What age is best for Adenoidectomy ?-various aspects-
Adenoidectomy alone is an effective treatment option for non-obese children younger than 7 years of age with moderate OSA and small tonsils. Adenoidectomy is clinically useful in children older than 4 years for placement of a tympanostomy tube.
The age for adenoidectomy surgery is between 3-12 yrs . But it is always better if the child is at least 4 yrs old .
Below 3 yrs of age adenoids cannot be removed as they are important for immune function.
Decision for adenoidectomy is to be done only by ENT specialist doctor that also after doing CT-SCAN -PNS-enlarged adenoids causing obstruction to nasopharyngeal airway should be demonstrated in this SCAN and the patient should be also symptomatic-that means that patient should have repeated episodes of cold with only temporary relief with medicines ,nocturnal mouth breathing ,developed chronic otitis media as a complication .
In case if any child requires adenoidectomy surgery then parents of that child can take appointment from ENT specialist doctor Dr Sagar Rajkuwar (MS-ENT ) by clicking on the link given below-
www.entspecialistinnashik.com
Adress- Prabha ENT clinic, plot no 345,Saigram colony, opposite Indoline furniture, Ambad link road ,Ambad ,1 km from Pathardi phata ,Nashik ,422010,Maharashtra,India-Dr Sagar Rajkuwar (MS-ENT),ENT (Ear,Nose,Throat),specialist doctor . Cel no- 7387590194,9892596635
Reasons why the age of 12 yrs is the upper limit for the age of adenoidectomy surgery is that after the age of 12yrs adenoids regress naturally and cannot produce symptoms .
Then the question arises that then why not to wait till each and every child becomes 12 yrs of age -answer is that if the child has repeated episodes of cold ,develops severe sleep apnoea ,or chronic otitis media with tympanic membrane central perforation or cholesteotoma ,then it is not wise at all to wait till the child becomes 12 yrs of age.
What are indications of adenoidectomy surgery ?
Recurrent nasal infections,
difficulty breathing through the nose,
obstructive sleep apnea,
snoring or mouth breathing ,
chronic sinusitis ,otitis media
What are Adenoids -?
Lymphoid tissue called adenoids is located at the very rear of the nose canal. Adenoids, like tonsils, aid in maintaining the health of the body by ensnaring pathogenic germs and viruses that we ingest or breathe in. Adenoids, pronounced “AD-eh-noyds,” play a vital role in protecting infants and young children against infections.
What are enlarged adenoids ?
Sometimes, in an attempt to combat an illness, adenoidal tissue temporarily swells (becomes larger) because adenoids retain germs that enter the body. Moreover, allergies may cause them to enlarge.
Sometimes the swelling goes down. Infection of the adenoids can occur at other times (called adenoiditis). If this occurs frequently, an ENT specialist doctor may advise their removal. Adenoids and tonsils may or may not be removed at the same time.
What are signs and symptoms of enlarged adenoids ?
Children who have swollen adenoids may:
struggle to breathe via their nose
respire via your mouth, which may cause dry lips and mouth.
converse as though their noses are pinching
exhale loudly (“Darth Vader” breathing)
possess foul breath
snoring
Obstructive sleep apnea causes the breathing to stop for a few seconds while you sleep, which can cause sleep disturbances. Learning, behavioural, growth, cardiac, and occasionally bedwetting issues might result from this.
suffer from recurring or persistent sinus or nose infections
possess hearing loss, middle ear fluid, and ear infections.
What is adenoidectomy surgery ?
The surgical removal of the adenoids is known as an adenoidectomy (ad-eh-noy-DEK-teh-me). Along with tonsil ectomy, it’s one of the most common surgical operations performed on children.
An adenoidectomy may be suggested by a medical professional if a child’s swollen adenoids are bothering them and are not improving with medication.
Preoperative preparations for Adenoidectomy surgery –
Patient should remain NBM for 6 hrs prior to surgery ,physician fitness should be done ,CTSCAN -PNS should be done .
Technique of adenoidectomy surgery-
It is done in general anaesthesia with a zero degree endoscope under direct vision and nasopharyngeal pack is kept for some time to reduce the bleeding .
it does not requires external incision or stitches after surgery -it is totally endoscopic proceedure .
Post adenoidectomy –
NBM for 6 hrs
After that first icecream and soft diet
Medicines to be taken as prescribed by ENT specialist doctor which includes antibiotics ,analgesics ,antacids .
Children can typically return home the same day as the operation. Some could have to spend the night being observed.
After an adenoidectomy, patients typically experience a few days of minor pain and discomfort, which can include runny nose, sore throat, noisy breathing, or poor breath.
After surgery, everything should be back to normal and the adenoids’ troubles should be resolved in less than a week. You don’t need to bother about stitches because the adenoid area will naturally heal.
Risks from adenoidectomy-
Most children who get an adenoidectomy don’t have any major aftereffects or issues. However, any operation carries some dangers, such as bleeding, infection, and anesthesia-related issues. Before the procedure, discuss the potential risks and advantages with your child’s physician.
Post op and post discharge from hospital-
As instructed by your healthcare practitioner, give your youngster pain medication.
Make lots of drinks available. After surgery, most children are able to resume normal eating and drinking within a few hours; however, you may begin with soft foods such as custard, soup, gelatin or mashed potatoes.
After surgery, kids should rest for a few days. Observe the guidelines provided by the care team regarding your child’s activities in the week after surgery and when it’s appropriate for them to return to nursery or school.
Consider using a cool-mist humidifier to assist relieve your child’s congested nose. Every day, clean the humidifier to stop the growth of mould.
In which circumstances an ENT specialist doctor should be contacted post op and post discharge ?
If the child acquires a fever, throws up within the first day or after taking medication, experiences difficulty twisting their neck, has neck discomfort or stiffness that doesn’t go away, and isn’t urinating at least once per eight hours.
Seek immediate medical attention if your child:
has bleeding after the first day; vomits blood or what seems to be coffee grounds; has blood trickling from the nostrils or covering the tongue for longer than ten minutes
