Services for Paediatric ENT
Tonsils & Adenoids
Does your child have frequent attacks of sore throat, cough, cold and fever?
The commonest pediatric ailments are recurrent URTI, sore throat and ear infection.
Does your child snore at night? Does he have repeated colds and coughs? Is your child a mouth breather or does he/she drool while asleep?
Your child could be suffering from adenoid infection.
How is it best to evaluate a child prone to recurrent ENT infections? Some schools of thought recommend long term antibiotics. Some recommend early surgery. Who is right?
At our clinic an integrated approach that evaluates the child in totality is followed. A brief approach to tonsils, allergies, sinusitis and ear infection follows:
Understanding Enlarged Adenoids
So, What are adenoids? They are a mass of lymphoid tissue, located in the passage that connects the back of the nasal cavity to the throat. Adenoids - which are also called nasopharyngeal tonsils but are separate from the tonsils in the throat - filter out bacteria and viruses entering through the nose and produce antibodies to help the body fight infections.
Most doctors believe that adenoids may not be important at all after kids reach their third birthday. In fact, adenoids usually shrink after about 5 years of age, and they often practically disappear by the teenage years. They become unusually enlarged due to recurrent allergies or infections and then create symptoms. Usually the swelling is temporary, but sometimes recurrent problems may cause the swelling to be persistent and excessive.
What Are the Symptoms of Enlarged Adenoids?
You may notice that your child :
- Complains of difficulty breathing through the nose
- Is breathing through the mouth
- Talks as if his or her nostrils are closed
- Breathes noisily
- Snores while sleeping
- Stops breathing for a few seconds while sleeping (called sleep apnea )
To get a really close look, the doctor may even want to take one or more X-rays. For a suspected infection, the doctor may prescribe oral antibiotics.
Exams and Tests
The adenoids cannot be seen by looking in the mouth directly, but can be seen with a special mirror or using a flexible endoscope through the nose.
Tests may include:
- X-ray (side view of the throat)
- Sleep apnea studies (severe cases only)
Surgical removal of the adenoids (adenoidectomy) will prevent complications, and will cure complications if they already exist from enlarged adenoids. Antibiotics may be used to treat ear, tonsil, adenoid, and sinus infections when they occur. It is inappropriate to wait forever for resolution!
Full recovery is expected. Right-sided heart failure is reversible when the sleep apnea and airway obstruction are treated.
Enlarged adenoids can cause health-threatening conditions such as chronic ear infections, sleep apnea, pulmonary hypertension, and right-sided heart failure.
When to Contact a Paediatric ORL:
If the child is symptomatic after 6 weeks of conservative management or has recurring episodes (> 4) in a year, it may be appropriate to discuss the matter with the paediatric ORL specialist.
Treating throat infections early may prevent the adenoids from becoming enlarged from long-term infection and inflammation. Adenoidectomy prevents the complications of long-term airway obstruction.
Conventional adenoidectomy is generally performed, but it is a blind procedure and it has its inherent deficiencies, which are addressed by the latest advancement in technique. We perform endoscopic Coblator-assisted adenoidectomy. This is the world's most advanced technique for the removal of tonsils and adenoids.
- 1. Blind procedure
- 2. Occasionally incomplete removal
- 3. Choanal part of the adenoids remain
- 4. Erratic mucosa preservation-slow healing
- 5. Post-operative haemorrhage reported
- 1. Done under endoscopic visual control
- 2. Precise and total removal
- 3. Choanal part is removed under vision
- 4. Good mucosal preservation-rapid healing
- 5. No post-operative bleeding in 8 years
What is Coblation ® Tonsillectomy?
Unlike traditional tonsillectomy procedures,which remove tonsils by burning, Coblation is an advanced technology that combines gentle radio-frequency energy with natural saline —to quickly, and safely remove tonsils. Because traditional procedures use high levels of heat to remove the tonsils, damage to surrounding healthy tissue is common. Coblation does not remove the tonsils by heating or burning, leaving the healthy tissue surrounding the tonsils intact. The innovative approach of Coblation results in minimal pain and rapid recovery for patients.
Coblation has been used in nearly three million procedures by surgeons in ear, nose, and throat (ENT) and other specialities.
How Are Chronic Tonsil Problems Usually Treated?
Depending on symptoms, and the frequency of infection, tonsils are typically treated with antibiotics or removed surgically in a procedure called a tonsillectomy. Doctors typically recommend performing a tonsillectomy based on the following guidelines :
- 3-4 episodes of infectious tonsillitis per year for three consecutive years.
- 5 episodes of infectious tonsillitis per year for two years.
- 7 episodes of infectious tonsillitis in one year.
Your doctor may suggest visiting an ENT surgeon to see if your child (or you) needs surgical removal of the tonsils.
How is Coblation Tonsillectomy Performed?
Coblation uses radiofrequency energy and natural saline, not heat, to gently dissolve tonsil tissue and remove the infected or enlarged tonsils. Coblation Tonsillectomy is a quick outpatient procedure that takes less than 30 minutes, and is performed in an operating room with general anesthesia. Most patients stay in the hospital only a few hours.
Why Is Coblation Tonsillectomy A Better Choice?
Patients report a better overall experience with Coblation Tonsillectomy after surgery when compared to traditional procedures. Studies show that patient calls and visits to the doctor due to complications after surgery are significantly less with Coblation Tonsillectomy.
Because of tissue damage caused by the heat of traditional tonsillectomy procedures, patients often take up to two weeks to return to a normal diet and to resume normal activity. Coblation Tonsillectomy is the gentle alternative offering a rapid recovery and minimal pain, with most patients resuming a normal diet and activities within just a few days.
Am I a Candidate for Coblation Tonsillectomy?
If your doctor recommends your tonsils and/or adenoids be removed, you are a candidate.
If your doctor recommends having your tonsils and/or adenoids removed, then Coblation may be the best solution for you.