Surgery to remove adenoids by laser

Adenoids can be characterized as a lymphatic tissue located in the area of the nasopharynx. This tissue is active and viable only in childhood. In children, this tissue performs a protective function, providing reliable protection against various infections. Adenoids prevent the penetration of infection into the lower layers of the respiratory system. The main mechanism of action is realized through the development of special biologically active substances that provide protective action. They also prevent the uncontrolled spread of infection through the body.

The peak of adenoid activity is 2-10 years. After about 10 years, the synthesis of special protective substances gradually decreases. By the age of 18 adenoids completely atrophy, and their protective function is stopped.

In the process of adenoid activity, unexpected situations can occur. They can become inflamed with excessive stress on them. This significantly reduces their protective function, which sometimes makes the body completely defenseless before infection. Inflamed adenoids do not cope with the protective function, passing the infection inside, into the respiratory tract. In severe cases, with a strong and neglected inflammatory process, adenoids can themselves act as a source of infection. In this case, specialists see only one way - removal of adenoids.

It should be noted that not all specialists converge on a single point of view about the need to remove adenoids. In this regard, there are still many disputes. Some experts argue that the removal of adenoids makes it possible once and for all to get rid of the source of infection, thereby reducing the likelihood of the occurrence and spread of inflammatory and infectious processes.

Others argue that it is by no means possible to remove the adenoids. You can only heal. This position is explained by the fact that adenoids are a kind of lymphoid tissue, perform a protective function. Their removal makes the body defenseless on the path of infection, allows it to freely spread through the body, penetrate the respiratory tract. Removal of adenoids can lead to a general decrease in the immune status, severe disorders in the immune system. To deprive a child of an organ that is designed to protect the body from infection is extremely unreasonable. Moreover, adenoids cease to exist after 18 years.

Currently, there is an alternative solution that allows you to find a compromise between the two extreme positions. The solution is one: removal of adenoids by a laser.

This method has become widespread and has proven itself, because it has several advantages over traditional surgical techniques. If earlier removal of adenoids occurred with the help of conventional surgical techniques, using a scalpel, now there is a laser technique. It is based on the fact that the laser beam makes it possible to remove the inflamed tissue, to stop the infectious process, to eliminate the edema, without disturbing the integrity of the skin. There are many techniques, which one to choose depends on the form, severity of the disease, aggravating factors. As a result, it is possible to normalize the state with minimal damage. Tonsils gradually return to normal.

Laser devices are created by military technologies, their adaptation is gradually taking place, adapting to the daily practice of the surgeon. With the help of the laser, it became possible to conduct operations without blood.

[1], [2]

Indications for the procedure

Remove adenoids should only be as a last resort. In the event that medication, homeopathic, or physiotherapy treatment does not have the desired effect, we can talk about the need for surgical intervention.

The need for urgent removal of adenoid tissue indicates the emergence of an acute inflammatory process in the region of the lymphoid pharyngeal ring, as well as severe inflammation of the adenoids. In some cases, the inflammation can be so strong that the adenoids significantly increase in size. As a result of an increase in adenoids, they can fill the entire space of the nasopharynx, pharynx. Breathing is blocked. There is such a pathology in the form of nasal congestion, difficulty in nasal breathing, night snoring.

Indication for removal is a change in the function of adenoids, loss of protective properties from infectious agents. Especially if the  adenoids  themselves begin to act as a hotbed of infection.

The need for removal is also indicated by constant inflammatory processes, swelling, cough, and hyperemia. If the child is suffering from coughing, a persistent runny nose, burning and  pain in the tonsils  and pharyngeal ring, the most rational solution will be the removal of adenoids.

The operation is indicated for acute and  chronic tonsillitis, pharyngitis and laryngitis, which are accompanied by an increase in palatine tonsils. This includes cases in which the child constantly breathes his mouth. Some children even walk around with their mouths open during the day, as the nasal breathing is difficult. All this occurs against the background of diseases of the nasopharynx, pharynx, accompanied by swelling and flushing. As a result of edema, there is a  decrease in hearing acuity. This is a consequence of changes in pressure in the eardrums.

[3]

Preparation

Prepare for laser surgery to remove adenoids should begin in advance. First you need to visit a pediatrician, consult with him. He will determine the risks and benefits of the procedure, assess whether there is a need for an operation, or better to resort to drug treatment methods.

If necessary, the doctor will appoint an additional consultation of the otolaryngologist, immunologist. The otolaryngologist will assess the degree of involvement of the adenoids in the inflammatory process, determine how much their function is changed and make a conclusion about the expediency of removing adenoids.

