Removal of the adenoids is usually recommended when seeking medical help late. Treatment of pathology is a lengthy process that requires regular procedures and medications.. The difficulty lies in the fact that in the early stages, when drug therapy is most effective, pathogenetic treatment is not carried out due to the latent course of the disease.. Therefore, often the treatment of adenoid vegetations is started only when they partially or completely block the nasal passages..

Currently, adenotomy is performed only in cases where it is impossible to do without it. A pronounced clinical picture makes you turn to an ENT doctor, who in such cases can recommend surgical intervention. Should I agree to such an operation

Surgery to remove adenoids - pros and consAdenotomy (the name of the operation to remove the nasopharyngeal tonsil) has been a stumbling block among specialists over the past decades. The fact is that cutting the tonsils, although it allows you to restore nasal breathing, does not exclude the possibility of a relapse of the disease, in addition, there is a risk of postoperative complications, including delayed consequences..

In children, adenotomy avoids irreversible changes caused by prolonged hypoxia caused by adenoids, including developmental delays..

The tonsil is a peripheral organ of the immune system and the first protective barrier on the way of air from the external environment to the internal environment of the body.. It is a dense nodule of lymphoid tissue.. The tissue of which it is composed plays a decisive role in the formation of cellular immunity.. Therefore, after removal of the adenoids, the body's resistance to external factors of aggression is sharply reduced - the risk of developing diseases of the upper and lower respiratory tract after adenotomy does not decrease, but increases.

Often, the removal of adenoid growths is carried out blindly.. A frequent consequence of this is the incomplete removal of adenoid vegetations, which leads to their regeneration and re-growth.. Only in some medical institutions, adenotomy is performed under endoscopic supervision - using a special movable probe with a camera. This method significantly increases the effectiveness of surgical treatment of adenoids..

Long-term adverse effects of adenotomy include: stenosis of the nasal nasopharynx, paralysis of the soft palate, fusion of the soft palate with the posterior pharyngeal wall, scarring of the Eustachian tube. However, it should be noted that such complications are extremely rare..

Currently, adenotomy is performed much less frequently than before.. This is due to the progression of new methods of conservative therapy, which make it possible to do without surgery in most cases.. But sometimes surgery is not enough. Indications for surgery:.

frequent infectious diseases of the upper and lower respiratory tract, prone to chronicity;

sleep apnea (episodes of stopping breathing);

complete obstruction of the respiratory passages, their obstruction for air flow;

sluggish pathological process that is not amenable to conservative treatment;

presence of systemic damage, such as hearing loss.

Currently, adenotomy is performed much less frequently than before.. This is due to the progression of new methods of conservative therapy, which make it possible to do without surgery in most cases..

In children, adenotomy avoids irreversible changes caused by prolonged hypoxia caused by adenoids, including developmental delays.. Therefore, children with III degree of adenoids can, and sometimes it is necessary, recommend surgical treatment.. In adults, the operation is performed in case of frequent infection, a significant decrease in the quality of life caused by impaired nasal breathing, and the failure of conservative therapy..

Preparation for surgeryAfter the diagnosis is established and a preliminary decision on surgical intervention is made, a thorough examination is carried out. It includes not only the study of adenoid vegetations, but also laboratory tests, including a complete blood count.. This is done in order to exclude reinfection - for some time there will be an open wound surface in the pharyngeal cavity, and if an infection gets there, unwanted complications are possible.. Therefore, adenotomy is not performed when there is a risk of an inflammatory process - in the presence of dental caries, diseases of the respiratory system, adenoiditis (inflammation of the adenoids). All infectious diseases must be cured before surgery.

How adenoids are removedThe operation is carried out by two methods - classical excision and removal of adenoids with a laser.

The instrument that removes the adenoids is called an adenoid. The excision is performed under local anesthesia, during the operation the patient does not feel pain - he can feel the touch of the instruments on the mucous membrane, but there is no pain. Such anesthesia consists in chipping the area around the tonsil with an anesthetic, lubricating the mucous membrane or spraying an anesthetic on it.. In some cases, it may be advisable to perform the operation under general anesthesia..

