The tonsils are collections of lymphatic tissue that surround the throat. There are lingual, tubal, palatine and pharyngeal, located on the back wall of the pharynx. Their main task is the formation of he althy microflora in the oral cavity and nasopharynx and protection of the upper respiratory tract from viruses and microbes entering them. This is the most important organ, so a child must have a good reason to remove the tonsils. Otolaryngologists believe that such an operation is unpredictable and a huge stress for a child's body.
How do tonsils work?
If the child is he althy, then at the age of 5-7 years, the tonsils gradually grow, then they decrease. Already by adolescence, they become similar to adults. It was once widely believed that enlarged tonsils were a disease and were removed. At the moment, the reason for the operation forremoval of tonsils in children is the frequency of inflammation of the tonsils and their functioning.
If such processes are delayed, it can lead to serious complications. Then the removal of the tonsils in the child becomes a necessity. The operation should be performed only by experienced surgeons, since the result of the operation and the absence of negative consequences will depend on the professionalism of the doctors.
If the inflamed tonsils interfere with the process of normal ingestion of food, the child begins to feel sick, loses appetite, this is the reason for the removal of the tonsils. The next reason for the operation is a sore throat disease more than 5 times a year. The question of surgical treatment is also raised when the child often suffers from purulent tonsillitis, which can cause complications in the form of kidney disease, osteomyelitis, rheumatism or infectious arthritis.
Under the age of five, operations are contraindicated for children. But in cases of a weakened body, when the tonsils are not able to perform their functions, and angina diseases become quite frequent, the doctor may prescribe surgery.
In the modern world, methods are used in which blood loss is minimal, there is practically no pain, and the recovery time is short. So there is no need to worry again.
Is it possible to do without removing the tonsils? Is there a risk?
The technique of carrying out operations to remove the tonsils in a child is perfectly worked out by doctors, and there is no particular risk. A piece of tissue is removed, providingtrouble. In recent times, such operations were common, but today therapy gives good results. Observations show that the frequency of respiratory diseases gradually decreases and exacerbations stop, and bronchitis and everything that was previously associated with chronic tonsillitis do not disappear after operations.
Most of the children after a tonsillectomy begin to feel much better. But we should not forget that tonsillectomy is not always able to solve such a problem as a sore throat, since it can be a manifestation of pharyngitis, the threat of which does not disappear after surgery, and it is likely that such pain may occur after a cold.
Indications for surgery
An operation to remove the tonsils in children is necessary when:
- complicated forms of chronic tonsillitis, if toxic-allergic manifestations are present;
- enlargement of the palatine tonsils, disrupting the normal process of swallowing;
- frequent peritonsillar abscesses, tonsillogenic phlegmon;
- Sleep apnea syndrome caused by enlarged palatine tonsils or adenoids;
ineffectiveness of the applied conservative treatment of tonsillitis.
Contraindications:
- interruptions in the endocrine system;
- blood clotting disorders;
- disturbed mental state, in which the course of the operation cannot besafe;
- some diseases of the internal organs during decompensation.
Possible consequences of tonsillectomy
Basically, after the removal of the tonsils, the child has no complications. He makes a full recovery. But in rare cases, there are consequences of removing the tonsils in children in the form of:
- laryngeal edema with risk of suffocation;
- possibility of bleeding with partial removal of the tonsils;
- vascular thrombosis and cardiac arrest;
- appearance of chronic inflammation of remnants of lymphoid tissue and their hypertrophy;
- development of pneumonia after aspiration of gastric juice;
- damage to the teeth and fractures of the lower jaw;
- injuries of the larynx, soft palate, throat.
The resulting complications can threaten the life of the child. According to statistics from the UK, 1 in 34,000 is fatal.
A child during an illness feels difficulty in nasal breathing, as swelling of the nasopharynx appears. The condition can be alleviated with the help of vasoconstrictor drops.
After a tonsillectomy, a wound remains, which is the gateway for infection. Immunity at this moment is weakened and the organs of the lymphoid ring need to have time to rebuild and take over the functions for its restoration, which can last two to three months. During this time, the child should be observed by an immunologist and an otolaryngologist.
Methods
On the eve of the operation to remove the tonsils in a child, the attending physician prescribes examinations of the patient. They take a blood test for biochemistry, a complete blood count and a blood test for clotting. With hemophilia or a low level of platelets in the blood, surgery is not performed. Because poor clotting can cause bleeding.
Currently, there are sparing methods of operations, including the removal of tonsils in children with a laser, ultrasound, radio frequency vibrations. Tonsils are partially removed without completely destroying their tissues.
