With the gradual increase in the number of children undergoing surgery, the number of children being followed up and reviewed in outpatient clinics is also gradually increasing, and I would like to summarize and introduce the questions of parents and some of the situations that exist after surgery.
The tonsils and adenoids are only part of the lymphatic ring of the pharynx. After the surgery, the other lymphatic tissues of the lymphatic ring can completely compensate for the immune function and will not cause any impact on the immune system. Some children may have colds and coughs after surgery. This may be caused by not eating properly for a period of time after surgery, or it may just happen to be the right time. In many cases, after surgery, the number of colds and coughs is significantly reduced because the reservoir of bacteria and viruses is removed. In a study conducted in our department, all post-operative children were followed up for two years and their cellular and humoral immunity indicators did not differ from those of the normal control group.
The literature reports that chronic cough may be related to inflammation of the tonsils and adenoids, and that recurrent sinusitis may be related to adenoid hypertrophy and inflammation, and that some children’s chronic cough improves and disappears and sinusitis is cured after surgery, but there are still some children with recurrent cough and sinusitis. This is not common, and not all problems can be solved after surgery.
This is because the nasal cavity and nasopharyngeal cavity are narrow and there is a symptom called pediatric snoring in children, which is mixed with obstructive apnea, and even sleep monitoring cannot distinguish them completely. Breath-holding, apnea and oxygen deprivation, parents do not need to be too nervous and overly concerned, and will get better after growing up full.
The main reasons for the recurrence of snoring, open-mouth breathing and breath-holding after surgery are as follows: 1) rhinitis and sinusitis attacks, especially in children with allergic rhinitis before surgery, in the autumn and winter seasons, when the temperature is low or when they have a cold. This is the most common reason, this part of the child in the treatment of rhinitis, sinusitis, symptoms can be improved or completely disappeared; 2, swelling of the bulge, hyperplasia, in the nasopharynx adenoids on the left and right side of each bulge, below the pharyngeal tube, the bulge must be preserved during surgery, can not be ablated, but after surgery, because of the cold, or allergic inflammatory stimulation However, after the surgery, because of the cold or allergic inflammation, the ramus will swell and proliferate, which will also block the posterior nostril, and sometimes the swollen ramus will be mistaken for adenoids, so we must review the electronic nasopharyngoscope to distinguish the two clearly; 3.Tonsils proliferate and hypertrophy again. Some of these children have to undergo a second surgery to have their tonsils ablated.
4, adenoids again, recurrence, this is also the most worried parents, the most easily thought of, this situation is mostly seen in the use of traditional adenoids scraping surgery, because can not completely see the situation of the posterior nostril, as well as the limitations of surgical instruments, the posterior nostril area has adenoids residue, resulting in hyperplasia, recurrence. And now the surgery under the direct view of the endoscope, as long as the surgery is handled well, this situation is generally rare.
5. Extensive scar tissue hyperplasia in the pharyngeal cavity and nasopharyngeal cavity, resulting in a reduction in the volume of the nasopharyngeal cavity and pharynx.
V. No relief of symptoms after surgery In the long term clinical work, it is true that there are very few children who, after surgery, no matter what treatment and handling, have no relief of symptoms of open-mouth breathing and breath-holding, and the cause cannot be found after consultation in many aspects, and need to put on a non-invasive breathing aid during sleep. Such children do exist, and it is hoped that with the development of medicine, better treatment will be provided to this group of children.