Laser surgery to remove adenoids

Adenoids can be described as lymphatic tissue located in 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 infection from penetrating into the lower layers of the respiratory system. The main mechanism of action is realized through the production of special biologically active substances that provide a protective effect. They also prevent the uncontrolled spread of infection throughout the body.

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

During the activity of adenoids, unexpected situations may be observed. They may become inflamed, if there is excessive load on them. This significantly reduces their protective function, which sometimes makes the body absolutely defenseless against infection. Inflamed adenoids do not cope with the protective function, allowing infection to enter inside, into the respiratory tract. In severe cases, with a strong and advanced inflammatory process, adenoids themselves can 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 agree on the need to remove adenoids. There are still numerous disputes on this issue. Some specialists claim that removing adenoids makes it possible to get rid of the source of infection once and for all, thus reducing the likelihood of the occurrence and spread of inflammatory and infectious processes.

Others argue that adenoids should never be removed. They can only be treated. This position is explained by the fact that adenoids are a type of lymphoid tissue and perform a protective function. Their removal makes the body defenseless against infection, allowing it to spread freely throughout the body and penetrate the respiratory tract. Removal of adenoids can lead to a general decrease in immune status and severe disorders in the immune system. It is extremely unreasonable to deprive a child of an organ that is designed to protect the body from infection. Moreover, adenoids cease to exist after 18 years.

There is currently an alternative solution that allows finding a compromise between the two extreme positions. There is only one solution: laser removal of adenoids.

This method has become widespread and has proven itself well, since it has a number of advantages over traditional surgical techniques. If previously adenoids were removed using conventional surgical techniques, using a scalpel, now there is a laser technique. It is based on the fact that a laser beam makes it possible to remove inflamed tissue, stop the infectious process, eliminate swelling, without violating 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 condition with minimal damage. The tonsils gradually return to normal.

Laser devices are created using military technologies, and are gradually being adapted to the surgeon's daily practice. With the help of lasers, it has become possible to perform operations without blood.

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Indications for the procedure

Adenoids should be removed only as a last resort. If medication, homeopathic, or physical therapy does not produce the desired effect, then surgical intervention is necessary.

The need for urgent removal of adenoid tissue is indicated by the occurrence of an acute inflammatory process in the area of the lymphoid-pharyngeal ring, as well as severe inflammation of the adenoids. In some cases, the inflammation can be so severe that the adenoids increase significantly in size. As a result of the enlargement of the adenoids, they can fill the entire space of the nasopharynx, pharynx. Breathing is blocked. This pathology manifests itself in the form of nasal congestion, difficulty in nasal breathing, and night snoring.

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

Constant inflammatory processes, swelling, cough, hyperemia also indicate the need for removal. If a child suffers from cough, constant runny nose, burning and pain in the tonsils and pharyngeal ring, the most rational solution will also be the removal of adenoids.

The operation is indicated for acute and chronic tonsillitis, pharyngitis and laryngitis, which are accompanied by enlargement of the palatine tonsils. This also includes cases in which the child constantly breathes through the mouth. Some children even walk with an open mouth during the day, since nasal breathing is difficult. All this occurs against the background of diseases of the nasopharynx, pharynx, accompanied by edema and hyperemia. As a result of edema, hearing acuity decreases. This is a consequence of changes in pressure in the eardrums.

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Preparation

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

If necessary, the doctor will prescribe an additional consultation with an otolaryngologist or immunologist. The otolaryngologist will assess the degree of adenoid involvement in the inflammatory process, determine how much their function has changed, and make a conclusion about the advisability of removing the adenoids.

The immunologist will assess the child's general condition, indicators of his immune system, determine the immune status, and give his recommendations and conclusions regarding how the removal of adenoids will subsequently affect the body's defense reactions.

