Cover image for an article on adenoid surgery

Nasal Adenoid surgery: everything you need to know about it

Nasal adenoid surgery is necessary for children with symptoms of adenoid hyperplasia. Nasal adenoids are removed with a simple surgery that improves the child's breathing.

Adenoidectomy is one of the most common operations performed on young children (usually less than five years). An operation for nasal polyps is performed when the polyps swell in children and cause severe symptoms that impede their normal breathing.

But what are nasal adenoids? Where is it located? Well, you might know what it is, but why is it inflated in the first place, or why is it so common? Is the surgical solution the only treatment for adenoids? Is Nasal adenoid surgery dangerous, or does it have complications? When does the child improve after the operation? You will get to know the answers to all these questions and more in this article, so follow us.

Overview of adenoid surgery

Nasal adenoid surgery is a simple and non-dangerous operation. It is not life-threatening, and the success rate is very high, with a noticeable improvement in the patient after the procedure.

Not operating nasal adenoidectomy may lead to the child not obtaining normal breathing and a decrease in the oxygen he receives, thus causing problems in growth and mental development (significantly if it is associated with enlarged palatine tonsils).

The removal of the palatine tonsils may accompany nasal adenoidectomy if they are all enlarged and obstruct the child's breathing or cause other symptoms.

What are nasal adenoids? Where are the nasal adenoids located?

Nasal adenoids are lymphatic defense tissue on the nose's roof. Its function is to protect the child from germs and viruses from the external environment through the nose, as it picks them up when they enter the airway and gets rid of them. The epithelium of the respiratory mucosa covers them.

The palatine tonsils are similar to the nasal adenoids in terms of structure and perform the same function: They protect the child from harmful organisms (bacteria) that enter the mouth through ingested food or air.

In some cases, the adenoids swell in the nose, which leads to obstruction of the airway in the nose and obstruction of breathing. As a result, the child breathes through his mouth, leading to many symptoms. Follow us to learn about them and whether he needs surgery to get rid of them.

Image showing the location of the nasal polyps and enlargement of the nasal polyps
Nasal adenoids hypertrophy

Symptoms of enlarged nasal adenoids

The severity of the symptoms of nasal adenoids varies according to the enormity of the adenoids. The larger the adenoids, the more disturbing symptoms they cause until they reach a stage where surgery to remove the adenoids (operation of the nasal polyps) becomes necessary. Among the most critical signs of nasal polyps are:

Difficulty breathing through the nose

In the enlargement of the nasal polyps, a blockage of the posterior nostril occurs, which impedes the passage of air, and breathing through the nose becomes difficult, which leads to a runny nose, snoring, and interruption of breathing during sleep several times per night. When a complete obstruction occurs, the child breathes through his mouth.

Mouth breathing

It leads to several symptoms: dry mouth, cracked lips, bad breath, gingivitis, and dental caries.

Sleep disorders

Uncomfortable sleep due to insufficient oxygen in the child during sleep, which leads to dullness and daytime sleepiness, and lack of concentration and activity, and may affect the future educational level of the child.

Recurrent otitis media

In the nasopharynx, there is an opening for a canal connected with the middle ear to equalize the pressure on both ends of the eardrum. Enlarging the nasal adenoid leads to blockage of this orifice, leading to otitis media in children. In this case, an operation for the nasal polyp (nasal adenoidectomy) is indicated.

Recurrent paranasal sinusitis

The enormity of the nasal adenoids leads to blocking the drainage openings of the adjacent sinuses, so the secretions accumulate in them. Because of that, inflammation occurs, causing the patient to have a headache and a high fever.

Nasal adenoids enormity causes

There is no specific reason for the enormity of nasal adenoids, but the following reasons are often considered the leading cause, which are:

  • Congenital adenoid hyperplasia: The child is born with enlarged adenoids since birth and increases in size with time.
  • Enlargement of nasal adenoids due to infection: Since the adenoids are lymphatic defense tissue, they will enlarge when infected.
  • Enlarged nasal adenoids after infection: The adenoids may remain enlarged after infection, causing the mentioned symptoms.

Nasal adenoids enormity diagnosis

An otolaryngologist makes the diagnosis in several methods. One of the methods for diagnosing the enlargement of the nasal adenoids is to insert a small mirror in the mouth that reveals the nasopharynx and shows the growth in the nasal adenoids, if any. It is sometimes very enlarged, so its lower borders appear in the mouth.

Image showing the location of the included nasal septum
Site of enlarged nasal polyps

Diagnosis can also be made through a nasal endoscope, which consists of a tube with a camera in front of it, and it is connected to a screen on the doctor’s side, where the camera is inserted into the nose and the enlargement of the nasal adenoids is shown and what is its size.

The diagnosis can also be made indirectly using an X-ray image, where we notice the narrowing of the air column in the nasopharynx from the air behind the larynx in the lateral head image.

