Adenoidectomy is necessary for children who suffer from symptoms of adenoid hypertrophy. The adenoid is removed by simple surgery, which improves the child’s breathing.
Adenoidectomy is one of the most common surgeries performed on young children (usually under five years old). Adenoidectomy is performed when the adenoids (also called nasal polyps in some countries) enlarge in children and cause severe symptoms that impede their normal breathing.
But what are nasal polyps? Where are they located? Well, you may know what they are, but why do they enlarge in the first place, or why are they common? Is surgical treatment the only solution to treat adenoids? Is Adenoidectomy dangerous, or does it have complications? When does the child improve after surgery? You will learn the answers to all these questions and more in this article, so follow us.
An overview of adenoidectomy
Adenoidectomy is a simple and non-dangerous nose surgery. It is non-life-threatening and has a very high success rate, with a noticeable improvement in the patient after the surgery.
Failure to perform Adenoidectomy may result in the child not having normal breathing and a lack of oxygen, which in turn may lead to problems with growth and mental development (especially if accompanied by enlarged palatine tonsils).
Adenoidectomy may be accompanied by tonsillectomy if all of them are enlarged and obstruct the child’s breathing or cause other symptoms.
What are nasal polyps? Where are nasal polyps located?
Nasal polyps (adenomas) are lymphatic defensive tissue located in the roof of the nose. Their function is to protect the child from germs and viruses that come from the external environment through the nose. They capture them as soon as they enter through the airway and get rid of them. They are covered with epithelium from the respiratory mucosa.
The palatine tonsils are similar to nasal polyps in structure and perform the same function: They protect the child from harmful organisms (bacteria) that enter the mouth through food or the air.
In some cases, nasal polyps become enlarged, obstructing the nasal airway and breathing. As a result, the child breathes through his mouth, which leads to many symptoms. Follow us to learn about them and whether he needs surgery to get rid of them.
Symptoms of adenoid enlargement
The severity of nasal polyp symptoms varies depending on the size of the polyp. The larger the polyp, the more annoying symptoms it causes until it reaches a stage where a polyp removal surgery (Adenoidectomy) becomes necessary. The most important symptoms of nasal polyp are:
Difficulty breathing through the nose
In the case of nasal polyp enlargement (adenoids), the posterior nasal opening is blocked, which obstructs the passage of air. This makes breathing through the nose difficult, leading to a runny nose, snoring, and sleep apnea several times a night. When a complete blockage occurs, the child breathes through his mouth.
Breathing through the mouth
This can lead to several symptoms, including dry mouth, cracked lips, bad breath, gingivitis, and dental caries.
Sleep disorders
Uncomfortable sleep due to insufficient oxygen in the child during sleep leads to lethargy and drowsiness during the day, lack of concentration and activity, and may affect the child’s educational level in the future.
Recurrent otitis media
There is an opening in the nasopharynx for a canal connected to the middle ear to equalize the pressure on both sides of the eardrum. The enlargement of the nasal adenoids blocks this opening, which leads to otitis media in children. In this case, nasal adenoid surgery (nasal adenoidectomy) is indicated.
Recurrent sinusitis near the nose
Enlargement of the nasal adenoids leads to blockage of the drainage openings of the adjacent sinuses, so secretions accumulate in them. As a result, inflammation occurs, causing headaches and high fever in the patient.
Causes of enlarged nasal adenoids
There is no specific cause for enlarged nasal adenoids, but the following reasons are often considered the main cause:
- Congenital adenoid enlargement: The child is born with enlarged adenoids (adenoids) since birth, and their size increases over time.
- Enlarged nasal adenoids due to infection: Since the adenoids are a lymphatic defensive tissue, they will enlarge when infected and infected.
- Nasal polyp hypertrophy after infection: The polyps may remain enlarged after infection, causing the mentioned symptoms.
Diagnosis of nasal polyp hypertrophy
An otolaryngologist makes the diagnosis using several methods. One method for diagnosing nasal polyp hypertrophy is inserting a small mirror into the mouth to expose the nasopharynx and show the enlargement of the nasal polyp, if any. In some cases, the nasal polyp is very enlarged, so its lower border appears in the mouth.
Diagnosis can also be made through a nasal endoscope, which consists of a tube with a camera at its tip connected to a screen on the doctor’s side. The camera enters the nose and shows the size of the nasal polyp.