After a preliminary conclusion has been made about the need to remove the adenoids, a consultation with a surgeon is scheduled. The surgeon must conduct an examination, a primary consultation. The surgeon diagnoses the patient, suggests a treatment strategy. If the need for surgical intervention is confirmed, the surgeon begins to develop an individual treatment plan, determines the feasibility of the operation. The scope of surgical intervention is selected, the optimal surgical technique and further treatment are determined.

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

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

After the conversation, the doctor will prescribe a set of necessary tests. A general and biochemical blood test is taken, the blood clotting rate and hemosyndrome are determined.

An X-ray of the paranasal sinuses may be required before surgery. In advanced cases, a CT scan may be required.

An important means of preparation is organizing the child's proper nutrition. The earlier the preparation begins, the more successful the operation will be. Approximately a few days before the operation, it is recommended to switch to a dietary diet: exclude fatty, spicy, smoked, salty foods from the diet. It is not recommended to eat foods that excessively irritate the mucous membranes, receptors: spices, marinades, preserves. You should exclude 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 steamed or boiled dishes.

The evening before the operation, the meal should be complete but light. Mashed potatoes or buckwheat porridge with steamed cutlets or boiled meat are ideal. Greens and grated carrots are suitable as an addition. It is not recommended to eat cereals, fresh vegetables and fruits.

In the morning, on the day of the operation, it is better to maintain a fasting regime. You cannot eat or drink. 2-3 hours before the operation, you can take 2-3 sips of water, no more.

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Technique laser removal of adenoids

Adenoids can be removed with a laser at any form and stage of the disease. Removal takes place in several stages.

The first stage is represented by a comprehensive diagnosis. At this stage, the features of the location of the adenoid tissue are determined, the causes of inflammation are detected. For this, the oral and nasal cavities are examined using a digital and endoscopic method. Then the condition of the auditory tubes is checked, they are examined. This is due to the fact that the auditory tubes are often affected by an inflammatory process, the consequence of which can be otitis, tubootitis. Obstruction of the tubes can cause serious functional and anatomical disorders of the auditory analyzer.

If such a need arises, tympanometry, X-ray examination of the nasopharynx and pharynx are carried out beforehand. Then they begin to check the state of the immune system: allergy tests are carried out at the slightest suspicion of an allergy. Additionally, a study on sensitivity to antibiotics can be carried out.

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

After this, they proceed directly to the operation. The patient is provided with full psychological and physical preparation. The optimal anesthetic is selected. The peculiarities of laser removal of adenoids are that the operation is carried out without incisions and cavity interventions. Therefore, the skin and mucous membranes are practically not damaged. In essence, this manipulation cannot be called an operation, but in terms of technique it is precisely 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 damaged it is. For example, in order to remove the nasopharyngeal tonsils, the simplest method is excision of the adenoids using a carbon dioxide laser. This technique helps to evaporate small growths. As a result, the adenoids are not completely removed, but only smoothed out.

In case of severe adenoid growth, the laser coagulation method is used. This method cauterizes the inflamed tissue, and it quickly falls off. During this operation, a focused laser beam is used. It moves in the direction from the body of the growth to its base. Interstitial coagulation is also used quite often. During this procedure, the submucous membranes of the adenoids are evaporated. The membranes of the organs remain intact.

A method often used is surgical vaporization in combination with a laser. First, the adenoids are excised using traditional surgical techniques, then the remaining inflamed tissue is vaporized using a laser.

After the operation, the rehabilitation period begins.

Laser removal of adenoids in the nose

Adenoids in the nose are a fairly common occurrence in everyday practice. If left untreated, they will not go away on their own. Inflammation and an infectious process will develop. Without treatment, the process only worsens, complications arise. These complications can be treated in various ways, but in most cases, a surgical method has to be used. Traditionally, drug therapy is powerless. An excellent alternative is laser removal of adenoids.

The laser is convenient to use, as the operation is quick and painless. The laser does not leave deep damage, and no incisions are made. Therefore, the recovery period is short. The trauma of the method is low. The method is recognized as safe, even for the smallest patients.