The immunologist assesses the general condition of the child, the indices of his immune system, determines the immune status, and gives his recommendations and conclusions about how the removal of adenoids in the future will affect the protective reactions of the body.

After a preliminary conclusion is drawn on the need to remove adenoids, a surgeon's consultation is appointed. The surgeon must conduct an examination, a primary consultation. The surgeon diagnoses the patient, suggests treatment tactics. If the need for surgical intervention is confirmed, the surgeon begins to develop an individual treatment regimen, determines the appropriateness of the operation. The volume of surgical intervention is chosen, optimal surgical technique is determined, further treatment is performed.

The doctor should be warned that the child has concomitant diseases, the presence of allergies, the admission of any medications. The doctor must be warned about taking medications that dilute the blood, otherwise there is a risk of bleeding. Even if the child periodically takes any medication, the doctor should know about it.

For example, there are cases when even taking aspirin, which the doctor did not know, caused serious complications, became a threat to the life of the child. The fact is that aspirin dilutes blood, so it can cause bleeding, which can be difficult to stop. This can lead to severe blood loss.

After the conversation, the doctor will appoint a set of necessary tests. A general, biochemical blood test is given, blood clotting rate, hemosyndrome is determined.

Before the operation, an X-ray photograph of the paranasal sinuses may be required. In advanced cases, a CT scan may be required.

An important means of preparation is the organization of proper nutrition of the child. The sooner the preparation begins, the more successful the operation will be. About a few days before the operation it is recommended to switch to diet food: to exclude fatty, sharp, smoked, salty foods from the diet. It is not recommended to eat foods that irritate excessively mucous membranes, receptors: spices, marinades, preservation. It should be excluded sweets, pastries, flour products. Bread should be consumed in moderation. Exclude foods that are heavy for the stomach: legumes, peas, corn. It is recommended to eat dishes cooked on steam, or boiled.

On the eve of the evening, before the operation, food intake should be full, but easy. Ideally suitable for mashed potatoes or buckwheat porridge with steam cutlets, or boiled meat. As a supplement, greens, grated carrots. It is not recommended to use cereals, fresh vegetables and fruits.

In the morning, on the day of surgery, it is better to keep the hunger regime. You can not eat and drink. 2-3 hours before the operation, 2-3 breaths of water can be taken, no more.

[4],

Technique of the removal of adenoids by laser

The laser can remove adenoids in any form and stage of the disease. The deletion takes place in several stages.

The first stage is represented by complex diagnostics. At this stage, determine the location of the adenoid tissue, discover the causes of inflammation. To do this, the oral and nasal cavities are examined with the finger and endoscopic method. Then check the condition of the auditory tubes, inspect them. This is due to the fact that the auditory tubes are often covered by the inflammatory process, which can result in otitis, tubototitis. Tubal obstruction can cause serious functional and anatomical abnormalities in the auditory analyzer.

If there is such a need, preliminarily conduct tympanometry, an x-ray examination of the nasopharynx, pharynx. Then they start to check the state of the immune system: they perform allergic tests at the slightest suspicion of allergy. In addition, a study of susceptibility to antibiotics can be conducted.

After the preliminary diagnosis has been made, the necessary information for the operation has been collected, the correctness of the diagnosis is checked. The doctor must make sure that the operation is really necessary.

 After this, go directly to the operation. The patient is provided with full psychological and physical training. Select the optimal anesthetic. Features of laser removal of adenoids are that the operation is performed without cuts and cavitary interventions. Therefore, the skin and mucous membranes are practically not damaged. In essence, this manipulation can not be called an operation, but in technology it is an operation.

The choice of the method by which the operation will be performed depends on the size of the enlarged lymphoid tissue, as well as on how much it is damaged. For example, in order to remove nasopharyngeal tonsils, the easiest way is to excise adenoids with a carbon dioxide laser. This technique promotes the evaporation of small growths. As a result, adenoids are not completely removed, but only smoothed out.

With a strong proliferation of adenoids, the laser coagulation method is used. This method cauterizes the inflamed tissue, and it quickly disappears. During this operation, a focused laser beam is applied. It moves in the direction from the body of the built-up edge to its base. Interstitial coagulation is often used. During this procedure, the submucosal membranes of adenoids evaporate. At the same time, the shells of the organs remain intact.

A method of surgical evaporation in combination with a laser is often used. First, adenoids are excised using traditional surgical techniques, then the remains of the inflamed tissue are evaporated using a laser.

After the operation, the rehabilitation period begins.

