Tonsils are accumulations of lymphatic tissue surrounding the pharynx of the ring. There are lingual, tubal, palatine and pharyngeal, located on the back wall of the pharynx. Their main task is the formation of healthy microflora in the oral cavity and nasopharynx and the protection of the upper respiratory tract from viruses and microbes entering them. This is an important organ, therefore, to remove the tonsils, the child must have good reason. Otolaryngologists believe that such an operation is unpredictable for a child’s body and is a huge stress.
How do tonsils function?
If the child is healthy, then at the age of 5-7 years, tonsils gradually grow, then they decrease. Already by the teenage period, 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 to remove the tonsils in children is the frequency of tonsil infection by the inflammatory process and their functioning.
If such processes are delayed, then this can lead to serious complications. Then the removal of the tonsils in the child becomes a necessity. The operation should only be carried out 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 nauseous, and appetite is lost, this is the reason for removing 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 diseases, osteomyelitis, rheumatism or infectious arthritis.
Until the age of five, surgery is contraindicated in children. But in cases of a weakened body, when the tonsils are not able to perform their functions, and tonsillitis diseases become quite frequent, the doctor can 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 once again you do not need to worry.
Is it possible to do without removing tonsils? Is there a risk?
The technique for conducting operations to remove the tonsils in a child is well-developed by doctors, and there is no particular risk. A piece of tissue that causes trouble is removed. Recently, such operations were common, but today therapy gives good results. Observations show that the frequency of respiratory diseases gradually decreases and exacerbations cease, and bronchitis and everything that was previously associated with chronic tonsillitis do not disappear after surgery.
After tonsillectomy, most children begin to feel much better. But we should not forget that tonsillectomy is not always able to solve such a problem as sore throat, since it can be a manifestation of pharyngitis, the threat of which does not disappear after surgery, and there is a possibility that such pain can occur after a cold.
Indications for surgery
Surgery to remove tonsils in children is necessary when:
complicated forms of chronic tonsillitis, if toxic-allergic manifestations are present;
enlarged palatine tonsils, disrupting the normal process of swallowing;
frequent peritonsillar abscesses, tonsillogenic phlegmon;
sleep apnea syndrome caused by enlargement of the tonsils or adenoids;
ineffectiveness of the applied conservative treatment of tonsillitis.
Contraindications:
interruptions in the endocrine system;
bleeding disorders;
disturbed mental state, in which the course of the operation cannot be safe;
some diseases of the internal organs during the decompensation period.
Possible effects of tonsillectomy
Basically, after removal of the tonsils, the child has no complications. He is recovering fully. But in rare cases, there are consequences of removing tonsils in children in the form of:
laryngeal edema with the risk of suffocation;
the possibility of bleeding with partial removal of the tonsils;
vascular thrombosis and cardiac arrest;
the appearance of chronic inflammation of the remains of lymphoid tissue and their hypertrophy;
the development of pneumonia after aspiration of gastric juice;
damage to teeth and fractures of the lower jaw;
injuries of the larynx, soft palate, and throat.
Complications that may endanger a child’s life. According to statistics conducted in the UK, 1 out of 34,000 deaths results.
The child during the illness feels difficulty in nasal breathing, as swelling of the nasopharynx appears. The condition can be alleviated with vasoconstrictor drops.
After tonsillectomy, the wound remains, which is the gateway to infection. Immunity at this moment is weakened and the organs of the lymphoid ring need to have time to rebuild and take on the functions to restore it, 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 the child, the attending physician prescribes a patient examination. He is taking a blood test for biochemistry, a general blood test and a blood test for coagulability. With hemophilia or a low level of platelets in the blood, operations are not performed. Because poor coagulability can cause bleeding.
Currently, there are gentle surgical procedures, including the removal of the tonsils in children with a laser, ultrasound, and radio frequency vibrations. Tonsils are partially removed without destroying their tissue completely.