First, the child is pre-prepared for adenoid removal. Then the procedure itself is performed. In most cases, preference is given to the coagulation or evaporation method. In this case, the submucous membranes of the adenoids are evaporated using a laser, and the adenoids themselves are gradually smoothed out.

Adenoids can be recognized by such a basic sign as impaired nasal breathing. The child breathes through the nose, often snores and sniffles during sleep. Even during the day, the child often walks with an open mouth, since he does not have enough air. Nasal congestion and constant runny nose are often observed. Smells are practically not perceived. All this occurs against the background of headaches, weakness, apathy.

In more advanced forms, the voice becomes nasal, hearing is impaired and worsens. Otitis and tubootitis may occur. If adenoids are not treated for a long time, the lymph nodes become inflamed and there is pain when palpated. The disease also affects the child's mental state. Children with adenoids have low perseverance, their mood is often bad, and their activity is reduced. As a result, school performance decreases and developmental delays may even occur.

Contraindications to the procedure

Not everyone can have adenoids removed. There are cases when removal is contraindicated. For example, it is not just not recommended to remove adenoids for children under 2 years of age. There is no point in this, since due to the high speed of recovery processes, the adenoids will grow back. It is also prohibited to remove adenoids in case of various anomalies in the development of the soft and hard palate.

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

Also, adenoids cannot be removed if you are taking blood thinners, if you suspect cancer, if you have infectious diseases, or in the period after preventive vaccinations (approximately 1 month after vaccinations).

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Consequences after the procedure

As a rule, after laser removal of adenoids, there are practically no consequences. Since the operation is minimally invasive and involves minimal intervention, doctors can even guarantee a complete absence of consequences.

Bleeding practically does not occur, since the damaging surface is minimal. Accordingly, blood cannot get into the stomach, and the use of hemostatic agents is not required.

When removing adenoids with a laser, general anesthesia is usually not used. Local anesthesia is sufficient. Therefore, reactions to anesthesia are also not observed.

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

During a routine operation, bleeding usually stops within 10-20 minutes. During a routine operation, nausea and vomiting may also occur immediately after the operation. This is an individual reaction of the body to anesthesia and passes quite quickly. Vomiting with blood clots, abdominal pain, and bowel problems may be a consequence of the child swallowing blood during the operation. Such disorders are a normal reaction that occurs when blood interacts with the contents of the stomach. They usually pass on their own and quite quickly.

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

Despite the fact that there are practically no consequences when removing adenoids with a laser, every parent needs to know in general terms what consequences a child can expect after the operation.

The main consequences of adenoid removal are three groups of consequences: infectious-allergic, functional, organic. In the first case, a short-term inflammatory process may be observed, the development of an infectious process due to infection. This may be accompanied by pain in the throat, nasopharynx, an inflammatory process. An allergic reaction may also be observed, which manifests itself in the form of a rash, hyperemia, swelling, redness, and an inflammatory process. Allergy may occur to anesthesia, medications used during surgery, antiseptics.

Functional disorders may be observed for some time after the operation. There may be a change in voice, cough, hoarseness, burning in the throat, which occurs as a result of mechanical damage to tissues and blood vessels. As a rule, these symptoms disappear after the rehabilitation period and should not cause any particular concern. Temperature may increase, which also indicates recovery processes occurring in the body.

During the operation, damage to blood vessels and bleeding may occur. Usually, they stop quite quickly and do not require special intervention.

Organic lesions manifest themselves in the form of systemic disorders, such as a disruption of the immune system, fever, general weakness, and deterioration of health.

Immediately after the operation, nasal breathing usually improves dramatically, but later, it may be disrupted again, nasal congestion, hoarseness, and a nasal voice will appear. This is usually a consequence of postoperative edema, which passes approximately on the 10th day.

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Complications after the procedure

After laser removal of adenoids, the probability of complications and relapse is insignificant. If they occur, it may be a human factor. Thus, the anatomical features of the child's nasal cavity do not always allow for the complete removal of overgrown tissue. If the doctor left at least a millimeter of tissue, it will grow again. If there is any doubt, the doctor may proceed to endoscopic tissue removal.

