Written By: Debjani Arora | Published : March 7, 2018 6:26 PM IST
This is one question that weighs heavily on every parent whose kid suffers from tonsils. For a parent, it isn't a very pleasant situation to deal. Kids who suffer from tonsils complain of pain when the gland swells. Sometimes doctors do suggest removing the tonsils for a smooth functioning and pain-free experience in kids. We got Dr Dillon Dsouza, Consultant ENT and Head and Neck surgeon, attached to Jaslok Hospital, Breach Candy hospital and Desa's Hospital to talk about the same.
What are adenoids?
They are two small lumpy tissues like structure situated behind the back of the nose where it joins the throat. They are a part of the lymphatic system which produces white blood cells and proteins and fats in a liquid form and plays an important role in body's immune system that fights infections. They are also known as a pharyngeal tonsil or nasopharyngeal tonsil. They usually disappear around four to five years of age.
After birth, they begin to enlarge and continue to do so until aged five to seven years. Symptomatic enlargement between 18 to 24 months of age is not uncommon. This is the reason why kids of that age snore as the nasal airway is obstructed and obstructed breathing may occur during sleep. However, this may be reasonably expected to decline when children reach school age and the tonsils shrink thereafter.
Why do some kids have enlarged adenoids?
Sometimes the gland might not shrink and get enlarged. An enlarged adenoid, or adenoid hypertrophy, can become nearly the size of a ping-pong ball and completely block airflow through the nasal passages. Even if the enlarged adenoid is not substantial enough to physically block the back of the nose, it can obstruct airflow enough so that breathing through the nose requires an uncomfortable amount of work, and inhalation occurs instead through an open mouth. The enlarged adenoid can also obstruct the nasal airway enough to affect the voice without actually stopping nasal airflow altogether.
Enlargement of the adenoid, especially in children, causes an atypical appearance of the face, often referred to as adenoid faces.
Features of adenoid faces include
How are they treated?
In most of the cases, they respond well to medication. They first need to be detected by x-rays or ct scans. Usually, antibiotics and anti-inflammatory medicines to stop allergies are used to treat them.
When should one remove adenoids?
If in spite of good medication and avoiding allergy-causing foods, there is severe difficulty breathing in a child or adenoid faces starts developing or the child keeps developing ear infections and discharge, removal of adenoids and tonsils is indicated.
How are they removed?
Surgical removal of the adenoid is a procedure called adenoidectomy. Adenoid infection may cause symptoms such as excessive mucus production, which can be treated by its removal. Studies have shown that adenoid regrowth occurs in as many as 20 percents of the cases after removal. Carried out through the mouth under a general anaesthetic (or less commonly a topical), adenoidectomy involves the adenoid being scooped out like scooping ice-cream or cauterised (burnt by electric current), or vaporised by lasers or melted by a machine called a coblator.
Is there any risk involved in the procedure?
Apart from the usual risks associated with anaesthesia and any surgery, there are no additional risks associated with adenoidectomy if done correctly.
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