There is a surge of adenoid and tonsil surgery patients during the winter and summer seasons, and many parents ask: What are the pros and cons of surgery? This is a good big question. So I would like to write the following science: First of all, let’s see what are the symptoms of adenoid hypertrophy? And the dangers?
I. Adenoid hypertrophy
1.Local symptoms
Children’s nasopharyngeal cavity is narrow, such as adenoid hypertrophy blocking the posterior nostril and pharyngeal pharyngeal opening, can cause symptoms in the ear, nose, throat and other places.
(1) Ear symptoms: obstruction of the pharyngeal orifice of the eustachian tube causes secretory otitis media, resulting in hearing loss and tinnitus.
(2) Nasal symptoms: It is often complicated by rhinitis and sinusitis, with symptoms such as nasal congestion and runny nose. When speaking with an occlusive nasal sound, snoring sound when sleeping, and sleep apnea in severe cases.
(3) Pharynx, larynx and lower respiratory tract symptoms: Because the secretion flows downward and irritates the respiratory tract mucosa, it often causes nighttime paroxysmal cough and is easily complicated by bronchitis.
(4) Adenoid face: Due to long-term open-mouth breathing, the facial bone development is impaired, the jaws become longer, the palate is high arched, the teeth are not aligned, the upper incisors protrude, the lips are thick, lack of expression, and the so-called “adenoid face” appears.
2. Systemic symptoms
The child shows anorexia, vomiting, indigestion, and then malnutrition. Poor respiration and insufficient lung expansion can lead to thoracic deformity. Poor breathing at night can cause long-term oxygen deprivation in children, endocrine dysfunction and growth disorders. Parents can find that their children have inattention, mood swings, night terrors, teeth grinding, night sweats, bedwetting and other symptoms.
Adenoid hypertrophy is one of the most common causes of obstructive sleep apnea hypoventilation syndrome (OSAHS). Excessive snoring and breath-holding during sleep are the two main symptoms. Open-mouth breathing during sleep, excessive sweating, morning headache, daytime drowsiness and learning difficulties are also common symptoms.
3.Harm of adenoid hypertrophy
(1) easy to form “adenoid face”
As children’s nasopharynx is relatively small, when adenoid hypertrophy, due to nasal congestion affects breathing and mouth open breathing, long-term mouth breathing, airflow impact on the hard palate will make the hard palate deformation, high arch, over time, the development of the face will be deformed, the upper lip short thick cocking, jaw sagging, nasolabial groove disappeared, hard palate high arch, teeth alignment is not neat, upper incisors protrude, poor bite, nasal septum flat curvature, etc., facial muscles The facial muscles are not easy to move, lack of expression, look like a piggyback or ugly duckling, medically called “adenoid face”.
(2) Prone to bronchitis
Adenoid hypertrophy in children can cause blockage of the nose, resulting in the backflow of snot to the pharynx, which stimulates the mucous membrane of the lower respiratory tract, often causing bouts of coughing and making them susceptible to bronchitis.
(3) Easy to cause children’s mental discomfort and unresponsiveness
Children who breathe through the mouth and nose for a long time are prone to head ischemia and oxygen deprivation, mental depression, headache, dizziness, memory loss and slow reaction.
(4) Affecting the growth and development of children
As children need a lot of oxygen for development, snoring will make children seriously lack of oxygen during sleep, which will directly lead to insufficient oxygen supply for brain development and reduce secretion of growth-promoting hormone, which will not only affect children’s height, but also reduce body resistance and affect children’s intelligence in the future. Therefore, such children are not only prone to respiratory infections, but also prone to chicken chest, funnel chest, and even induce pulmonary heart disease. Therefore, children snoring has more harm than adults.
II. Tonsil hypertrophy and chronic tonsillitis
1. Symptoms.
Repeated episodes of sore throat, easy to catch a cold or a history of peri-tonsillar abscess, accompanied by symptoms of tonsillar-derived systemic diseases. The more common ones: myocarditis, streptococcal infectious nephritis.
Frequent discomfort in the pharynx or bad breath. Severe halitosis with a large accumulation of bean-like pus plugs in the tonsillar fossa, or with a large growth of anaerobic bacteria.
The tonsils have abundant peripheral nerve receptors and are prone to various reflex dysregulation phenomena during inflammation. For example, paroxysmal cough, foreign body sensation in the throat, and various sensory abnormalities.
Tonsillar hypertrophy, causing breathing difficulties, snoring, foaming at the mouth, slow eating, and difficulty in swallowing.
Crypt pus plugs are swallowed, which can cause digestive disorders in those with gastrointestinal sensitivity.
Toxin absorption, causing headache, weakness of limbs, easy fatigue, etc., inattentiveness in class and sleepiness.
2.Tonsil surgery indications
Acute tonsillitis with recurrent attacks, or those who have caused parapharyngeal gap infections or peri-tonsillar abscesses although they have not had recurrent attacks.
Excessive enlargement of the tonsils, which hinders swallowing, breathing and vocalization.
Lymph node enlargement in the angle of the jaw for unknown reasons.
Non-surgical treatment is ineffective for diphtheria carriers.
Tonsillar-derived systemic diseases, such as nephritis, myocarditis, rheumatism, etc.
Tonsillar keratosis, tonsillar-derived tumors.
Chronic rhinitis, sinusitis for a long time, suspected to be related to chronic tonsillitis.
After reading so many hazards, are parents scared in their hearts that they must be cut?A meta-analysis article on immune function after tonsil surgery was published abroad in 2015: it was concluded that there was no effect on systemic immune function after removal. However, the immune function of children under 4 years old is significantly weaker than that of older children. Therefore, we do not agree with either the “harmless surgery theory” or the “blanket palliative theory”. Parents are understandably afraid of the risks and side effects of surgery. However, to do or not to do? The decision needs to be based on the child’s condition, history, complications, and the effectiveness of medication. The use of general anesthesia intubation is to ensure the safety of the surgery and to prevent secretions, blood or water from backing up into the trachea and causing asphyxia. The traditional local anesthesia squeezing or scraping procedure does not guarantee the effectiveness of the surgery, but the safety of the surgery will also have a great impact on the child’s psychology. The most common complications of the current surgery are: postoperative bleeding. Our hospital adopts endoscopic tonsil and adenoids hemostasis technology, which has a lower rate of postoperative bleeding due to a clearer view and more complete hemostasis.