The incidence of pediatric adenoid hypertrophy is increasing year by year, and parents are now often looking for information about adenoid hypertrophy on the Internet, and they are quite familiar with the name adenoid hypertrophy. I hope to give you some help, of course, these are only my personal opinions, there will be doctors have different views, my views are only to provide you with reference. 1, sub adenoid hypertrophy or not to surgery? This is the most important concern for parents. Generally, I decide according to the child’s symptoms, the course of the disease, the results of nasal endoscopy or radiography, and the presence of other complications. There are generally 3 types of nasal endoscopy or radiographs, mild, moderate and severe, mild is generally not recommended for surgery, severe is generally recommended for surgery as soon as possible, moderate depends on the child’s symptoms and the course of the disease and age. If the child sleeps poorly at night, has breath-holding, and has been doing so for a long time, or has been doing so repeatedly, and the nasal endoscopy or radiographs suggest that adenoid hypertrophy is obvious, it is recommended to operate as soon as possible; however, if the child only has such a condition after the recent cold, which has not happened before, or only has snoring without obvious breath-holding, it is recommended to observe first, and it is not recommended to operate immediately, and some parents of children say that the symptoms at night are Some parents say that the symptoms are obvious at night, but the test results show that the obstruction is not very heavy, so it is recommended to do a sleep monitoring before determining whether surgery is needed. If the child’s symptoms are not very obvious but are accompanied by rhinosinusitis, and there is no significant improvement after a period of medication, surgery is also recommended; if the child’s symptoms are not particularly severe, but he or she is particularly prone to colds, and the symptoms are severe after each cold, surgery is also recommended. If your child has frequent episodes of otitis media and is not well treated with medication and has hearing loss, although adenoid hypertrophy is not very heavy, surgery is also recommended as soon as possible. 2. At what age can a child have surgery? This is also a concern for parents. Generally, I do not recommend surgery for children under 2 years old because it is relatively easy for children under 2 years old to relapse after surgery, but if the child’s symptoms are severe and seriously affect the child’s sleep and growth and development, it is recommended to operate early. For us, the surgical approach and difficulty are the same, and there is no increased difficulty of surgery or anesthesia risk because of the child’s young age. In my case, the youngest age was 6 months, because the child could hardly sleep at night and the parents carried the child around to seek medical help, so I decided to operate on the child, and the child’s sleep improved significantly after the operation. In our hospital, we have done a lot of children under 2 years old in recent years, and in my cases there have been cases of recurrence about 1 year after the operation and another operation. 3. Will the adenoids shrink on their own? This is one of the most frequently asked questions by parents. Generally, adenoids will shrink on their own after 6~7 years old, but now we find that there are many children who do not shrink and gradually increase in size, which seriously affects their learning. Therefore, whether the adenoids will atrophy varies from person to person. If the child’s adenoids are very large and the symptoms are heavy, expecting that they will gradually atrophy after the age of 6 and unwilling to operate, I personally do not recommend it very much, whether surgery is needed or not is decided by the symptoms and examination results, otherwise it will lead to other complications. 4.Surgical method and anesthesia? The child’s surgery was performed under general anesthesia. Modern anesthesia technology should be safe for such an operation, and I personally believe that the pediatric anesthesia in our hospital can be completely trusted. The surgery was performed by transoral adenoidectomy under nasal endoscopy, using a combination of imported aspirator and low-temperature plasma knife, which is minimally invasive, with minimal intraoperative bleeding and very mild postoperative reactions. Parents are often concerned about whether low-temperature plasma is better than imported aspirators for adenoid surgery. I have found that low bleeding is an advantage in using low-temperature plasma for adenoid surgery, but if adenoid hypertrophy is obvious, the plasma knife cannot be completely removed because the plasma tip is shorter and cannot reach the surgical site. 5.About the tonsils? Parents are also very concerned about whether the tonsils should be surgically removed or not. If the tonsils are enlarged, it will also affect breathing and lead to sleep disorders, so it is necessary to deal with it, especially if the tonsils are 3 degrees enlarged, it is necessary to deal