The most common questions about tonsil and adenoidectomy surgery
The most common cause of snoring in children is enlarged tonsils and adenoids, and the common symptoms include nasal congestion, snoring, inattention, coughing, and reduced learning ability. This has a great impact on the growth and development of children.
When it comes to surgery, parents are often very worried and afraid. When it comes to tonsil and adenoidectomy, parents often ask, “Is the surgery very invasive?” “Is it a minimally invasive surgery?” “Is it a plasma radiofrequency procedure?” “Can my child tolerate this surgery?” “Is it better to use laser surgery or plasma surgery?” And so on.
To these questions of parents, now talk about the surgical treatment of tonsils and adenoids.
1. Do adenoids have to be operated?
Surgery should only be considered if medication has proven ineffective. Generally speaking, if there is no significant improvement after two weeks of medication, or if the symptoms are not relieved by more than half after four weeks of continuous treatment, surgery is more likely to be required.
2.Does the tonsil have to be operated?
Tonsil hypertrophy, or recurrent tonsillitis, require surgery. The drugs are not effective for recurrent tonsillitis and tonsillar hypertrophy. If you don’t have surgery, it will lead to chronic rhinitis and affect nasal ventilation.
3.Can adenoid surgery solve all the problems?
The best effect of surgery is in solving the difficulty of breathing through the nose, that is, solving nasal congestion, especially nasal congestion at night and snoring and apnea (breath-holding). This is followed by runny nose, cough, and then ear symptoms such as hearing loss. Surgery is only an important part of the treatment. After surgery, review and follow-up treatment will be conducted according to the doctor’s recommendation, such as the use of nasal hormones and oral antihistamine medication.
4.What problems can tonsil surgery solve?
Like adenoidectomy, removal of tonsils can lift the obstruction of the upper airway and make snoring significantly relieved or disappear. In addition, if there were recurrent tonsillitis before, the surgery will stop the attacks.
Chronic tonsillitis can flare up acutely whenever there is a sudden change in temperature or a change in season and resistance decreases. Do you often have recurrent sore throat and fever? What are the complications of repeated acute inflammation of the tonsils? Are you faced with the difficult decision of removing your tonsils due to heart or kidney disorders? Take the above questions with you.
Read the following introduction and you will find the answer.
What are the causes of chronic tonsillitis?
The reason for this is that it is not a good idea to have a good time. The pathogenic bacteria such as streptococcus and staphylococcus are the most common.
What are the symptoms of chronic tonsillitis?
The main clinical manifestations are recurrent sore throat and fever, in addition to discomfort in the throat, foreign body sensation, dryness, itching, irritating cough, and bad breath. Acute attacks may be accompanied by headache, weakness of limbs, easy fatigue or low-grade fever.
What are the dangers of chronic tonsillitis?
Chronic tonsillitis can not only cause infections in neighboring organs, leading to otitis media, sinusitis, larynx, trachea and bronchitis. More importantly, it can become a focal point of infection in the human body, causing systemic diseases such as nephritis, arthritis and endocarditis. Because of the similarity between the tissue structure of tonsils and that of important organs such as kidneys, joints, and heart, when tonsils become repeatedly infected as foci, they produce antigen-antibody complexes that run in the blood circulation, precipitate in the terminal vascular areas of organs, and induce inflammatory reactions in the corresponding organs.
How is chronic tonsillitis diagnosed?
A history of recurrent sore throat and fever is an important basis for the diagnosis of chronic tonsillitis. Usually chronic tonsillitis can lead to tonsillar hypertrophy; however, in some patients, due to repeated inflammation, which causes tissue fibrosis, instead the tonsils shrink. Therefore, the diagnosis of chronic tonsillitis cannot be based on the presence or absence of tonsillar hypertrophy.
What should I do if I have chronic tonsillitis?
There is no special medical treatment for chronic tonsillitis. It may be beneficial to participate in physical exercise to enhance physical fitness and resistance to disease, and to take vitamin C and cod liver oil. However, tonsillectomy is the most important treatment for chronic tonsillitis.
What are the misconceptions about chronic tonsillitis?
1, should not be removed tonsils were cut: in clinical work, often encountered some chronic pharyngitis or simple tonsillar hypertrophy of patients were removed tonsils, the results of the surgery symptoms not only no relief, but will aggravate. Therefore, clinicians should not only correctly understand chronic tonsillitis, but also strictly grasp the indications for surgery.
2, many people are worried that after the removal of tonsils, the immunity will be reduced. In the future, there will often be upper respiratory tract infections, and it is difficult to control them. In fact, these worries are not necessary. The palatine tonsils are the lymphatic tissue of the pharynx, which has a certain immune function and a certain defense against upper and lower respiratory tract diseases, but this role of the tonsils will gradually decrease or even fade with age.
