What are tonsils and adenoids? Tonsils are structures located on both sides of the throat and consist of lymphoid tissue, which is one of our body's defense mechanisms. Adenoids are similarly a structure consisting of lymphoid tissue and located in the nasopharynx (nasal cavity) behind the nose.
What are their functions? Tonsils and adenoids play a role in defense against microbes that come through the air, especially in the first 3 years of age. These are our structures that play. While these defense mechanisms are extremely important when they are healthy, it is known that their removal by surgery does not have a negative effect on the body defense system and health in cases where their structures and functions are damaged.
In what cases is adenoidectomy performed? Adenoidectomy The adenoid removal operation, called adenoid removal, is performed in case of one or more of the following conditions.
1-Adenoid that is large enough to hinder breathing: Overgrown adenoid causes mouth breathing, snoring and It causes symptoms such as stopping breathing during sleep (sleep apnea). Inability to breathe through the nose can cause persistent upper respiratory tract infections, throat infections, asthma and allergic diseases, as well as smell and taste disorders. If large adenoids are left untreated, they cause structural problems in the ear and cause permanent problems. In addition, in children who constantly have to sleep with their mouths open, the upper jaw and tooth structures deteriorate and permanent orthodontic problems arise. It has been proven in the literature that the cognitive functions of children with symptoms of breathlessness due to adenoid size are negatively affected, and that there is a significant improvement in the patients in the first year after surgical treatment. It has also been shown that some of these children have nocturnal urinary incontinence (enuresis nocturna) and that this symptom disappears with treatment.
2-Middle ear diseases due to Eustachian tube obstruction: The adenoid is susceptible to microorganisms. acts as a reservoir. Recurrent ear diseases due to eustachian tube obstruction or exposure to inflammatory discharge due to adenoids (acute otitis media: middle ear inflammation or serous otitis media: fluid accumulation in the middle ear) or it may come out. In the presence of these diseases that do not improve with treatment or recur, it may be necessary to insert a ventilation tube into the eardrum along with adenoidectomy.
3-Chronic sinus infections caused by adenoids: Similar to ear problems, enlarged or infected adenoids can cause secretions to accumulate in the nose or cause recurrent sinus infections.
How is surgery decided? The patient's family is an important guide for us when deciding on surgery for children with adenoid problems. When families, as mentioned above, complain about their children's snoring and sleeping with their mouths open, apply to us, we perform a detailed ENT examination. Then, we look at the patient's adenoid with a camera, which we call nasal endoscopy, and decide on the surgical situation.
Can the adenoid shrink on its own? Adenoids usually shrink after the age of 10. However, waiting for it to shrink may lead to sleep apnea, nasal congestion, middle ear diseases, and permanent deformities in facial and dental development. Additionally, many studies have shown that learning and growth are negatively affected by sleep disorders. Moreover, it has been demonstrated that learning ability and the course of growth and development return to normal after surgical treatment. For this reason, the approach of waiting for serious adenoids to shrink in size is an extremely risky and wrong behavior.
How is the surgery performed? It is performed under general anesthesia and takes 10-15 minutes. Adenoid tissue is removed by curetting from the nasal passage.
What is the post-operative process? Nasal congestion improves after 7-10 days. In the postoperative period, it is sufficient for us to follow the child's activities without restricting them or recommending a special diet program and to check them 1 week later.
What are the complications of tonsillectomy?
Apart from anesthesia-related risks, which are almost impossible to predict, the most important complication of surgery is bleeding.
1-Bleeding: It is the most important and frequently encountered complication after tonsillectomy. It is more common in adults. As may occur in the early postoperative period The risk continues until the 15th day. Therefore, the diet that must be followed for 15 days after the surgery is explained in detail to our patients. We also recommend that they do not go out of town during this period.
2-Infection: Increased bad breath, discomfort in the nasal and throat, and late bleeding may be signs of infection. Administration of antibiotics usually provides recovery.
3-Pain: There may be a sore throat in the first two weeks and painkillers may need to be used.
4 >- Soft palate dysfunction: Rarely, nasally speaking, liquid drinks and food leaking into the nasal passages and nose may occur after the surgery. These complaints decrease and disappear over time.
5-Injury to teeth, gums, lips and tongue: these situations are related to surgical equipment and are very rare.
Frequently asked questions after surgery
1- Is it necessary to stay in the hospital after surgery? We usually discharge our patients on the evening of the surgery day. However, if one or more of the following conditions exist, we prefer to be admitted for 1 night.
* The patient lives too far away (or does not have easy transportation)
* Adult patient
* Inability to take enough food by mouth after surgery
* Severe nausea and vomiting after surgery
* Presence of other accompanying diseases
2- What should post-operative nutrition be like? We recommend soft and liquid foods for the first 15 days after surgery. Fruit juices are especially not recommended as they are acidic and will cause pain. Since the diet to be followed after the surgery is extremely important, our patients are informed in detail by the surgeon who performed the surgery.
3- Can medication be used after the surgery? Antibiotics are used because they contribute to wound healing and prevent the development of infection.
4- Can sports activities be done after surgery? We do not recommend strenuous exercises for 2 weeks after surgery.
What are the conditions that can be considered normal after surgery?
Sore throat: T Sore throat after onsillectomy is a common condition in older children and adult patients. It may take up to 15 days after surgery.
Earache: Earache is frequently observed after tonsillectomy. This pain originates from the surgery area and is known as referred pain.
Fever: There may be a mild fever.
Visibility of white plaques in the tonsil bed: White plaques can be seen for 2 weeks after the surgery. These plaques are healing tissue. The uvula may sometimes appear edematous.
When should I call my doctor?
Bleeding: Ice water or ice cream may be helpful for mild leaks. If bleeding continues, call your doctor immediately.
Dehydration: If not enough fluid is consumed for 24 hours, the patient may experience low and concentrated urine output and lethargy (lethargy, apathy). In this case, contact your doctor.
High fever: Call your doctor in case of fever of 39 degrees and above, cough and difficulty breathing.
When should I go for a check-up? We want our patients to be checked on the 7th day after surgery.
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