What are the adenoids?
The adenoids are small glands at the back of the nose. There role is to kill germs during early childhood. It is believed that after the age of about 3 the adenoids are no longer need.
The human body can kill germs even without the presence of adenoids. However, they should only be removed if they cause more harm than good.
When should they be removed?
In some children the adenoids are so big that they block their nose and can only allow them to breathe through their mouth. This can cause snoring. Occasionally this can also cause cessation of breathing for a few seconds during sleep.
The adenoids can also cause ear problems by preventing the tube that joins the nose to the ear (Eustachian tube) work properly.
For children older than 3 adenoids can be removed at the same time with placing ventilation tubes (grommets) in the ears, as this can prevent glue ear ( fluid in the middle ear) from coming back. This can also help in reducing the problem of a blocked nose with colds.
What are the alternatives?
The adenoids usually shrink with time and therefore symptoms improve. Surgical excision helps in getting rid of the symptoms sooner but with calculated small risks. You should discuss with your surgeon weather to wait and see or have surgery.
In some children the use of steroid nasal sprays can help reduce symptoms before deciding to go ahead with an operation. Antibiotics usually do not help.
What do I need to know about the operation?
Your child will need about a week off school. If your child has a cold or a sore throat before the operation, let your surgeon know as the operation might need to be postponed until better.
The operation is done under a general anaesthetic. The adenoids are removed through the mouth and the bleeding is stopped.
You need to stay in hospital usually overnight or occasionally you can go home the same day. Your child will need only simple painkillers if there is pain or discomfort. Make sure he or she rests at home away from crowds or smoky places.
What are the possible complications?
The operation is safe but just like any other operation it entails some small risks.
The most serious complication is haemorrhage. This happens very rarely, usually in 1 in 200 cases. It is very important that you let your surgeon know if there is any family history of haematological problems.
During the operation there is a small risk to chip or knock out a tooth, especially if it is loose. You should let your surgeon and anaesthetist know if there is such a tooth.
Some children have nausea or vomit after the operation. This is usually temporary.
The nose may seem to be blocked immediadedly after the operation but it will clear within a few days.
Your child might have a sore throat for a few days and will need regular simple painkillers for that period of time. The sooner she or he gets back to normal eating the better for recovery.
If you notice any bleeding, either from the mouth or from the nose, you should take the child to hospital and contact your doctor.
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