After the age of 5 to 6 years, the immune function of the tonsils is gradually replaced by other organs. Repeated inflammation of the tonsils causes fibrosis of the tonsils, at which point the tonsils not only lose their defensive role, but also engulf bacteria that multiply in the crypt of the gland, inducing recurrent attacks of acute tonsillitis. The tonsils at this time, not only have no important immune function, but on the contrary are more harmful to the human body, and safer after removal. It should be said that removing the tonsils because of chronic tonsillitis is more beneficial than harmful.
5, adenoids and tonsils, must both be removed? Is it possible to leave one of them?
Generally speaking, if the reason for surgery is snoring in children over four years old, it is better to remove all three (one adenoids and two tonsils) so that the tonsils or adenoids left behind will not proliferate again (compensatory hyperplasia) and require a second surgery.
6.Wouldn’t the immunity be affected if all the above three things are cut out?
Removal of tonsils and adenoids in children over 4 years old will not affect immunity. This is a reliable conclusion from research, so there is no need to doubt. It has been confirmed by numerous clinical studies. We have also done many children from 2 to 4 years old and have not found much effect on the children in the post-operative follow-up.
7.It is said that tonsillectomy can lead to pharyngitis, is that true?
In traditional surgery, the patient is under local anesthesia, which is painful and uncooperative, and the bleeding is difficult to control. The surgeon performs the surgery under very difficult conditions, and sometimes a mucus-secreting gland at the lower pole of the tonsil is accidentally cut off as well.
The method we currently use can avoid these shortcomings (general anesthesia, good exposure and vision, easy to control bleeding, and no accidental cutting of mucus glands), and the removal of adenoids is done under a 70 degree nasal endoscope.
8.How dangerous is the surgery?
For adenoid surgery and tonsil surgery itself, the biggest risk is bleeding, which occurs at a very low rate of less than 1%. However, because of the general anesthesia, the risk of anesthesia is much higher than the surgery itself, especially for children under three years old. In fact, the younger the child is, the lower the complications and the faster the recovery after surgery, while the older the child is, the heavier the post-operative reaction and the slower the recovery.
9.I heard that general anesthesia can affect the child’s intelligence, is there such a thing?
No, there is no such thing. The effect of anesthesia drugs on children is limited to the period of anesthesia and 24 hours after the end of anesthesia, after that there is no longer any effect on the body, let alone on intelligence.
10.How painful is the surgery?
Adenoids surgery alone is not very painful. Children are usually free to move around in the afternoon of the day of surgery, and can eat semi-solid food that night and regular food the next day. Most children do not look like they have just had surgery the day after surgery. Postoperative analgesia is usually not needed. If combined with a tonsillectomy, the pain can be greater.
However, recently we have been using post-operative analgesia, and at the end of the surgery, the anesthesiologist will connect your child to an analgesic pump, which releases a small amount of pain relief into your child’s body through a vein on a continuous dose basis, making it possible to be virtually pain-free for two days after surgery. You can eat semi-solid food the night of the surgery, usually for about a week. In the case of plasma surgery, it is generally recommended to eat for two weeks.
11.How long does the surgery take?
The surgery time for adenoids alone is about 20 minutes (meaning from the start of excision to the completion of hemostasis), and if combined with tonsillectomy, the time is about twice as long (30-40 minutes in total). But the child is in the operating room for much longer than that (about 150 minutes in total) because there is also pre-surgery preparation, anesthesia and post-surgery anesthesia recovery time. For the parents, it can feel like longer than a year.
12.How long does the hospital stay take?
It usually takes anywhere from 7 days, mainly for pre-operative checkups and waiting, and you can usually be discharged on the 4th day after surgery.
13.How long do I have to rest after being discharged from the hospital?
Generally, you can go to school normally, and there is no special recommendation to rest at home. For children who have had tonsillectomy at the same time, if the school cannot provide semi-solid food at noon, you can consider resting at home for a few more days until you can eat solid food.
14.What should I eat after the surgery?
For adenoid surgery alone, you can eat semi-solid food that night and regular food the next day. If combined with tonsillectomy, you can eat semi-solid food on the night of surgery, and generally you have to eat for about a week, and you can basically resume normal diet after 3 weeks. In case of plasma surgery, it is generally recommended to eat for two weeks. It is important to encourage your child to eat as early as possible so that more movement of the pharyngeal muscles can make the pain go away sooner and reduce the possibility of foreign body sensation in the pharynx later. It is not necessary and not allowed to eat the so-called big tonic food, which will increase the possibility of bleeding.
15.Can I eat ice cream?
Yes, you can. Eating ice cream can reduce pain and will also reduce the chance of bleeding. But it is not necessary to eat, do not eat bad stomach.
16.Is there anything I can’t eat?
Except for the aforementioned tonic things, solid food, and overly spicy and stimulating food, all other things can be eaten.
17.Is there any food that can promote wound healing?
There is no such thing. Ordinary food is fine.
18.When do I need to review after the surgery?
One week and two weeks after discharge from the hospital, if there is no special need, there is no need to review. If there is a need, the doctor will explain the time of re-examination (usually two months after the surgery).