Non-surgical Nose adenoids enormity treatment

Before resorting to adenoidectomy operations, the ENT doctor may prefer first to try to treat the adenoids using medications for the nasal polyps (without the process of the nasal adenoids). It is used here before adenoid procedures:

antibiotics

Since the adenoids may be caused by infection and sepsis with germs, the use of antibiotics may help kill these germs and get rid of them, and thus the adenoids may disappear, and we do not need to perform the adenoidectomy.

steroids

Treatment with a nasal spray that contains steroids may help reduce the size of the adenoids in the nose, and thus the symptoms will go away, and we do not need to remove the adenoids or surgery in the nose.

Nasal Adenoid surgery in Turkey

Not all enlarged adenoids require surgery or treatment. Nasal adenoids are lymphatic defense tissue in children that continues to exist until five. Then The adenoids begin to shrink and get smaller until they almost disappear at puberty. Therefore, the presence of enlarged nasal adenoids in adults is rare.

If the nasal polyps are severe and cause many disturbing symptoms for the child and do not respond to non-surgical treatment, then you should think about an operation for the nasal adenoids, and Bimaristan Medical Center will guide you to the best hospitals and the most skilled surgeons in Turkey Contact us.

A nasal Adenoidectomy is performed by an otolaryngologist (ENT specialist) who first anesthetizes the child using general anesthesia (a short-term anesthetic that lasts only the duration of the operation). That is, the child sleeps and feels nothing during the surgery because he is under the influence of anesthesia.

First, a piece of plastic is placed to keep the mouth open during surgery. Then he inserts the mirror and the trowel (a tool or scalpel in the form of a spoon for scraping and removing the nasal adenoids). He then applies heat and tampons the area using sterile gauze to stop the bleeding.

Alternatively, electrocoagulation may be used in nasal polyp surgery to ensure removal while coagulating the area, thus providing less bleeding.

A picture showing the operation of the nasal septum
Nasal Adenoid surgery, nasal adenoids in the mirror before excision

When the palatine tonsils are also enlarged, and there is a complaint of frequent inflammation, then we perform a procedure of Palatine tonsillectomy With the Nasal Adenoidectomy.

Usually, nasal adenoid removal operations do not last more than 30 minutes, after which the child goes out to his room to rest for a few hours and is watched by his surgeon; then, the child is discharged on the same day.

Post Nasal Adenoid surgery

Nasal Adenoid surgery is very safe nose surgery. Still, some disturbing symptoms appear in the child after the adenoidectomy for only a week or ten days (but usually the period is two or three days), and these symptoms include:

  • pain in the ear
  • Inability to open the mouth
  • Difficulty swallowing
  • sore throat

After this short period, the child will be able to breathe normally through his nose, sleep better, and become more alert, focused, and active during his day, in addition to the disappearance of his recurrent otitis media and sinusitis. You can see these results and improvement for the better usually after two weeks at the latest from the operation.

Complications of adenoid surgery

Nasal Adenoid surgery, as mentioned above, is considered one of the safest operations for children. However, surgery is not without the possibility - even a slight one - of complications or damages. Among these potential risks (adenoidectomy damages):

  • bleeding
  • break a tooth
  • Infection and fever
  • Blockage in the nose
  • Presence of nasal discharge
  • A change in the voice

Therefore, if you encounter any of the following symptoms after the surgery to remove the adenoids in the nose, you should see a doctor immediately, namely:

  • Bleeding red blood from the child's mouth
  • Black, brown, or red blood in vomit
  • High temperature and chills (shivering)
  • Severe pain despite painkillers
  • Inability to drink fluids after the rest period from surgery

Nasal adenoids are common in children. However, not all require surgery because nasal adenoids decrease in size as the child grows until they disappear in adulthood. Some children may suffer from slight enlargement at some point in their lives, then pass, and the child's condition improves without treatment, but some have enlarged nasal adenoids significantly.

The solution here is to remove the severely growing adenoids to relieve the child from these symptoms and ensure an everyday life and healthy growth. Some cases of adenoids may be cured with non-surgical treatment. However, rest and an operation for nasal polyps remain the basis of treatment.


Sources

  1. NHS
  2. MedlinePlus
  3. KidsHealth
  4. healthdirect
  5. Mount Sinai

Frequently Asked Questions:

The operation of the adenoids does not change the shape of the nose because it is performed from the inside of the mouth, and therefore the nose has nothing to do with the surgical work.

The cause of bleeding after the adenoid operation is often due to the movement of the gauze that you hold the surgical site from its place. See your doctor immediately if you notice any signs of nosebleeds after the operation of the nasal adenoids.

This is due to the presence of gauze blocking the bleeding site, in addition to the swelling (edema formed after surgery) in the place where the adenoids were removed. The blockage will go away shortly after the operation.

Nose adenoid surgery is not considered dangerous, it is a simple operation that takes a short time, and the patient is discharged from the hospital on the same day as it is performed; the nose adenoid surgery results are satisfactory, and the recovery after it is fast.

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