Removal of adenoids in the nose with a laser

Adenoids in the nose are quite common, occurring in everyday practice. If they are not treated, they do not pass by themselves. Inflammation, infection will develop. In the absence of treatment, the process only worsens, complications arise. These complications can be treated in various ways, but in most cases it is necessary to apply the surgical method. Traditionally, drug therapy is powerless. An excellent alternative is the removal of adenoids by a laser.

The laser is convenient to use, because the operation is quick, painless. Deep damages the laser does not leave, cuts are also not done. Therefore, the recovery period does not last long. Traumaticity of the method is low. The method is considered safe, even for the youngest patients.

First, the child is first prepared to remove the adenoids. Then produce the procedure directly. In most cases, preference is given to the coagulation or evaporation method. In this case the submucous membranes of the adenoids are evaporated by means of a laser, and the adenoids themselves are gradually smoothed out.

Adenoids can be recognized by such a basic symptom as a violation of nasal breathing. The baby breathes through the nose, often snores and snorts during sleep. Even in the daytime, a child often walks with his mouth open, since he lacks air. Often observed nasal congestion, a persistent runny nose. Smells are almost not perceived. All this occurs against a background of headache, weakness, apathy.

With a more neglected form, the nasal voice, disturbance and deterioration of hearing is noted. There can be otitis, tubototy. If the adenoids are not treated for a long time, lymph nodes become inflamed, and painfulness is felt during palpation. Illness is also reflected in the child's mental state. Children with adenoids have low perseverance, mood is often bad, activity is reduced. As a result, school performance declines, there may even be a delay in development.

Contraindications to the procedure

Adenoids can not be removed by all. There are cases when the removal is contraindicated. For example, children under the age of 2 years to remove adenoids is not just not recommended. This makes no sense, because due to the high rate of recovery processes, adenoids will grow again. It is also forbidden to remove adenoids at various anomalies of development of soft and hard palate.

In the presence of blood diseases, with low coagulability, hemophilia, any other abnormalities, surgery is also not recommended. In the acute phase of any disease, with diseases of the upper respiratory tract, skin diseases, the operation is not performed.

Also, adenoids can not be removed by taking blood thinning medications, if there is a suspicion of cancer, with infectious diseases, in the period after the prophylactic vaccination (about 1 month after vaccination).

[5], [6]

Consequences after the procedure

As a rule, after removal of adenoids by a laser, the effects are practically not observed. Because the operation is not very traumatic, it means minimal intervention, doctors can guarantee even a complete absence of consequences.

 Bleeding almost does not occur, since the damage surface is minimal. Accordingly, the blood can not get into the stomach, the use of hemostatic agents is not required.

When removing adenoids by laser, general anesthesia, as a rule, is not used. It is enough to use local anesthesia. Consequently, reactions to anesthesia are also not noted.

The risk of developing an infection is also minimal, since no incisions are made, the wound surface is small.

 In a routine operation, bleeding usually stops for 10-20 minutes. In normal surgery, nausea and vomiting can also occur, immediately after the operation. This is an individual reaction of the body to anesthesia, and it passes quite quickly. Vomiting with blood clots, abdominal pain, stool disorder can be a consequence of the fact that the child swallowed blood during the operation. Such violations are a normal reaction that occurs when blood interacts with the contents of the stomach. Usually they pass by themselves and quickly enough.

But if after removal of the operation with a laser, signs of bleeding persist for a longer time, you should immediately consult a doctor.

Despite the fact that when removing adenoids with a laser, there are almost no consequences, each parent needs to know in general outline what consequences the child may have after the operation.

The main consequences of adenoids removal are three groups of consequences: infectious-allergic, functional, organic. In the first case, there may be a short inflammatory process, the development of an infection process due to infection. This can be accompanied by pain in the throat, nasopharynx, inflammatory process. There may also be an allergic reaction, which manifests itself in the form of rash, hyperemia, edema, redness, inflammation. Allergy can go for anesthesia, medicines used during surgery, antiseptics.

Functional disorders can be observed for some time after the operation. There can be a change in voice, coughing, hoarseness of voice, burning in the throat, which occurs as a result of mechanical damage to tissues, vessels. As a rule, these symptoms disappear after the expiration of the rehabilitation period and should not cause any special concern. The temperature can rise, which also indicates the regenerative processes taking place in the body.

During surgery, vascular damage can occur, and bleeding may occur. Usually they stop quite quickly, they do not require special intervention.

Organic damage manifests itself in the form of systemic disorders, such as immune system disorders, fever, general weakness, deterioration of well-being.