Long-term adverse effects of adenotomy include: stenosis of the nasal nasopharynx, paralysis of the soft palate, fusion of the soft palate with the posterior pharyngeal wall, scarring of the Eustachian tube.

After treating the operating area with an antiseptic, the surgeon introduces an adenoid into the oral cavity.. This is a special knife with rounded sharp edges that allows you to grab and remove the tonsil at the very root.. The operation can be performed both blindly and under endoscopic supervision.. The excision occurs very quickly, after which the surgeon stops the bleeding and packs the wound. The whole operation, together with the introduction of anesthesia, takes 10-15 minutes..

There are two types of laser adenotomy - multiple irradiation with a directed beam of light energy (takes place in several sessions) and one-time removal of adenoids with a high-power laser.

In the first case, several sessions provide coagulation of blood vessels inside the tissues of the tonsil, its drying and a significant reduction in. In the second - under general anesthesia, the adenoids are removed immediately and completely. Why use this method? It has a number of advantages, which are confirmed by positive reviews:.

high efficiency - the probability of re-growth of tissues is practically absent;

instant coagulation - there is no need to resort to additional means to stop the blood, the laser immediately cauterizes all vessels, minimizing blood loss;

maximum asepsis - high temperature at the point of contact between the laser and the mucous membrane destroys all microorganisms;

no irritating effect on surrounding tissues.

A video about the removal of adenoids is placed at the bottom of the article..

Postoperative periodThe recovery period after adenotomy is quite short. The operation is performed on an outpatient basis, that is, without the need for hospitalization. Immediately after its completion, the patient is transferred to the ward under observation for several hours, or this time is in the doctor's office. Then the doctor assesses the condition of the wound and the general parameters of the patient's body - his body temperature, respiratory rate, heartbeat. If all is well, the patient can go home..

Often, the removal of adenoid growths is carried out blindly.. A frequent consequence of this is the incomplete removal of adenoid vegetations, which leads to their regeneration and re-growth..

The recommendations of the attending physician after surgery usually include the rejection of food that irritates the mucous membrane, because. spicy, spicy, hot and cold foods. All food should be carefully mechanically processed, mashed, slurry. The functionality of the nasopharynx in the postoperative period may be slightly reduced.. Talking after surgery is usually painful and unpleasant, so for the first few days after surgery, it is advisable not to talk, or to talk as little as possible.. There is swelling of the mucous membrane, there may be slight bleeding. It is recommended to regularly change the turundas in the nasal passages and pay attention to the amount of blood on them.. In case of increased bleeding, you should consult a doctor.

After a while, the swelling will decrease and airway patency will be restored..

Do I need to follow any special recommendations in the late postoperative period Definitely, because after the removal of the tonsils, immunity is significantly weakened. It is necessary to pay attention to the prevention of diseases, avoiding SARS, for which it is necessary to avoid places with large crowds of people, especially during seasonal peaks of viral diseases.

In the postoperative period, it is necessary to protect yourself from seasonal viral infections. It is recommended to maintain a certain temperature and humidity in the room - approximately 18-20 ° C and 60-70% humidity, respectively.. Wet cleaning should be carried out several times a week, and the room must be constantly well ventilated.

Walks in parks or forests with coniferous trees are shown, the phytoncides emitted by them have a positive effect on the dynamics of recovery. Sea air is also recommended, which can be replaced by a visit to the salt room.

Adenotomy is not performed when there is a risk of an inflammatory process - in the presence of dental caries, diseases of the respiratory system, adenoiditis (inflammation of the adenoids). All infectious diseases must be cured before surgery.

If a few days after the operation there is an increase in sore throat, nasal breathing, bad breath, fever, headaches and general malaise, this may indicate the onset of an inflammatory process.. In this case, you should immediately consult a doctor, since even a banal viral infection in conditions of an organism weakened by surgical intervention can acquire a severe course..

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