In recent years, the incidence of pediatric adenoid hypertrophy has been on the rise year by year, and we are quite familiar with the disease term adenoid hypertrophy and tonsillar hypertrophy, but how exactly do we treat them? Parents will be very concerned. Here are some frequently asked questions to talk to parents, hope to give you some help, of course, these are only my personal opinion, there will be doctors have different views, my these opinions only to provide you with reference. Gong Zhengpeng, Department of Otolaryngology, Head and Neck Surgery, Affiliated Hospital of Guizhou Medical University
1. Should children with adenoid hypertrophy be operated or not?
This is the most important issue for parents, and it is generally decided according to the child’s symptoms, the course of the disease, and whether there are other complications. If the child snores at night, breathes with open mouth, sleeps poorly, or even has breath-holding for a long time, or if this happens repeatedly, surgery is recommended. However, if the child only has such a condition after the recent cold, which has not happened before, or only has snoring, no breath-holding, no tossing and turning to sleep, etc., it is recommended to observe first, and immediate surgery is not recommended. If the child’s breath-holding symptoms are not very obvious, but if the child is accompanied by rhinosinusitis or otitis media, and there is no significant improvement after a period of medication, surgery is also recommended.
2. At what age can a child have surgery?
This is a great concern for parents. Surgery is generally not recommended for children under 2 years old because it is relatively easy to recur after surgery for children under 2 years old, but if the child’s symptoms are severe and seriously affect the child’s sleep and growth and development, surgery is recommended. For us, the surgical method and difficulty are the same, and there is no increased difficulty in surgery because of the child’s young age.
3. Surgical method and anesthesia
The child’s surgery was performed under general anesthesia, and modern anesthesia techniques should be safe for such an operation. The operation is minimally invasive, with minimal intraoperative bleeding and minimal postoperative reaction.
4. About tonsils
Should the tonsils be removed surgically or not. If the tonsils are enlarged and affect breathing, surgery is needed. Surgery is needed for recurrent inflammation of the tonsils.
5. About post-operative problems
If you have adenoids surgery alone, you can eat semi-liquid on the day after you wake up from anesthesia (usually 6 hours after surgery). The next day, if your child does not have obvious sore throat, you can eat normal food and only avoid overheated diet; if you have tonsillectomy at the same time, you usually have to have a liquid diet for about 3 days, and then decide whether you can eat semi-liquid according to your child’s condition. After the operation, the follow-up is usually 2 weeks. 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, and these conditions will gradually recover. However, there are a few children who will have some snoring after surgery due to enlarged turbinates or nasal-sinusitis, and need to treat nasal-sinusitis.
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This article is partly referenced from the original article by Prof. Cao Rongping, Department of Otolaryngology-Head and Neck Surgery, Shanghai Xinhua Hospital.