Monday, 25 July 2011

Surgery for Adenoids

Published in City Times

Surgery for Adenoids

The adenoids are located in the naso-pharynx, high in the throat behind the nose and roof of the mouth. Like the tonsils, the adenoids are also lymphoid tissues and are susceptible to germs and consequent infection because of their position at the entrance to the breathing passage, says Dr. Nadhim Kadhim Saaoudi, Specialist ENT, Head & Neck Surgeon, Jumeirah Prime Medical Centre.

The most common problems occurring with the adenoids are recurrent or chronic infections, adenoiditis or enlargement and blockage of the nasal passages.

A child with enlarged tonsils, most likely breathes with the mouth which in turn predisposes it to snoring and difficulty in breathing. The other symptoms associated with adenoiditis include recurrent ear infections, noisy breathing, fluid collection in the middle ear, cough and conductive deafness.

Usually there is infection of the tonsils associated with the adenoids. In such instances, treatment of tonsils also treats the adenoids. However, for this to be effective, we give some systemic decongestants, nasal drops in addition to the antibiotics. Bacterial infections of the adenoids are treated with antibiotics. Basically, the inflammation is self-limiting in that it subsides by itself. But sometimes, the adenoids get so enlarged and become so frequently infected, that they give the child frequent earaches, ear infection, effusion and deafness. In such instances, we need to act beyond treatment with medicines. Despite good and appropriate treat with medicines, if the child is not relieved of the recurrent infections, etc, we go for surgery to remove the adenoids. The surgery, known as adenoidectomy, is performed under general anesthesia and may be beneficial to children with chronic earaches accompanied by fluid accumulation in the middle ear.

Sometimes, the fluid in the middle ear may be very thick, leading to a condition called ‘glue ear’. In this condition, free passage of air to the middle ear may not be possible. In such conditions, the adenoids are surgically removed and then certain procedures are undertaken to remove the fluid from the middle ear. Dr.Saaoudi explains, “We usually perform a myrrnghotomy to suck the fluid out. But sometimes, even this is not possible because the fluid becomes so thick that it will not come out with suction. In these instances, we combine the myrrhngotomy with inserting a ventilation tube or grommet. The grommet allows for the free flow of air into the middle ear and to dry the ‘weeping’ ear.

What are the complications from surgery?
Surgery has its own problems, first of them being the incision itself. The tympanic membrane by nature, has a fantastic ability to heal. So generally, the incision would heal within two days.

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