Adenoidectomy is very common in the Pediatric Otolaryngology Department of Shandong Otolaryngology Hospital. Tian Jiajun, the director of the department, performs more than 1,000 adenoid operations every year, most of which are under the age of 12. of children. For Director Tian Jiajun, it is “difficult” to appease the nervousness of the parents of children than to complete an operation. From the difficulty of the operation, to whether it hurts after surgery, to whether general anesthesia will make the child “stupid”, parents’ worries can be described as trivial. Also a father, Director Tian Jiajun understands the feelings of the parents of the children very well, and will answer them in detail every time.
Adenoid surgery is a well-established technique. The earliest adenoid surgery was performed by Danish physician Hans Wilhelm Meyer in the 1860s. The 1990s ushered in a new era of direct vision adenoid surgery. In the 21st century, adenoidectomy methods such as electrosurgery, laser, and plasma radiofrequency ablation based on the dissection principle have been promoted and popularized. Low-temperature plasma radiofrequency ablation technology uses ultra-low frequency 100kHz radiofrequency alternating current to excite sodium chloride transmitter to form plasma, which directly acts on the target tissue, breaks the molecular bonds between tissue cells, and makes it cleave and vaporize. Its working temperature is maintained at 40~70℃, which effectively reduces the high temperature damage to normal tissues, which is in line with the concept of minimally invasive. Due to the advantages of accuracy of resection and low blood loss, low-temperature plasma radiofrequency ablation has become the main surgical method for adenoidectomy in Shandong Otolaryngology Hospital. Using a 70° nasal endoscope as the light source and monitoring system, the field of vision is clearer. During the operation, it can not only accurately remove adenoids, ensure sufficient resection range and resection depth, but also effectively protect the Eustachian tube round pillow, posterior nostrils and vertebrae. former organization, etc.
After the adenoids were fully exposed during the operation, the adenoids were gradually excised from the bottom to the top with a plasma knife under the nasal endoscope. In addition to ablation, excision is also a commonly used method in adenoid surgery. If the adenoid hyperplasia is severe, the above two methods can be combined, part of the tissue is cut in one piece, and the remaining part is cannibalized.
During the procedure, the child needs general anesthesia and is unconscious throughout the procedure. Many parents are concerned about whether general anesthesia will adversely affect their children’s growth and intellectual development. Parents can rest assured that there is no definitive evidence from the current study that short-term general anesthesia surgery will negatively affect children’s growth and intellectual development. A top international authoritative magazine has also published an article pointing out that children receiving general anesthesia will not adversely affect the development of the child’s brain and nervous system.
The vast majority of patients do not experience pain after adenoid surgery. They should not eat or drink within 2 hours after surgery, drink water properly after 2 hours, and eat a liquid diet after 4 hours. , On the day of the operation, a cold liquid diet is mainly used, and the normal diet can be resumed on the 1st day after the operation. In order to reduce the local reaction of the surgical wound, the child can also use nasal spray and nasal irrigator to irrigate the nasal cavity. Some children may develop prevertebral lymphadenitis after surgery. The main symptom is neck pain. Children dare not do head-up movements for a certain period of time after surgery. This has a very low clinical incidence and may be related to preoperative adenoids. Severe inflammatory reaction or damage to the prevertebral fascia during adenoidectomy is relevant. Therefore, do not remove too deep during surgery to avoid damage to the prevertebral fascia. Use antibiotics reasonably during the perioperative period. For children with sinusitis, add mucus. expelling agent.
Compared with the harm caused by adenoid hypertrophy to children, such as adenoid appearance, adverse effects on surrounding organs, abnormal growth and development, the risk of adenoidectomy is lower, and even can be ignored. Therefore, if the condition requires surgery, parents can choose surgery with complete confidence.