Tonsils and Adenoids : Tonsils (tonsil) and adenoids (adenoid) are organs called lymphoid tissue that play a role in the body's immune system. Tonsils are located at the entrance of the pharynx, on both sides of the root of the tongue. Adenoids, on the other hand, are called nasopharynx and are located in the upper part of the pharynx, that is, in the back of the nasal cavity.
Functions of Tonsils and Adenoids:The tonsil and adenoid are part of the lymphoid tissue and contain lymphocytes. These lymphocytes produce antibodies that help the body's immune system. However, the role of tonsils and adenoids in the immune system is not significant and they are often non-functional. The fact that there are no negative immune-related conditions in people who have tonsils and adenoids removed shows this.
What Problems Do They Cause: Tonsils and adenoids can cause both infections and some problems depending on their size. . Although adenoids are mostly a childhood problem, tonsils can cause disease in both children and adults. Adenoid enlargement in adults is a condition that needs to be taken into consideration and the possibility of cancer in this area should not be taken into consideration. Frequent infections both affect the daily life of the patient and cause frequent medication use. However, the most important consequences of infections (inflammations) are that heart valves, joints and kidneys are at risk.
In addition to infections, the size of tonsils and adenoids also leads to important consequences. Large tonsils; It causes swallowing, feeding and speech problems. In addition, food and tissue residues accumulated on the tonsils cause bad breath and poor hygiene. Large adenoid tissue causes, first of all, nasal congestion. It causes patients to sleep with their mouth open and snore. The nose regulates the temperature and humidity of the inhaled air and traps some harmful particles. For this reason, it causes some respiratory problems in mouth-breathing patients. For example, frequent pharyngitis. Adenoids also cause the following problems:
* Ventilation disorder in the middle ear and resulting collapse of the ear, hearing loss and communication disorders. Hearing loss is sometimes at a level that parents cannot notice, but it is often It is also the first reason that brings the patient to the doctor.
* Developmental disorder in the jaw and facial bones
* Inflammation of the throat (pharyngitis), cough and lower respiratory tract problems due to postnasal drip
* Headache
* Sinusitis
* Apathetic 'appearance' due to facial expression
How to Treat:Treatment for acute inflammation of the tonsils and adenoids is usually medications. The most common medications are antibiotics, painkillers and, if allergic factors are considered, antihistamines. Although tonsils and adenoids, which do not cause serious problems and do not cause frequent infections, are treated with medications, sometimes tonsils and adenoids need to be removed.
In Which Situations Should It Be Removed:Deciding on removal of tonsils and adenoids Although sometimes it is easy, sometimes it requires following the patient for a certain period of time. Situations that lead to the decision for surgery are as follows:
* Frequent infections: The generally accepted situation is having three or more infections a year in successive years.
* Even if there is no infection in the tonsils, they enlarge enough to make swallowing difficult
* Unilateral growth of tonsil tissue (as it may be a symptom of lymphoma or other malignant diseases)
* Frequent accumulation on the tonsils, which may cause bad breath
> * Frequently causing sinusitis and lower respiratory tract problems
At What Age Should Surgery Be Performed:There is no exact age for surgery. The decision is made according to the damage the disease causes to the patient. The commonly accepted situation is that the patient must be over 3 years old for tonsil surgery. Adenoid removal can be done even at the age of 2. Many times, waiting for the child to grow up causes the problems caused to the patient to continue while the surgery is postponed.
How is Tonsil and Adenoid Surgery Performed: Although local anesthesia is sometimes performed for tonsil adenoids. Removal of tissue requires general anesthesia. In my practice, I think that it is essential for both operations to be performed under general anesthesia for patient comfort. Removal of the tonsil is done by removing it together with the surrounding capsule through an appropriate incision. Name enoid surgery involves scraping the enlarged tissue. The surgery duration is generally short and varies between 20-30 minutes. There is usually no need to stay in the hospital after the surgery. Sometimes, it may be necessary to stay in the hospital for 1 night, especially due to the risk of bleeding.
What are the Risks and Complications of the Surgery:Like every surgery, tonsil and adenoid surgeries may have risks and complications. Local or general anesthesia always carries some risks. However, developments in anesthesia techniques and drugs reduce this risk day by day. Apart from this, the most common complication is bleeding. Although it can sometimes reach serious dimensions, this problem is rare with careful and meticulous work and appropriate follow-up of the patient. Pain is the condition that disturbs the patient the most, especially in adult patients. There is a belief that pharyngitis occurs after surgery. This is a wrong idea. If patients expect that there will be no sore throat after tonsil removal, they may be mistaken. Existing pharyngitis has nothing to do with tonsil removal. Sometimes infected tonsils even increase pharyngitis.
What to Pay Attention to After Surgery:The most important rules to follow are related to nutrition. Since the possibility of bleeding is higher, especially in the first 3 days, cold and liquid foods should be chosen. For this reason, foods such as cold milk, soup, fruit juice, pudding, ice cream, and loaf of bread are ideal. Vomiting dark blood on the first day of surgery is normal and is related to blood swallowed during surgery. However, persistent red blood new blood requires immediate medical attention. Starting from the 5th day, normal food is gradually introduced. The patient's unwillingness to eat anything due to pain causes the pain to continue. Be sure to drink plenty of fluids and not skip your diet. Refusal to feed can especially cause a decrease in body resistance and delay healing. It is expected to have a mild fever after the surgery. It usually returns to normal with adequate fluid intake and antipyretic medications. Sometimes patients consult a doctor a few days after the surgery and complain about inflammation in the tonsil area. This is usually a good thing that forms a white covering in that area after the tonsils are removed. The healing tissue frightens the patient.
Drug treatment is very effective in the early period. Surgery may be required in chronic sinusitis that does not respond to persistent drug treatment. The purpose of the surgery is; is to open blocked sinus passages. In this way, ventilation of the sinuses is ensured. The infection regresses and disappears in the ventilated sinus.
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