Diagnosis can also be made indirectly through an X-ray, where we notice the narrowing of the air column in the nasopharynx compared to the air behind the larynx in the lateral head image.
Treatment of nasal polyps without surgery
Before resorting to adenoid removal operations, the ear, nose, and throat doctor may prefer to treat the polyp first using medications for the nasal polyp (without performing a nasal polyp operation). Here, before adenoid operations, the following are used:
Antibiotics
Since the enlargement of the polyp may be caused by infection and bacterial infection, the use of antibiotics may help kill these bacteria and get rid of them, and thus, the enlargement of the polyp may disappear, and we do not need to perform an adenoid removal operation.
Steroids
Treatment with a nasal spray containing steroids may help reduce the size of the nasal polyp, thus eliminating the symptoms and not requiring a polyp removal or nasal surgery.
Adenoidectomy in Turkey
Not every enlarged polyp requires surgery or treatment. Nasal polyp is a lymphatic defensive tissue in children that continues to exist until the age of five, after which the polyp begins to shrink and get smaller until it almost disappears in adulthood, so nasal polyp enlargement is rare in adults.
If the nasal polyp is severe causes many annoying symptoms for the child, and does not respond to non-surgical treatment, then you should consider performing a nasal polyp operation. Bimaristan Medical Center will guide you to the best hospitals and most skilled surgeons in Turkey, so contact us.
The surgeon specializing in ear, nose, and throat diseases (ENT specialist) performs a nasal polyp removal operation, where he first anesthetizes the child using general anesthesia (anesthesia with a short-term anesthetic that lasts only during the surgical procedure). That is, the child sleeps and does not feel anything during the surgery because he is under the influence of anesthesia.
First, he places a plastic piece to keep the mouth open during the surgery. Then, he inserts the mirror and the curette (a spoon-shaped tool or scalpel to scrape and remove the nasal polyp). He then applies heat and presses the area with sterile gauze to stop the bleeding.
Alternatively, electrocoagulation may be used in nasal polyp removal surgery to ensure removal while simultaneously coagulating the area and thus ensuring less bleeding.
When the palatine tonsils are also enlarged with complaints of recurrent inflammation, we perform a tonsillectomy with a nasal polyp operation.
A nasal polyp removal operation usually does not last more than 30 minutes, after which the child goes to his room to rest for a few hours and is monitored by his surgeon, then the child is discharged on the same day.
After Adenoidectomy
A nasal polyp operation is considered a very safe nasal operation. Still, some annoying symptoms appear in the child after nasal polyp removal surgery for only a week or 10 days (but usually the period is two or three days), and these symptoms include:
- Ear pain
- Inability to open the mouth
- Difficulty swallowing
- Sore throat
After this short period, the child can breathe normally through his nose, sleep better, and become more alert, focused, and active during the day. In addition, his recurrent otitis media and sinusitis have disappeared. You can see these results and improvement usually after two weeks at most from the operation.
Complications of adenoidectomy
As we mentioned earlier, Adenoidectomy is one of the safest children’s surgeries; however, no surgical procedure is free of the possibility – even a simple one – of complications or damages, and these potential risks (harms of Adenoidectomy):
- Bleeding
- Tooth fracture
- Infection and high-temperature
- Nasal blockage
- Nasal discharge
- Change in voice
Therefore, if you encounter any of the following symptoms after nasal polyp removal surgery, you should see a doctor immediately:
- Bleeding of red blood from the child’s mouth
- Black, brown, or red blood in vomit
- High temperature and chills (shivering)
- Severe pain despite painkillers
- Inability to drink fluids after the period of rest from the surgical procedure
Nasal polyp enlargement is common in children, however, not all of them require surgery, because nasal polyps decrease in size as the child grows until they disappear at puberty. Some children may experience slight enlargement of the nasal polyps at some point in their lives, and then the child’s condition improves without treatment. Still, some of them develop severe enlargement of the nasal polyps. The solution here is to remove the severely enlarged adenoids to relieve the child of these symptoms and ensure a normal life and healthy growth for him. Some cases of nasal polyp enlargement may be cured with non-surgical treatment; however, rest and Adenoidectomy remain the basis of treatment.
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