What is adenoid?
The upper respiratory tract is in constant contact with microorganisms during breathing.
There are many lymphoid formations under the mucous membrane in the nasal region called the nasopharynx, which fight the microbes coming from the nose. As a result of passive smoking, i.e. parents smoking near the child, allergies and exposure to repetitive exposures, especially microorganisms, these lymphoid formations enlarge and form the adenoid. The adenoid reaches its maximum size around 4-7 years of age and generally shrinks after this age. The frequency of adenoids has increased in recent years, especially as children who go to kindergarten constantly infect each other.
How does it cause problems?
Nasal meat creates problems for two main reasons. First; When it gets too big, it closes the nasal passage mechanically and creates serious problems called obstructive sleep apnea, up to a pause in breathing during sleep. Secondly; Regardless of its occlusive feature, when the adenoid is invaded by microbes, it prepares the environment for their growth like a garbage dump. This situation causes recurrent infections in the upper and lower respiratory tracts, since the part where the adenoid is located is a complete junction. As a result of the long duration of the problem, a typical facial expression called "adenoid face" occurs in children, which is characterized by a long and thin facial structure, high palate, forward growth of the upper jaw, constantly open mouth, bad teeth and sunken under eyes.
In children after the two main reasons listed above; obstructive sleep apnea, upper respiratory tract resistance syndrome, snoring, nasal congestion and related mouth breathing, distraction and related decrease in academic success, restlessness and irritability, urination at night, swallowing and speech disorder, decrease in taste and smell, middle ear Problems such as fluid collection, decreased hearing, abnormal facial and tooth development, growth and development retardation, pulmonary hypertension, cor pulmonale, otitis media, sinusitis, tonsillitis, and lung inflammation are encountered.
How is it diagnosed?
In the endoscopic examination of pediatric patients who apply to the clinic with the problems mentioned above, the diagnosis is made by the abnormal appearance of the tissue. In the past, the presence of adenoid was investigated by radiographic imaging or a maneuver called finger-touch. As is known, radiographic imaging has a radiation disadvantage for the child. For this reason, we do not have a film taken unless it is necessary, that is, as long as the child adapts to the endoscopic examination. On the other hand, the quality of the tissue is also observed in the endoscope and its differential diagnosis is made from tumor, infection, cyst and similar lesions. Finger examination is an extremely traumatic and painful procedure for the child and should not be performed.
When should it be done?
Surgery can be performed at any age when the correct indication is given. It is reported in the world literature that this surgery is performed from the age of 1 year. In the past, it was used as a criterion after the age of 3, since the complications of anesthesia were more feared. Today, safer surgery can be performed in children with more modern anesthetic agents. However, unless it is necessary, attention is paid to the age limit of 3, where the child can tolerate anesthesia more easily.
What are the risks of the surgery?
Although safer anesthesia is possible with modern anesthetic drugs, the risk of death from anesthesia is reported to be 1 in two hundred thousand in healthy individuals all over the world. Since the working area is close to the mouth of the Eustachian tube, which connects the middle ear cavity to the nasal cavity, damage may occur here. In this case, permanent middle ear problems may occur. Bleeding and nasal adhesions may occur very rarely after surgery.
What awaits the patient after surgery?
Adenoid surgery, often together with tonsils, is the most common surgical procedure in childhood, almost all over the world. The operation itself is 8-10 minutes and takes an average of 30-45 minutes, including the time to sleep and wake up in the operating room. After waking up from anesthesia, the patients are discharged after approximately 5 hours and they can eat everything on the same day, provided that it is not too hot and solid. Children feel pain in their throats rather than their nasal passages for 2 days because of the endotracheal intubation tube used for anesthesia rather than the surgical wound. It would be appropriate for children not to go to school for 4-5 days due to open wounds.
As a result; Adenoid is a common ailment in children and can cause serious problems if not treated on time. It is extremely important for the health of the child to be treated without delay in an appropriate center after the correct diagnosis.