TONSILLECTOMY, ADENOIDECTOMY AND EAR TUBE APPLICATION
The importance of explaining and performing all three of these surgeries is due to interrelated reasons and problems.
Tonsillectomy; It is defined as the removal of both tonsils inside the mouth. Tonsil surgery constitutes an important part of ear, nose and throat surgeries. It is not as easy or simple a surgery as it seems. After the age of 3, depending on the frequency and size of the infection(see chronic tonsillitis page), a decision for surgery may be made. In addition, adenoid formation in the nasal area often accompanies these patients. These problems also lead to the accumulation of ear fluid (see serous otitis) therefore, this surgery, adenoidectomy (adenoid removal) and ear tube application can be performed at the same time.
< br /> Pre-operative process: Before the surgery, the patient is evaluated for general anesthesia. Pediatric patients are evaluated by a pediatrician. Bleeding, liver and kidney function tests and viral markers are planned as blood tests. In case of active infection, it is treated first.
Operation process: The duration of the surgery varies depending on all these interventions. Tonsillectomy takes approximately 45 minutes, adenoidectomy 15 minutes, and ear tube application 10 minutes. This period reaches 90 minutes after the patient sleeps and wakes up.
Tonsil surgery is a type of surgery in which the tonsil is removed from the bed in the mouth with the appropriate technique and the operation is terminated by controlling the bleeding of the removed area (with cauterization or stitching). . Adenoid surgery is an operation in which the adenoids in the nasal area are removed from the mouth with appropriate tools (curette extending behind the uvula and soft palate).
In ear tube application, the presence of fluid behind the eardrum is detected by a scratch and If there is a relatively sticky dark liquid, which we call glue, a tube is placed on the eardrum. One part of this tube is behind the eardrum, the other part is in front of it, and since there is a hole in the middle, it provides ventilation.
After the operation: Especially when the patient is taken to bed after surgery He will not remember most things because he is under anesthesia. Agitation and crying are common in children during this period. They calm down and fall asleep within approximately 30-45 minutes, while the anesthesia effect gradually decreases, but their breathing should be monitored during this sleep period. When they wake up, they will be calmer when they see their relatives next to them. Oral feeding begins with white ice cream 2 hours after being taken to bed. Liquid drinks such as ayran and milk are consumed in approximately the 3rd hour. For nutrition and diet recommendations, see the relevant page.
The patient is on the 6th-8th day of the surgery. The patient can be discharged after timely checks (bleeding and oral feeding) are performed. When discharged, the patient may be prescribed antibiotics, antihistamines, painkillers and nasal drops. After the surgery, it may be difficult for the patient to speak due to both pain and swelling in those areas. There may be minor swelling on the tongue and lips. On the first day after surgery, painkillers are given every 8 hours. On the second day, this can be reduced to every 12 hours and then given according to the pain condition. While adult patients experience tonsillectomy surgery more painfully, children tolerate it better. Care should be taken to use medications and comply with the diet. While there may be early bleeding, late bleeding may occur between 11-13 days after surgery. Bleeding may occur, especially if the diet is disrupted. The patient may have difficulty swallowing saliva in the first few days and may have to spit out mixed with blood. Especially strains that irritate the throat should be avoided.
On the 5th postoperative day, white spots will be observed in the tonsil surgery areas. This is the healing tissue. It is not inflammation. It disappears completely towards the end of the 2nd week.
It is done warmly and only to wash the body. The whole body bath can be done warmly on the 7th day after the surgery. We can be a little more tolerant in diet and activities only in patients who have undergone adenoid surgery. We can start a normal diet after 1 week, and on the 5th day of school or nursery.
Of course, in cases of more intense bleeding, a doctor should be contacted immediately and intervention should be carried out in the hospital.
In patients with ear tubes, use a silicone plug or Vaseline cotton in the bathroom to block the ear. In fact, although it is not easy for water to leak behind the eardrum due to intra-ear pressure, We generally hear about clogging from patients, especially in summer. This process can be facilitated by having earplugs made according to the ear mold from hearing aid companies.
Patients who have this triple surgery are called for a check-up in the first week, medication, diet and points to be taken into consideration are repeated, and they are called back for a check-up after 1 month. Patients with ear tubes are followed regularly every 2-3 months. Ear tubes remain in the eardrum for 6 to 24 months and 99%fall into the external ear canal and the doctor removes them from there. Rarely, tubes that take longer to fall and cause problems (such as infection) are removed by the physician. In this case, the possibility of a hole in the eardrum increases, so it should be closely monitored. The eardrum that cannot repair itself should be closed immediately at the appropriate age and time.
This group of surgeries are common problems and surgeries in the ear, nose and throat department. After surgery with appropriate indications, satisfactory results are obtained, especially in children. Children's sleep patterns are ensured, their appetite is regulated and their growth and development are accelerated. Their school lives are more successful as they get rid of frequent infections.
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