Adenoids in a child: treat or remove?

Adenotomy is a routine operation for surgeons. It is not considered an emergency or urgent operation, so it is performed after a series of diagnostic tests. Planned surgery lasts no more than 10-20 minutes and is performed under local or general anesthesia. After the procedure, the patient is under medical supervision for 5-6 hours. That is why the operation is performed in the morning, and the patient returns home in the evening. In extremely rare cases, when there are complications, the patient is left overnight in the hospital.

Is it dangerous to remove adenoids in children?

The third tonsil, or adenoid tissue, develops by 3-6 months of life, but after 12 years it begins to decrease and by 20 years it becomes completely invisible. In a child's body, it acts as an additional barrier to pathogenic microorganisms. The tonsils filter the air inhaled through the nose, protecting the larynx and other organs of the respiratory system.

The size of adenoid tissue is normal until frequent infectious and inflammatory diseases lead to its atrophy. Strong proliferation of lymphoid tissue closes the entrance to the nasal cavity, causing a number of painful symptoms:

• Impaired nasal breathing has a negative impact on overall well-being, causing problems with academic performance and absent-mindedness.
• Atrophy leads to blockage of the auditory tube, disrupting ventilation of the middle ear. Against this background, hearing loss and discharge of purulent contents are possible.
• Long-term mouth breathing leads to abnormal development of the facial skeleton. The lower jaw begins to droop. This causes deformation in the formation of teeth, as the upper incisors protrude forward.
• Incorrect breathing can cause a disruption in the anatomy of the spinal curvature.

The above symptoms develop gradually as the disease progresses. Timely removal of adenoids helps prevent such complications. Surgical treatment is not dangerous. The otolaryngologist performs the procedure under local or general anesthesia (depending on the patient's age and type of surgery). The removal lasts less than 20 minutes, and the risk of complications is minimal. After surgery, the immune system is fully restored within a few months.

One of the most common surgical operations in pediatric ENT practice is the removal of adenoids. The procedure is performed if there are appropriate indications. The reason for the operation are the following symptoms:

• Sleep apnea syndrome.
• Exudative otitis.
• Malignant degeneration of the nasopharyngeal tonsil.
• Maxillofacial anomalies.
• Drug therapy does not produce the desired effect.
• Frequent relapses of adenoiditis (more than 4 times a year).

Let's consider the features of adenoid removal in children: the pros and cons of this treatment method:

Advantages	Flaws
The operation allows to get rid of pathological symptoms of adenoids. After 2-3 days normal breathing and oxygen supply of the body are restored.	The surgical intervention is performed using anesthesia, which already represents a risk of complications of less than 1%.
Various surgical intervention techniques allow us to select the optimal treatment option individually for each patient.	Regardless of the removal method chosen, there are varying degrees of risk of recurrence.
The procedure is performed under general or local anesthesia. The little patient does not feel anything, and the operation takes no more than 20 minutes.	The operation does not guarantee a reduction in the frequency of infectious diseases in children, since inflamed adenoids are the result of frequent infections, not the cause.
Removal is performed on an outpatient basis. In case of inpatient treatment, the hospital stay takes no more than 3 days.	Removing adenoids leaves the body without a protective barrier. Because of this, the frequency of infectious diseases may increase. Especially with a weakened immune system.
Modern methods of adenotomy allow for the complete removal of atrophied lymphoid tissue, sealing the vessels and preventing bleeding. The procedure is necessary to restore nasal breathing and prevent hearing impairment.	Adenoid tissue recovers within 4-6 months. The frequency of relapses depends on the patient's age and the characteristics of his immune system.
Preparation for surgery consists of a set of diagnostic procedures. Recovery is quick and virtually complication-free.	After the operation, the immune system is weakened for several months. Recovery occurs after other tonsils of the lymphoid ring take over the protective functions.

Treatment is divided into conservative and surgical. The opinions of specialists on the need to remove adenoids and the effectiveness of this procedure are very contradictory. Opponents of the operation believe that the operation threatens a significant decrease in immunity, the risk of complications. There is also a risk of relapse. Opponents argue that drug treatment is no less dangerous. Since missing the time to perform the operation, you can cause irreparable harm to the child's body.

Removal of adenoids in children with allergies

Inflammation of the tonsils caused by various allergens is allergic adenoiditis. The painful condition may be associated with inhalation of dust, pollen, animal hair, or may arise due to food irritants. Allergies negatively affect the respiratory tract. The mucous membrane of the tonsils becomes irritated, inflamed, and hypertrophied. Long-term contact with the allergen leads to tissue deformation. Most often, this disease is diagnosed in children aged 4-8 years.

Types of adenoids caused by allergic reaction:

• The first stage is the early stage of tonsil inflammation. Due to the pathological process, a part of the nasopharynx is replaced.
• The second degree – the inflammatory process affects 2/3 of the nasopharynx.
• The third stage is a severe and pronounced pathological process. Without appropriate treatment, it leads to respiratory failure and even death.

Most often, allergy sufferers are prescribed drug therapy to relieve the inflammatory process. To speed up recovery, physiotherapy procedures are used: inhalations, rinsing. Antihistamine drops are used to reduce swelling of the nasal mucosa. Vitamin intake and healthy nutrition are also recommended to improve immunity.

Removal of adenoids in children with allergies is a radical method of treatment, which is carried out only under appropriate medical indications. This is due to the risk of complications due to increased sensitivity of the mucous membrane of the nose and throat to various irritants. But with timely and correct treatment, the occurrence of side effects is minimal.