removal is indicated, but only in the presence of concomitant symptoms – frequent infections, difficulty nasal breathing, hearing disorders.

Why are children's adenoids removed?

The operation is performed to prevent or treat recurring ear infections, sinusitis, chronic rhinitis, and respiratory disorders.

The most modern method of adenoid removal?

The most modern method is endoscopic cervical adenotomy, which is performed under general anesthesia and allows the doctor to accurately control the removal process.

At what age is it better to remove adenoids?

The optimal age depends on the child's health status, but surgery is usually recommended for children from 3 to 6 years old.

What could be the consequences?

In rare cases, voice changes or swallowing disorders may occur.

What happens to a child after an adenotomy?

After surgery, nasal breathing usually recovers, the frequency of infections decreases, and overall health improves.