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To decide to have tonsillectomy or not? Many parents ask themselves this question when their children often suffer from strep throat and have oversized tonsils. Is there an unambiguous answer to them? What are the indications for tonsil removal? How does tonsillectomy work?

Tonsilectomy(tonsillectomy) is still controversial.The tonsilsare located on both sides of the throat, between the back of the tongue and the uvula that grows out from the palate. They produce substances (so-called antigens) that are used to produce antibodies - an effective weapon against microorganisms. They play a very important role in babies and toddlers. However, as the child grows older, the tonsils produce less and less effective antibodies. Therefore, in adolescence, they are no longer so important in building the body's immunity. So removing them does not harm the child.

Overgrown tonsils

Sometimes the palatine tonsils get too large. This usually happens after frequent infections. They are then a mechanical obstacle in the throat that makes it difficult to swallow. The pharyngeal tonsil (the so-called third tonsil) can also overgrow, which makes it difficult to breathe through the nose. But this is not the end of the troubles associated with it. The overgrown adenoid clogs part of the Eustachian tube, and then no more fresh air reaches the middle ear. If the condition persists for a long time, fluid begins to build up in the ear. This ends up with hearing loss or otitis media. An easily observable outward symptom of adenoid hyperplasia is that the baby is snoring while sleeping. If snoring is accompanied by apnea, lasting a few or several seconds, the tonsil must be removed. This cannot be taken lightly, as apnea can lead to severe changes in the lungs and, in extreme cases, even to cardiac arrest.

Overgrown palatine tonsils, even if they are not the cause of frequent inflammations or tonsillitis, make it difficult for a child to swallow. The toddler does not want to eat because he cannot swallow without problems. In such situations, the tonsils are not completely removed, but only trimmed, i.e. surgically reduced.

Angina chasing angina

Even normal-sized palatine tonsils can cause chronic inflammation. The tonsils are then very porous, they have the so-called niches in whichbacteria accumulate and this is where they enter the bloodstream. The doctor will then tell the parents that the tonsils are a hotbed of inflammation. It is also often the cause of sinus and laryngitis. If this condition is not treated, a child may develop arthritis, inflammation of the heart muscle or the brain, also known as rheumatic fever. But it is not everything. Every few months there are acute pharyngitis in the form of angina. If they recur several times a year, think about removing them. When making a decision to remove the tonsils, one must take into account one more thing - complications of frequent angina. The most common is the peritonsillar abscess. It is an inflammation characterized by the formation of pus in the so-called free tissue space. A kind of pus-filled tumor then forms around the palatine arch and uvula. This is accompanied by a very severe sore throat whenever you try to open your mouth. Otolaryngologists call this condition trismus. The patient keeps his chin close to the chest (the so-called compulsive tilted position of the head), which gives him an unnatural appearance. The abscess must be incised and carefully cleaned. Sometimes such a procedure has to be repeated several times. It is very painful. After cleaning the abscess, the tonsils should be removed. After angina, along with rheumatic fever, there may be purulent infections of the soft tissues of the neck, and even intracranial abscesses. These are life-threatening conditions that must never be taken lightly.

What does tonsil excision look like?

The tonsil removal procedure is performed with a special device that resembles an eyelash curling device. It should be performed under general anesthesia (this is no longer done with local anesthesia). Before the operation, an ECG, a chest X-ray, a general urinalysis, and thorough blood tests should be performed, including bleeding and clotting times, and other factors that inform about the state of the circulatory system. This research is very important. The success of the operation or its postponement depends on their results. It must be remembered that the wounds after removal of the tonsils are not sutured, they have to heal themselves. So if the blood does not clot badly, it can lead to severe bleeding, and in the worst case scenario, even the death of the child. For three weeks after the surgery, you have to be careful, do not exercise or lift. Food should be chilled and mushy, with no hot spices.

Third tonsil in children - operation

Cutting out overgrown tonsils is necessary when a child develops diseases such as angina, pharyngitis or otitis too often - and the treatmentpharmacologically ineffective. What is the removal of the third tonsil in children, how long does the convalescence take, does the operation carry any risks for the child? Edyta Witkowska, otolaryngologist from Medicover Hospital, answers these and many other questions regarding the operation of the third tonsil.

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