In some cases, there may be an increase in temperature, which may be caused by various reasons. This includes an intensive recovery process and the penetration of infection. When an infection penetrates or postoperative edema spreads, inflammation of the middle ear, inflammation of the inner ear may be observed. General well-being may also worsen, and concomitant diseases may worsen.

There remains a risk of allergic reactions.

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

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Care after the procedure

After adenoid removal, the child requires a postoperative regimen. The main attention should be paid to nutrition. The food should be light and at the same time balanced. Coarse, solid food should be excluded from the diet. It is recommended to eat food in liquid form. The food should be high in calories, contain fresh products containing a large amount of vitamins. Such a diet will have to be followed from 3 to 10 days. In the presence of complications or other indications, the diet period can be extended. The doctor will inform you about this.

For at least 3 days, you cannot bathe in hot water, take a steam bath, or sunbathe. Staying in stuffy and hot rooms is also contraindicated.

For 2 weeks, you should avoid physical exercise and sports. This period can be extended up to 1 month. You cannot run, jump high, or make sudden movements.

If necessary, the doctor may prescribe medications that promote better healing of the surgical wound. Such medications include: naphthyzinum, tizin, galazolin, sanorin and other medications. They are used for about 5 days. Solutions that have an astringent or drying effect can also be used. Iodine-containing medications have proven themselves well. They dry out and promote wound healing. Nasal rinsing may be required. The doctor will also inform you about this.

For some time after the operation, the temperature may rise, especially in the evening and morning. It is necessary to consult with the doctor about what antipyretic drugs can be taken. In no case should you give the child aspirin or any other drugs containing acetylsalicylic acid. It thins the blood and can cause bleeding.

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Reviews

Marina. After the adenoids were removed, the child began to feel much better. The inflammation decreased, the cough also disappeared. We stopped working exclusively "for the drugstore", buying expensive drugs for constant swelling, tonsillitis, sore throats. On the day of the operation, the child was sleepy, weak, and cried constantly. But already on the second day, his health began to improve, and his appetite returned.

Elena. The child had his adenoids removed. After that, the condition improved at first. For six months, there was no pain in the throat or swelling. During this six months, the child never fell ill. But after this period, the child began to get sick even more. Throat and nasopharyngeal diseases became more prolonged and more severe. If before, tonsillitis or laryngitis mainly bothered him, now he began to get sore throats. We visited three different doctors and an immunologist. The immunologist says that this is a consequence of the removal of the adenoids. According to the immunologist, adenoids are a protective barrier to infection, they protect the body. Now the child does not have such protection, which means that he has become even more susceptible to infection, and recovery occurs faster. He says that they should not have been removed, that there are now many treatment methods. Over time, they would have stopped becoming inflamed. In addition, by about 18 years old, adenoids generally atrophy on their own.

Galya. I think there is no need to rush to remove them. Besides, you can always remove them. They say that adenoids atrophy on their own after 18 years, the child outgrows them. I have seen this for myself. I am 27 now, about 20 years ago doctors tried their best to remove my adenoids. Every visit to the doctor for the slightest reason ended with me being sent to a surgeon, and he tried in every way to persuade us to have the operation.

But my mother was always against it, and I was always against it too. Once we were finally admitted to the hospital. They decided that it had to be removed – there was no other way out. The doctors did the necessary tests, and it turned out that I had low blood clotting. With such indicators, the doctors were simply afraid to perform the operation, they said that I would simply bleed to death during the operation. So they discharged me “with nothing”.

Of course, I was sickly. I often had colds, and I constantly caught tonsillitis. This continued until I graduated from school. But after I turned 18, diseases of the throat, nasopharynx, and adenoids completely stopped bothering me. Since I turned 18, I have practically never been sick, and no one has touched my adenoids! I almost never go to the doctor, except for those cases when I need to undergo some kind of medical examination or commission.