The fall and winter seasons are a high incidence of pediatric tonsillitis. Zhang Tianyu, a specialist from the Fudan University Affiliated ENT Hospital, reminds that tonsillitis is a common and frequent disease in children, and parents should not only be concerned about the two typical symptoms of fever and sore throat, but also seek timely medical attention for symptoms such as snoring at night and ear discomfort in children. These complications are often accompanied by acute inflammation and do not recover naturally as the disease progresses, which can have a significant negative impact on a child’s lifelong healthy growth.
Basics
Acute tonsillitis in children
Dr. Zhang Tianyu said that tonsillitis is prone to infants and children between the ages of half and six years old, with typical symptoms of fever and sore throat. Tonsillitis is divided into acute and chronic, pediatric patients rarely have chronic, acute septic tonsillitis accounts for the vast majority of the proportion of children affected.
The change of season from fall to winter, with a large temperature difference between day and night, is a high incidence of pediatric tonsillitis. As the autoimmune system of young children is not yet perfect, once the immunity is reduced due to cold, fatigue, humidity, etc., the tonsils are located in the throat and easily suffer from bacterial infection and cause systemic symptoms such as fever, sore throat, fatigue, headache, etc., and may be accompanied by some complications. If treatment is incomplete or recurrent, it may damage heart and kidney functions, and in serious cases, it may cause nephritis, myocarditis, rheumatic heart disease, etc.
High incidence of urban pediatrics
Dr. Zhang Tianyu pointed out that compared to rural children, urban children have more chances of contracting tonsillitis because they are usually less stimulated by the outside wind, sun, cold and heat and have less resistance. Other causes of pediatric tonsillitis are the following.
1, low resistance. For example, premature children born with congenital deficiencies, children who are usually malnourished, children suffering from diseases, etc.
2. Hypertrophy of the tonsils. There are physiological as well as pathological ones. If there are no other symptoms, physiological hypertrophy is a normal phenomenon and can be treated without treatment. If pathological hypertrophy is present, medical examination and treatment are required.
Confusion resolution
Doubt 1: Is it possible to remove it surgically?
Asker: Mrs. Du, 33 years old
My son is 4 years old and his tonsils are often inflamed and cause high fever. What will be the effect on my child after the surgery?
Expert tip: Tonsils should not be removed casually.
The tonsils are a lymphatic organ that plays a role in immunity, so it is important to listen to the advice of a specialist and take a cautious approach when deciding whether to remove them surgically; basically, surgery should not be considered for children before the age of 4, although it depends on the child’s condition. Generally speaking, if a child’s tonsils are physiologically enlarged and there are no symptoms of fever, congestion, pus, or sore throat, then this is normal and no treatment is necessary. However, when the physiological enlargement affects breathing, swallowing and pronunciation, surgical removal of the tonsils should be considered.
Generally speaking, surgery to remove a child’s tonsils must meet certain conditions: first, the tonsils have become a focal point, and there is damage to kidney and heart function; second, tonsillitis is recurrent, once a month or once every two months; third, snoring occurs when the child sleeps. If any of the above conditions are met, surgical removal of the tonsils can be considered. So far, the medical community has not found any significant adverse consequences for children after tonsillectomy.
Doubt 2: How to take care of it at home?
Asker: Mrs. Hu, 29 years old
It is heartbreaking to see my daughter lying in bed with high fever. What should we parents do in order for her to recover as soon as possible?
Expert tip: Let your child rest well.
The course of treatment for acute suppurative tonsillitis is not less than one week, usually 8-10 days. During this period, the most important thing is to let your child rest well. There have been extreme cases of heart failure in young children who have not rested properly because of tonsillitis. In addition to bed rest, parents can let their children drink more water to replenish the water lost due to high fever and to promote the excretion of toxins in the body; eat a light diet, preferably with watery and easily absorbed food, such as thin rice soup, fruit juice, etc., and do not eat stimulating food; keep indoor air circulation to reduce the chance of reinfection; take anti-inflammatory drugs under the guidance of the doctor, and take and stop the drugs on time, etc.
You can also take preventive vaccination to enhance the child’s resistance with medication. The child’s nutritional intake should be comprehensive, and the child should eat all grains and cereals, and not be too picky, so that the child’s body presents a dynamic balance of health.
Complications
Most parents focus on their children’s acute tonsillitis, but tend to ignore complications such as snoring and otitis media, which are not obvious clinical symptoms. Dr. Zhang points out that these potential complications, which are easily masked by inflammation, must generally be treated with additional medication and will not automatically return to normal as the disease progresses.
Dr. Zhang reminded parents that if complications are not treated in time, they will have a great impact on the child’s growth and development. Therefore, while treating your child’s tonsillitis, if you find that your child has sleep snoring or ear discomfort in life, you should seek medical treatment as soon as possible to reduce complications and sequelae.
Complication 1: Pediatric snoring
Under normal circumstances, young children also often make a slight snoring sound when they sleep. However, if loud snoring is continuously emitted, it is abnormal and should be considered as a medical condition.
Expert analysis: Children suffering from tonsillitis are prone to hypertrophy of the proliferators, blocking the posterior nostrils, making the air in and out of the nasal cavity obstructed, and the child is forced to mouth breathing after sleeping. As the whole body muscles relax during sleep, the tongue also falls down to the pharyngeal cavity loosely, so that the pharyngeal cavity becomes narrow and unobstructed, when the gas hits the tongue root and other tissues from time to time, thus emitting a burst of snoring. When children snore, the upper and lower teeth do not bite together normally, and long-term mouth breathing can easily lead to the development of facial deformities and the formation of “proliferative face” characterized by the prominence of the middle of the face. Due to the long-term mouth breathing in sleep, the brain is deprived of oxygen at night, the daytime spirit is poor, appetite is poor, academic performance will also decline, and growth and development are slow.
Countermeasure: Parents should take their children to the hospital for careful examination and correct medication to relieve the symptoms of pediatric snoring so that the children’s memory, intelligence and physical and mental development can be normalized.
Complication 2: Secretory otitis media
The ears are a little stuffy! This little symptom is still difficult for young children to express in words and is often hidden by the surface symptoms of acute tonsillitis.
Expert analysis: The eustachian tube in the ear regulates the pressure in the ear to keep it in balance with the atmospheric pressure, in addition to its defensive and cleansing functions. In autumn and winter, when there is a large temperature difference between day and night, children with tonsillitis often develop negative pressure in their ears, creating a feeling of stuffy ears. The mucous membrane inside the ear is affected by the negative pressure and secretes more sticky fluid, but it cannot be discharged in time due to the dysfunction of the eustachian tube, so it accumulates in the ear and causes hearing loss, ear pain, etc. If secretory otitis media is not treated in time, it can lead to a series of secondary diseases, causing hearing impairment in children and even becoming a cause of deafness.
Countermeasures: Since autumn and winter are the most common seasons for otitis media, parents should bring their children to the doctor as soon as possible if they notice ear discomfort in order to reduce the occurrence of sequelae.