Adenoidectomy

There are three degrees of the adenoids:

• I degree – normal breathing in the day time, while at night the blood rushes towards the adenoids, causing their swelling so that a patient can breathe only through the mouth;
• II degree – a patient breathes through the mouth day and night, and sometimes wheezes in his/her sleep;
• III degree – the adenoids get enlarged, overlapping most of the vomer, there are complications in the form of speech disorders and hearing loss.
• Treatment of I degree adenoids may be conservative: in significant nasal congestion vasoconstrictors are used;
• in acute adenoiditis antibiotics are administered (after preliminary bacterial inoculation of the nasal discharge and detection of infectious agents sensitive to them).

In the adenoids of II and III degree surgical removal is recommended. Today adenoid removal is a painless, safe and fast operation. Adenoids are removed under local or general anesthesia, under the endoscopic control. It is necessary for the complete removal of the lymphoid tissue without any residue to prevent the problem recurrence. With age, this operation is more difficult – it is conditioned by the presence of concomitant diseases, declined parameters of tissue healing process. To accelerate the damaged tissue regeneration AMC-therapy – an individual program based on autologous growth factors application and oligopeptides extracted from the patient’s platelet count in maximum concentration offered at the Institute of Plastic Surgery «Virtus» for the first time in Ukraine.

What may happen in case of adenoids enlargement?

• Sleep apnea – a short stop of breathing during sleep, not infrequently provoking an elevation in blood pressure
• Adenoid tissue of II and III degree blocks the auditory passage – there is a permanent feeling of stuffiness in the ears. Ventilation disorder of the tympanic cavity badly influences hearing, and this, in turn, often leads to absent-mindedness
• Constant mouth breathing provokes disturbance in the facial skeleton growth, which results in change of occlusion and speech disorders in children
• The adenoids of large size may change voice sonority
• In adolescents the adenoids can cause a curvature of the spine development
• Constant nasal discharge irritates the skin of the nose vestibule, and their ingestion results in the gastrointestinal tract disorders
• Prolong shallow mouth breathing causes abnormal development of the chest, sometimes – anemia
• In severe hypertrophy may be observed weakening of attention, memory impairment, headaches

So, it is a high price paid for late actions.

The Institute of Plastic reconstructive surgery «Virtus» is equipped with a unique set of diagnostic equipment (endoscopic diagnosis with video fixation). Narrow Band Imaging (NBI), a powerful optical image enhancement technology, is based on the narrow band of blue and green light to illuminate the area under study, which falls in the hemoglobin absorption band. NBI (early diagnosis of malignant tumors) allows to identify problems objectively and choose the necessary method of treatment (surgical or therapeutic). Narrow band imaging is not worse than chromoendoscopy in identifying foci of precancer and early cancer.

Contraindications

They are present in adenotomy, as in any other surgery:

• During the epidemic of acute infectious diseases (including 2 weeks after the end)
• Blood diseases
• Severe cardiovascular disease
• Exacerbation of skin diseases, etc

Therefore, before surgery, patients undergo examinations, including nasal endoscopy, dental health, blood count and urine tests, measuring the duration of bleeding time and blood coagulation, etc.

Indications and contraindications for removal of adenoids

Indications for removal of adenoids in children are complications of respiratory infections, frequent inflammatory processes that cannot be cured conservatively. The main indications for adenotomy include:

• Sleep apnea (stoppage of breathing)
• Constant breathing through the mouth
• Frequent otitis in children aged 3-4 years and older
• Chronic sinusitis

Contraindications to adenotomy are few and relative. Contraindications include disorders of the hemostasis system (blood coagulation), disorders of the development and function of the palate, some diseases that cause neuromuscular disorders (Arnold Chiari syndrome, Kabuki syndrome, pseudobulbar syndrome, etc.)

Result of removal of adenoids

Adenotomy will allow to quickly solve the health problems with which the patient applied: eliminate the chronic inflammatory process in the nasopharyngeal tonsils and normalize nasal breathing. However, it will still be necessary to treat a runny nose after removal of adenoids: the child will suffer from acute respiratory diseases and complications may still occur.

Rehabilitation after removal of adenoids

After removal of adenoids, a home regimen is required for 5-7 days. During the home regimen, you should reduce physical activity and exclude hot food. Provided that the general condition is satisfactory and there is no elevated temperature, a week after the removal of adenoids, the child can return to his usual lifestyle.

What will happen if adenoids are not removed

Adenotomy is performed strictly according to indications. If, in the presence of indications, the operation to remove adenoids is not performed, negative consequences may occur. The result of the increase and inflammation of the nasopharyngeal tonsils are:

• Hearing loss
• Sinusitis
  Bronchitis
• Chronic sinusitis
• to swell
• Improper bite
• Deformation of the chest due to difficult nasal breathing (swollen chest)
• A decrease in the number of erythrocytes and hemoglobin due to insufficient saturation of blood with oxygen
• Disturbances in the work of the gastrointestinal tract