When removing glands in a child with a coblator, there are a lot of advantages:
no pain;
the procedure lasts only 15-20 minutes;
minimum percentage of complications;
the impossibility of infection in the absence of an open wound and the absence of the need for antibiotics;
a quick return to normal life.
This method of operation is now the safest and most effective. Operations are carried out in specialized clinics in which there is special equipment.
Another method of removing tonsils in children in several stages at specific intervals in time, using liquid nitrogen. The downside is the slow absorption of dead tissue, swelling of the lymph nodes and the appearance of pain when swallowing. There is only one contraindication - personal intolerance.
The postoperative period after removal of the tonsils in children
What kind of feelings can a child have after surgery? During the first hours, the child will be sleepy and lethargic, then gradually begin to return to normal. Initially, in the throat, he will feel a foreign body, since the walls of the pharynx and the base of the tongue will be swollen. About a day after the operation, the swelling will pass.
In the first hours after surgery, the child may feel sick. If nausea is very strong and begins to provoke an emetic process, an antiemetic injection is necessary.
How should a child behave after removal of the tonsils? It is recommended to lie on your side, spit out the blood released into a special tank. After a few hours, when the blood flow stops, he will be allowed to turn around, then rise, and after a few hours and 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, quite large dark red wounds are formed that can very quickly become infested with various microorganisms. This is normal. Healing starts from the edges due to the growth of a healthy section of the throat mucosa surrounded by wounds. The healing process lasts ten to fourteen days. If the body temperature rises, even up to 38 degrees, this is considered normal and it is not necessary to treat it.
Should a child use antibiotics?
If you believe the experts, then neither before nor after the operation to remove the tonsils in children there is no need to use antibiotics. Numerous studies show that the appointment of such drugs does not reduce the risks 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 paratonsillar abscess and the presence of heart valve defects.
Sore throat and voice changes
In the first hours after surgery, as the effect of anesthesia takes place, the sore throat may intensify and become more pronounced, especially when swallowing saliva. In this case, the child is prescribed analgesic injections. Tolerate pain is not necessary. In the future, you can take painkillers inside. In the process of healing, the pain will go away and the need for such drugs will disappear. Due to swelling of the mucous membranes, the effects of drugs and pain, in the first hours after surgery, the voice can hoarse and become nasal. No need to make the child talk, throat must be saved, and you can communicate with him through notes.
Postoperative nutrition
In the first hours, the child should not drink and eat, since the swallowing reflex has not yet been restored. It will be possible to start eating after about four hours. Eating will help reduce pain, you can give ice cream. It is safe, well eliminates sore throat and helps to restore strength due to calories.
You need to feed the child 30 minutes after taking the pain medication, when the pain subsides and makes it possible to swallow food. It is better if it will be his favorite dishes, preferably in a semi-liquid state, cold, or slightly warmed up. Sour drinks and juices are contraindicated.
The first days in the hospital
It is recommended to spend at least three days in a hospital, during which nausea will pass and the voice will partially recover. For several 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", preparations containing codeine are contraindicated in children. When processed inside the body, codeine can lead to very serious side effects and even sudden death. You can give your child non-steroidal drugs, all but Ketorol, which increases the risk of bleeding.
Home Recovery
Full recovery occurs in 10-14 days, after complete healing of the wound. The pain becomes less intense over time and becomes tolerable by the beginning of the second week. At this point, you can abandon painkillers. In the event that distant complications may develop, you can not take the child away from the hospital.
If the child eats little at this time, it’s okay. The main thing is that the amount of fluid received is about one and a half liters per day, so that there is no dehydration that aggravates a sore throat. Drink with a straw in small sips. Water should be cold or slightly warm. It is necessary to limit physical activity so as not to provoke bleeding, but walks in the fresh air are allowed.
Removal of the tonsils in children, parental reviews
According to many parents, there is no need to "be conducted" on the simplicity of the operation. Indeed, the removal of 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.