Children with recurrent tonsillitis or tonsillar adenoid hypertrophy that interferes with sleep breathing (please refer to the article I posted on this subject) need tonsillar adenoid surgery. What are the options for tonsil adenoid surgery and what are the pros and cons of each?
I. Tonsil squeezing Pros: The surgery can be performed under local anesthesia and can be done on an outpatient basis. It saves time, effort and money.
Disadvantages: The surgery is not delicate enough; if the child has recurrent inflammation, there may be more bleeding; the child needs a certain degree of cooperation and must be over 6 or 7 years old; the adenoids cannot be operated at the same time; there is some mental trauma to the child.
At present, few hospitals perform this type of surgery.
Tonsil dissection Advantages: Local anesthesia is available for older children (above 12 years old), but it is not used for long time because of the need for close cooperation of the child. General anesthesia is suitable for children of all ages. Adenoids can be performed at the same time as general anesthesia. The cost is lower than plasma.
Disadvantages: Sometimes ligation is required to stop bleeding. Intraoperative bleeding is high.
Some hospitals also perform this type of surgery.
Plasma tonsil or (and) adenoids ablation Advantages: The procedure requires general anesthesia and is suitable for children of all ages, with little intraoperative and postoperative bleeding and mild postoperative pain. The adenoids can be removed comprehensively, and the possibility of postoperative residuals is small, with relatively few recurrences.
Disadvantage: high cost.
In the past two years, our hospital has been performing this kind of surgery, and parents have responded well.
Adenoids scraping Pros: fast surgery, medium bleeding, less cost compared to plasma surgery.
Disadvantages: relatively easy to remain and relatively easy to recur.
Our hospital no longer performs this type of surgery.
V. Adenoidectomy under aspirator Advantages: comprehensive removal of adenoids during surgery, less likely to recur.
Disadvantages: relatively higher cost (compared with scraping), relatively more bleeding (compared with scraping and ablation), more need for electrocoagulation to stop bleeding during surgery, and sometimes need to perform nasopharyngeal tamponade after surgery.
Some hospitals use this type of procedure.