Tonsils and adenoid

Tonsil and adenoid operations are one of the most common operations among children. Even they are not rare in adults. It is a valuable operation eventhough with the use of antibiotics. 

Recent studies showed that adenoid operations also help middle ear problems. 

What are the roles of adenoid and tonsils?
These are lymphoid structures like found in many parts of our bodies. These are accumulated lymphoid tissue situated at back of our mouth. Nasopharynx is the name given to the space at the back of our nose. Adenoid is situated at the upper part of it. Tonsils are situated at the back of both sides of the tongue. 

They are found at the beginnig of the respiratory and digestive systems. They are one of the first organs meet with air and food. They help immune system of the body. Like every tissue if they do their job nicely they are useful but if they begin to give harm to body then they are tretated accordingly. 

Their job is important at early ages, their importance decreases as human gets older. There is not a scientific data that after 3 years old they are useful for body. People whom tonsils and adenoids are taken out did not show any immune or other kind of defect after their operation. 

There is a wrong public belief that tonsils and adenoid filter the microbes. This is not true. Microbes are microscopic structures; very large food can pass through the mouth how they can filter microscopic structures. 

How doctor control tonsils and adenoid?
Basic methods are:
1-Medical history
2-Physical examination
3-Bacteriologic culture
5-Blood laboratory examinations

Which diseases effect adenoid and tonsils?
Main problems seen in children are frequent infections and the size of them. Frequent infections can be seen in adults also. Abscess can form around tonsils. Tumors can be seen in tonsils either. 

When should I admit to my doctor?
If you think that you or your child have problems because of adenoid and tonsils then you should admit to doctor. Frequent tonsillitis, fever, bad odor in breath, nasal obstruction, sleeping with mouth open, snoring, sleep disorders, saliva in bed, sweating during sleep, apnea, squeezing the teeth, enuresis. 

How are tonsils and adenoid treated?
Every child can have 1-2 tonsillitis every year. There are two main reasons to take them out by surgery: 1-Infections even though antibiotic usage. 2-Apnea because of big size tonsils and adenoid. Sleeping with mouth open with or without apnea can cause dental, orthodontic problems beside restless sleeps. 

Chronic infections can effect the neighbouring tissues and organs. By effecting the Eustachian tube middle ear problems can be seen. 

Tumor or cancer suspician is also another indication for taking out tonsils. 

If following conditions are seen, then we say that tonsils and adenoid give harm to body instead of help.
1-Frequent tonsillitis ( 3 times since last 3 years, 5 times since last 2 years, 7 times since last year.) 
2- If tonsil abcess occurs (Recently some wait the second attack)
3-Their sizes are big enough to cause breathing and feeding problems.
4-They hire some pathologic microbes.
5-Continuous infection eventhough suitable antibiotic treatment. 

In the following conditions adenoids are taken out:
1-If they cause airway obstruction that causes apnea. Adenoids can be taken in newborns as early as 2 days old.
2-Long term nasal obstruction, mouth breathing and snoring conditions.
3-Frequent middle ear infections or infections that resist to medical treatment.
4-If congenital closure occurs at the back of the nose in newborn (choanal atresia) adenoidectomy is added to this correction operation.
5-Requrrent rhinitis and sinusitis.
6-Together with some ear operations in children. 

Tonsil and adenoid operations are done through the mouth. They can be done safely in summer time. What is important is to do the operation at necessary time. 

How is the patient prepared for the operation?
You should be prepared when your doctor says that you need an operation. 

Child and the parent should talk about the operation and all the fears of the child should be discussed. You should encourage him/her saying that doctor is trying for him/her to have a better health. Please try to be with him/her as much as possible before and after the operation.They should be aware of their sore throat after the tonsil operation. Also encourage them by saying that tonsils and adenoid are not their important part and their external appearance will not change after the operation. It may help them to talk with a friend who undergone tonsil operation. 

Aspirin or similar drugs should not be used at least 10 days before and after the operation. Inform doctor for any kind of drug usage. Patient’s past medical history should be explained to doctor as much as possible. 

Patient should not eat or drink anything at least 6 hours before the operation. If not, patients can vomit and aspirate the stomach contents during anesthesia. 

Do not hesitate to ask any kind of question to your doctor. 

What can happen after operation?
Swallowing difficulty, fever, sore throat, ear pain, nausea and vomitting can all be seen after the operation. Rarely bleeding occurs. In that case you should inform the doctor.

My persistent symptoms 31 May, 2013 - 12:14

I am writing to you from St. John's, Newfoundland (Canada). I have a sinus problem started in Nov 2008 upon working for more than a month in a gas plant. I did not have sinus problems prior to this date.

At that time, I may have been exposed to airborne asbestos and other irritants. In the place where I lived at that time, the Winter is so harsh. Temperature during Winter is normally at least 25 Cecilius below zero.

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