During the annual holidays, Tian Jiajun, Director of Pediatric Otolaryngology Department of Shandong Otolaryngology Hospital, is the busiest day. There are almost dozens of children making appointments in the outpatient clinic every day. A large proportion of the patients who came to the clinic were those who came to the clinic because of “hypertrophic adenoids” causing sleep snoring and mouth breathing. Director Tian Jiajun mentioned that in the process of outpatient consultation, the most tangled question for the parents of children is “whether or not to remove the adenoids”. Some parents reject surgery very much, and some parents actively request surgery because they have seen successful cases after surgery.
Adenoids, also known as pharyngeal tonsils, are lymphoid tissues that form part of the inner ring of the lymphatic ring in the pharynx. Adenoids, like tonsils, are present after birth and grow in size with age. Under normal physiological conditions, 2-6 years old is a period of vigorous proliferation, 7-8 years old, the volume develops to the maximum, gradually shrinks after 10 years old, and basically disappears in adults. Therefore, for patients with mild symptoms and a short medical history, conservative treatment can be considered first and wait for the adenoids to shrink naturally. If conservative treatment is ineffective, or if symptoms persist after conservative treatment, accompanied by recurrent episodes of secretory otitis media, rhinitis and sinus inflammation, or even adenoid appearance, surgical removal of adenoids should be performed as soon as possible.
Whether the removal of adenoids will affect the child’s immunity is the most concerned issue for parents when choosing surgical treatment. Indeed, adenoids, as lymphoid tissues, have certain immune defense capabilities in infancy. Therefore, children under 3 years old generally do not easily consider surgical treatment, and basically rely on drugs and observational conservative treatment. With the increase of age, the immune system of the body is gradually improved, the function of adenoids is gradually weakened, and the immune function of the pathologically hypertrophic adenoids itself has weakened.
In addition, after the adenoid is removed, the surrounding lymphoid tissue will compensatory hyperplasia and automatically assume the immune function of the adenoid, so surgical removal of the adenoid will not reduce the child’s immunity force.
Adenoid facies is one of the most serious symptoms of enlarged adenoids. Therefore, parents are most concerned about the appearance of adenoids for adenoid hypertrophy. Misaligned teeth, prominent upper incisors (buck teeth), shortened chin, prominent upper lip, thickened lips, and collapsed bridge of the nose, these manifestations are difficult to fully recover through post-correction. In this age of beauty, many parents choose surgery because they are worried about the appearance of their children’s adenoids. In addition, adenoid hypertrophy affects the quality of sleep in children, resulting in inability to concentrate during the day, memory loss, unresponsiveness, decline in academic performance, and even affect normal growth and development. It is also one of the reasons why parents insist on surgical treatment.
According to the child’s condition and weighing the pros and cons, the doctor will give parents the most helpful advice. If conservative treatment can achieve the best treatment effect, then surgery is not necessary; if surgery is required, parents do not need to worry, adenoidectomy is very mature. Nasal endoscopic adenoid ablation is now used, which not only has less trauma, but also can accurately determine the scope of surgery. Director Tian Jiajun performs more than 1,000 adenoidectomy operations every year. The operation time is short and the intraoperative blood loss can be almost zero. Director Tian finally reminded the majority of parents: no matter which treatment method is chosen, adenoid hypertrophy should be taken seriously; but parents should not blindly judge the severity of the disease by themselves. If there are related symptoms, they should seek medical treatment in time to avoid missing the best stage of treatment.