There are a lot of advantages when removing tonsils from a child with a coblator:
- no pain;
- procedure lasts only 15-20 minutes;
- minimum complication rate;
- no chance of infection in the absence of an open wound and no need for antibiotics;
- quick return to normal life.
This method of operation is now the safest and most effective. Operations are carried out in specialized clinics that have special equipment.
Another method of removing the tonsils in children in several steps at certain intervals in time, using liquid nitrogen. The downside is the slow resorption of dead tissues, swelling of the lymph nodes and the appearance of pain when swallowing. There is only one contraindication - personal intolerance.
Postoperative period after removal of tonsils in children
How does a child feel after surgery? During the first hours the child will be sleepy and lethargic, then gradually begin to return to normal. At first, he will feel a foreign body in the throat area, since the walls of the pharynx and the base of the tongue will be swollen. About a day after the operation, the swelling will go away.
In the first hours after the operation, the child may feel sick. If the nausea is very strong and starts to provoke a vomiting process, then an antiemetic injection should be given.
How should a child behave after the removal of the tonsils? It is recommended to lie on your side, spit out the blood into a special reservoir. After a few hours, when the flow of blood stops, he will be allowed to turn, then rise, and after a few hours, get up. The diet after removal of the tonsils in children should be selected by specialists. Doctors usually explain everything in detail.
What does the throat look like after surgery?
In place of the removed tonsils, rather large dark red wounds are formed, which can very quickly become inflamed by various microorganisms. This is fine. Healing begins from the edges due to the growth of a he althy area of the throat mucosa surrounded by a wound. The healing process lasts ten to fourteen days. If the body temperature rises, even up to 38 degrees, this is considered normal and does not need to be treated.
Should my child take antibiotics?
According to experts, neither before nor after the operation to remove the tonsils fromchildren do not need antibiotics. Numerous studies show that the appointment of such drugs does not reduce the risk of complications and they do not reduce sore throat. But sometimes the use of antibacterial drugs is advisable. The doctor recommends the use in case of an increased risk of bacterial endocarditis, the development of peritonsillar abscess and the presence of heart valve defects.
Having a sore throat and voice change
In the first hours after the operation, as the effect of anesthesia wears off, the pain in the throat may intensify and become more pronounced, especially when swallowing saliva. In this case, the child is prescribed painkillers. You don't have to endure pain. In the future, you can take painkillers inside. In the healing process, the pain will go away and the need for such drugs will disappear. Due to swelling of the mucous membranes, the action of drugs and pain, in the first hours after the operation, the voice may become hoarse and become nasal. No need to force the child to talk, the throat must be protected, and you can communicate with him through notes.
Postoperative nutrition
In the first hours, the child should not eat or drink, as the swallowing reflex has not yet been restored. It will be possible to start eating in about four hours. Eating will help reduce pain, you can give ice cream. It's safe, good for sore throats, and helps you recuperate through calorie intake.
Feedthe child is needed 30 minutes after taking the painkiller, when the pain subsides and makes it possible to swallow food. It is better if these are his favorite dishes, preferably in a semi-liquid state, cold, or slightly warmed up. Acidic drinks and juices are contraindicated.
First days in hospital
It is recommended to stay in the hospital for at least three days, during which the nausea will pass and the voice will be partially restored. A few days in the postoperative period, the sore throat is quite severe, so the use of the necessary painkillers should be at regular intervals.
It can be "Paracetamol" or "Nurofen", drugs containing codeine are contraindicated for children. Codeine, when processed inside the body, can lead to very serious side effects and even sudden death. You can give your child non-steroidal drugs, everything except Ketorol, which increases the risk of bleeding.
Recovery at home
Complete recovery occurs in 10-14 days, after complete healing of the wound. The pain becomes less intense over time and will become bearable by the beginning of the second week. At this point, you can stop painkillers. In the event that long-term complications may develop, the child should not be taken far from the hospital.
If the child eats little at this time, it's not scary. The main thing is that the amount of fluid received should be about one and a half liters per day, so that there is no dehydration, which increases the pain in the throat. Drink with small strawssips. Water should be cold or slightly warm. Restriction of physical activity is necessary so as not to provoke bleeding, but outdoor walks are allowed.
Removal of tonsils in children, reviews of parents
According to many parents, it is not necessary to "be led" by the simplicity of the operation. After all, removing the tonsils in a child is not an easy task. This is an open wound, anesthesia, a shock state of a little man and unpredictable consequences. Before making a decision, you need to listen to the opinion of experts.
