Adenoid tonsillectomy for snoring in children

  Adenoid and/or tonsillar hypertrophy is the most common cause of sleep disorders in children, so adenotonsillectomy is currently the first line of treatment for sleep disorders in children.  Indications: Children with the following symptoms: snoring at night, open-mouth breathing, sleep disturbance, night sweats, urination, etc.; nasal congestion during the day, runny nose, nasal discharge or incomplete blowing; open-mouth breathing, wheezing with slight activity; hearing loss, attention deficit, irritability, irritability and other behavioral problems, growth and development disorders, whose main symptoms persist for more than 2 months and who have failed to achieve results with standardized conservative treatment.  Surgical methods: Traditional adenoidectomy is usually performed by scraping with a spatula, but it is less commonly used nowadays. The more popular methods are nasal endoscopic resection under direct vision with a power cut and suction system and low-temperature plasma radiofrequency ablation. Removal of adenoids under direct nasal endoscopy will be clearer, reduce damage to surrounding tissues, and facilitate the removal of adenoids protruding into the posterior nasal orifice, greatly reducing the chance of recurrence after surgery.  Cryo-plasma ablation of adenoids can reduce the amount of intraoperative bleeding. These two approaches are the current mainstream procedures, each with its own advantages and disadvantages. The classic tonsillectomy is a “cold peel” procedure, which has the advantage of no intraoperative thermal damage and quicker postoperative recovery, but has the disadvantage of relatively more intraoperative bleeding and more significant postoperative pain. Cryogenic plasma tonsillectomy is now widely used. Cryogenic plasma excision is achieved by using electrical currents conducted in the body’s normal salt solution or gel.  The energy generated by the radiofrequency activates the salt solution to produce an area of proton activation, and the activated protons can break the molecular bonds between the tissues. Since the temperature generated by this process is relatively low, it theoretically reduces thermal injury and postoperative pain and decreases intraoperative bleeding, but the pseudomembrane of the postoperative wound takes longer to shed and recovery time is prolonged.  Postoperative pain and recovery: The adenoids are in the area of the posterior nostril, and children generally do not feel much after scraping and are not in pain after surgery. The first three days after the tonsil surgery, the child may be uncomfortable, after all, the tonsils are in the throat, eating, drinking, swallowing and speaking all have to pass through there, may feel pain, but generally tolerable. It is recommended to apply cold compresses with ice packs or drink some ice water or eat some ice cream after surgery to stop both the bleeding and the pain. Usually you can eat soft food after one week, and a completely normal diet will take at least two weeks afterwards.