with it. Generally, if the child is 8 years old or older, or if the tonsils are frequently inflamed, it is recommended that all of them be removed. However, if the child is younger and the tonsils are not often suppurating, partial ablation of the tonsils can be performed using low-temperature plasma, mainly to improve breathing problems, but there is also a possibility that the tonsils may become hypertrophic and hyperplastic again after surgery, and the tonsils may become inflamed frequently, requiring another operation possibly, although it is not common, but we have come across such cases, which are related to the individual differences of patients. Tonsils are partially ablated by low-temperature plasma, which has the advantages of less surgical trauma, almost no bleeding during surgery and less postoperative pain, so it is popular among parents. 6.How to make a clear diagnosis? In our hospital, we generally use nasal endoscopy to confirm the diagnosis. In addition to clarifying the degree of adenoid hypertrophy, nasal endoscopy can also find out whether the child has other rhinitis or sinusitis diseases, but if the child is too young or cannot cooperate, lateral nasopharyngeal film examination is feasible. If there is already a film or nasal endoscopy in an outside hospital, and it is clearer and more definite, further examination is not necessary. 7.Surgery appointment and hospitalization time? However, if you are far away and you have already confirmed your surgery at the local hospital, you can leave me a message online and I will try to arrange it for you as soon as possible, but you have to wait for a few days, because it is impossible to reserve a bed for you. Because there are so many patients, we can only make appointments for patients from out of town who are close by. The surgery is usually a 3~4 day hospital stay. 8.What about tympanic tube placement? If adenoid hypertrophy leads to secretory otitis media, it needs to be dealt with at the same time during surgery. Generally, if the otitis media is not very serious, the course of the disease is not very long, the intraoperative microscopic examination reveals that there is not much fluid, it is not sticky, and the child’s hearing is not affected, it is possible to perform tympanocentesis or tympanotomy during surgery and extract the fluid. However, if the child has hearing loss and the intraoperative examination reveals a lot of fluid or very sticky fluid, it is recommended that a tube be placed. After tube placement, generally the ears should not enter water or swim. After six months, most of the tympanic ventilation tubes will gradually fall off, if not, follow up for another six months and remove the tubes according to the situation. Most of the tympanic membrane will heal within one month after the tube is removed, but a few small perforations will remain, and after another six months of follow-up, most of them will heal, but only a few will not grow well and will remain perforated. Can otitis media recur after placement of tubes? The answer is yes, many children find hearing loss again after the tubes are placed and removed, which is mostly related to the child’s cold and rhinitis. 9.What are the post-operative problems? If you do adenoids surgery alone, you can eat semi-liquid 6 hours after surgery, and the next day, if the child does not have obvious sore throat, you can eat ordinary food, you do not need to pay special attention to diet, if you do tonsil surgery at the same time, you usually have to have about 3 days of liquid, then according to the child’s situation, then decide whether you can eat semi-liquid, children with tonsils line plasma radiofrequency ablation can generally return to normal in about a week Diet, if you perform a total tonsillectomy, it may take about 10 days to 2 weeks to return to normal diet after surgery, mainly depending on the child’s recovery. The follow-up visit is usually 2 weeks after surgery. If the child is out of town and has adenoids surgery alone, he or she may not need to be followed up. If the tympanoplasty is performed at the same time as the otitis media, it is better to follow up every 3 months after the surgery. After surgery, some children still snore and hold their breath at night, even more than before surgery, and parents are very worried. It is normal for such a situation to occur 1~2 weeks after surgery, because there will be edema of the operative cavity, swelling of the oropharynx and swelling of the nasal cavity after surgery, etc. These conditions will slowly get better as the child gradually recovers. However, there are a few children who snore after surgery because of enlarged turbinates, rhinitis and sinusitis, or allergic rhinitis, which is not related and will be improved with nasal drops or medication for rhinosinusitis, but there are very few children who still snore after surgery because of thick tongue, backward tongue root or small jaw or the child is particularly obese. But if there is no obvious breath-holding, it usually does not need special treatment, but if there is still breath-holding and oxygen deprivation, it may be more difficult to deal with these cases.