Immediately after the operation, nasal breathing usually improves dramatically, but in the future, it can again break, there will be nasal congestion, hoarseness, nasal voice. This is usually a consequence of postoperative edema, which occurs approximately on the 10th day.

[7], [8]

Complications after the procedure

After removal of adenoids by laser, the probability of complications and relapse is insignificant. If they arise, it can be a human factor. So, the anatomical features of the nasal cavity of the child do not always allow to completely remove the expanded tissue. If the doctor left, at least a millimeter of tissue, it will grow again. If there is any doubt, the doctor may go on to endoscopic removal of the tissue.

In some cases, there may be an increase in temperature, which can be caused by various causes. This is an intensive recovery process, and penetration of the infection. When infection or dissemination of postoperative edema can occur, inflammation of the middle ear, inflammation of the inner ear. Also, overall health may worsen, and accompanying illnesses may worsen.

There is a risk of allergic reactions.

However, in general, complications are rare. The results are favorable in most cases. The child is fully recovered within 1-4 weeks.

[9],

Care after the procedure

After removal of adenoids, the child requires compliance with the postoperative regimen. The focus should be on nutrition. Food should be light, and at the same time balanced. Rough, solid food should be excluded from the diet. It is recommended to eat food in liquid form. Food should be high in calories, contain fresh foods that contain a large amount of vitamin. This diet should be observed from 3 to 10 days. In the presence of complications, or other indications, the term of the diet can be extended. This will inform the doctor.

At least for 3 days you can not swim in hot water, sweat, sunbathe in the sun. Being in hot and stuffy rooms is also contraindicated.

Within 2 weeks, you need to exclude physical education, sports. This period can be extended to 1 month. You can not run, jump high, make sudden movements.

If necessary, the doctor can prescribe medications that promote better healing of the surgical wound. To such preparations carry: naftizin, tizin, galazolin, sanorin and other preparations. Apply them about 5 days. Also, solutions that provide an astringent or drying effect can be used. Well-proven drugs containing iodine. They dry, promote the healing of wounds. It may be necessary to wash the nose. This will also inform the doctor.

Some time after the operation, the temperature may rise, especially in the evening and in the morning. Necessarily need to consult a doctor about what antipyretic drugs can be taken. In no case should not give a child aspirin, and any other drugs containing acetylsalicylic acid. It dilutes blood, and can cause bleeding.

[10], [11], [12]

Reviews

Marina. After removing adenoids, the child began to feel much better. Inflammation decreased, coughing also disappeared. We stopped working exclusively "on the drugstore", buying expensive drugs for permanent edema, tonsillitis, angina. On the day of surgery the child was drowsy, weak, constantly crying. But already on the second day the state of health began to improve, there was an appetite.

Elena. The child was removed adenoids. After that, the condition first improved. Within six months, there was no pain in the throat, swelling. For six months the child has never been ill. But after this period the child began to get sick even more. Diseases of the throat, nasopharynx have become more prolonged, more severe. If previously worried mainly tonsillitis or laryngitis, now began to appear sore throats. There were three different doctors, an immunologist. The immunologist says that this is a consequence of the removal of adenoids. According to the immunologist, adenoids are a protective barrier to infection, protect the body. Now the child does not have such protection, which means that he became even more vulnerable to infection, recovery is faster. He says that it was not worth removing them, that now there are many methods of treatment. Over time, they would cease to become inflamed. In addition, by about 18 years, adenoids in general are atrophied themselves.

Galya. I think that it is not worth hurrying to remove. In addition, remove - always have time. They say that adenoids after 18 years atrophy themselves, the child outgrows. I was convinced of this on my own experience. To me now 27 years, approximately years 20 back doctors all forces tried to remove to me adenoides. Each visit to the doctor for the slightest reason resulted in the fact that I was sent to a surgeon, and he tried to persuade us in all ways to have an operation.

But my mother always was against it, and I also always resisted. Once we all the same have put in hospital. We decided that we must remove it - there is no other way out. Doctors made the necessary tests, it turned out that I have low blood clotting. At such rates doctors simply were afraid to do an operation, they said that during the operation I just bleed. So they wrote me out "with nothing."

I certainly was painful. Often I often had colds, I constantly took up sore throats. This continued until about the end of school. But after I turned 18, diseases of the pharynx, nasopharynx, adenoids, I absolutely stopped worrying. Since I turned 18, I practically do not get sick, and nobody touched the adenoids! I almost do not apply to doctors, except for cases when it is necessary to undergo any medical examination, or a commission.