Adenotomy: removal of the adenoids

Adenoiditis - symptoms and treatment

Adenoids are growths of the pharyngeal tonsil located on the vault of the nasopharynx. During inflammation, adenoids increase in size, blocking nasal breathing. Adenoiditis most often occurs in children of preschool age. The disease has vague symptoms. The first and second degree of inflammation is treated conservatively. The third requires surgical intervention. You will learn more about how to treat adenoids in children.

Factors that can provoke the disease:

• artificial feeding;
• allergic reactions;
• frequent colds;
• hypothermia of the body can cause acute adenoiditis in children;
• presence of rickets, exudative diathesis;
• unfavorable ecological environment.

It should be noted that inflammation of adenoids in adults occurs much less frequently than in children.

Symptoms and causes of adenoids

As mentioned above, the disease proceeds slowly. The main symptom of adenoiditis is the impossibility of nasal breathing and snoring during sleep. Irritation and causeless anxiety, as well as a constantly open mouth, are manifestations of adenoid growth. Many children have a headache in the morning, and their voice acquires a hoarse tone. For the appearance of the listed symptoms, parents should contact a pediatrician, after which the treatment of adenoids will be prescribed.

Classification of adenoid vegetations:

• first degree – the child breathes hard at night, sometimes "snores" (adenoids cover the third part of the nasopharyngeal lumen);
• second degree – violation of nasal breathing during the day (50% of the nasopharynx is closed by adenoids);
• third degree – the child cannot breathe through the nose, speech is impaired.

Among the most frequent causes of inflammation of the adenoids, doctors single out childhood infections, frequent acute respiratory infections, decreased immunity, chronic tonsillitis, and heredity.

Treatment of adenoids

The choice of therapy and treatment regimen is determined by the doctor, taking into account the degree of growth of the tonsils and the condition of the child. We will remind that the first and second degree of adenoiditis is treated conservatively. However, everything is individual. The question of removing adenoids is raised only in case of ineffectiveness of conservative therapy.

For the treatment of adenoids, immunomodulators and antihistamines, homeopathic drugs, anti-inflammatory and vasoconstrictor drops, as well as saline preparations for washing the nose are used. Of the physiotherapeutic methods, quartzing of the nose and laser therapy are recommended. Cryotherapy of adenoids is effective for the first and second degree of the disease. Cryotherapy for a child is performed under local anesthesia.

Indications for removal of adenoids

Absolute indications for removing a pathological pharyngeal tonsil are 24-hour nasal breathing disorder, hearing loss, improper jaw development, and sleep apnea. In each specific case, the decision is made by a specialist.

Surgical treatment: basic methods

1. Operation using an adenotome - a special knife used to remove adenoids. The disadvantages of such a surgical intervention include insufficient examination of the field and bleeding.
2. Laser removal is a low-traumatic and extremely precise operation.
3. Endoscopic adenoscopy in children is the most common method of surgical intervention with high efficiency.
4. Coblation is an operation performed using a cold plasma instrument. Advantages: painlessness, no bleeding, quick recovery after surgery.

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Types of analgesia during adenotomy

The operation to remove adenoids is performed under local anesthesia and with the use of general anesthesia. Each type has its advantages and disadvantages.

For local anesthesia, a solution of lidocaine or ultracaine in the form of a spray is used. 30 minutes before the operation, the child is sedated. Local anesthesia is performed before the operation itself. Its advantages include the absence of "exit" from anesthesia and the absence of aspiration, as well as the minimal time of surgical intervention. As a rule, local anesthesia is recommended for children starting from 8 years old.

Adenotomy is performed under general anesthesia for children of preschool age. The advantages of the method include complete analgesia. Long-term "exit" from anesthesia, the danger of aspiration (getting food into the respiratory tract), exposure to toxic drugs are disadvantages.

A child after adenotomy: what to pay attention to

After removing the adenoids, the baby must be turned on its side and a towel placed under the head, into which the child will spit saliva. At this time, parents should monitor the nature of discharge and the general condition of the child. During the first days after the operation, the baby will be under the supervision of a doctor.

When "coming out" of anesthesia, the child may experience vomiting, nausea and dizziness. Small children often cry and scream. Because of this, it is important for parents to constantly be near the baby. You can feed and drink a small patient after the doctor's permission. After discharge from the hospital (with general anesthesia in three days, with local anesthesia in one day), the specialist prescribes a treatment regimen for full recovery and prescribes a diet recommended for the child after adenotomy.

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