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Adenotomy is now a routine procedure. It is most often performed in children with adenoid hypertrophy, although it is not always necessary. Adenotomy is performed when the doctor indicates the tonsil as the cause of persistently recurring infections or in the case of obstruction of the nasopharynx. Occasionally, this procedure is also performed on adults, but these are rare cases.
The tonsils are formed in the throat from lymphoid tissue and are an element of the so-called Waldeyer lymph ring. It consists of the palatine tonsils, lingual, trumpet and pharyngeal tonsils, side bands and lymphatic lumps located on the back of the pharynx. Whole Waldeyer ring it is located in such a way that it is exposed to contact with antigens that easily reach it from the external environment. It is in the tonsils that many cells of the body’s immune system are found, and as you know, in the first years of life, a child’s body “learns” to resist. Up to 6-7 years of age, the child’s lymph nodes grow very intensively. Then, in the adolescence period, the side bands and absorbent lumps overgrow. Thus, it sometimes happens that a child needs to remove the pharyngeal tonsil, also called the third tonsil, due to frequent recurring infections that put too much strain on the entire body. So it is carried out adenotomia. The procedure is part of one-day medical procedures, and the convalescence is short and not burdensome.
Adenotomy – necessity or prevention?
Properly built pharyngeal tonsil it has an oval shape. However, sometimes its image changes and its overgrowth is irreversible, which has negative consequences for the whole organism, and then its removal becomes simply a necessity. However, such a decision should not be rushed and should not be removed prophylactically. Physiology works like this tonsils they enlarge in almost any inflammation that develops in the throat. However, this is the correct response of the body, indicating that it defends itself against the development of infection and is a normal response of the immune system to viruses or bacteria.
On the other hand, enlarged tonsil it cannot block the entire breathing process, so it cannot restrict the openness of the nose in any way. If the body’s infections continue to recur, it may become alarming tonsil hypertrophyand thus irreversible disturbance of the nasal passages.
In rare cases adenoid hypertrophy it is caused by high allergic tendencies. Sometimes it also happens that a predisposition to tonsil hypertrophy are inherited from parents or grandparents.
Third tonsil hypertrophy – symptoms
On the one hand, it is very easy to see that something is wrong with the third tonsilon the other hand, they can be easily overlooked. In people with tonsil it loses its normal structure, partial or complete loss of nasal patency is observed. These people begin to breathe their mouths more and more. They snore while sleeping and have symptoms of obstructive apnea. Interestingly, many children change the timbre of their voice, which is technically called back, closed carrying.
Overgrown pharyngeal tonsil results in persistent and recurring inflammations of the pharynx and lower respiratory tract. This is precisely because of the obstruction of the nasal passage. At the same time, there may or may not be an obstruction of the Eustachian tube, which results in the loss of proper ventilation of the middle ear, and the next stage is repeated otitis.
In children with an overgrown adenoid sometimes the shape of the face changes, becoming too long, pale and quite poor in terms of facial expressions. Babies often have their mouths open because they just have to breathe.
Adenotomy – indications for the procedure
Medicine divides indications to be carried out adenotomii to be absolute and relative. The first is a situation in which there is no longer any doubt and the procedure must be performed. Down absolute indications is nasal obstruction, which is manifested by breathing only through the mouth, both during the day and at night. Tonsil it should also be absolutely removed when it comes to obstructive sleep apnea. In these cases, there is nothing to wait for, you have to act.
However, they are also relative indications, and these are situations where making a decision is not that easy. This happens in the case of recurrent infections of the middle ear, respiratory tract, sinuses, throat or even craniofacial deformities. It must be remembered that tonsils are an important element of the human immune system, and over time the body can learn to effectively defend itself against viruses and bacteria, thus cutting out pharyngeal tonsil would be unnecessary and detrimental to the whole organism.
The procedure itself is routine today and is performed under supervision endoscope. Diode lasers, shakers or harmonic knives are used. Plasma knives are used more and more often, which shortens the time of healing and convalescence as much as possible.