Tonsils and adenoids
Tonsils and adenoids should not be removed if they do not cause anxiety. In the first half of the century, the tonsils and adenoids were blamed for so many troubles that many still believe that they should be removed, and the earlier, the better. This is a wrong opinion. Tonsils exist, apparently, in order to help the body suppress the infection and increase its resistance. The trouble is that there are so many bacteria that the tonsils sometimes become the storehouse of the bacteria they are called upon to destroy. And the adenoids, overflowing, swell so that the passage in the back of the nose is blocked. This prevents breathing and prevents the release of bacteria from the nose.
Tonsils and adenoids consist of a so-called lymphatic tissue, they are similar to glands located on both sides of the neck, in the armpits and in the groin. All these glands, including tonsils and adenoids, swell, if
is nearby, because all act, killing bacteria and increasing resistance: the body.
Tonsils. In a normal healthy child, until the age of seven or nine, the tonsils gradually increase in size, then decrease again. In previous years it was believed that enlarged tonsils are a disease, and they should be removed. Now it is believed that the size of tonsils in itself does not matter. The question is how they work and whether there is a chronic disease. In any case, the doctor will not judge their size in the course of a throat disease or immediately after recovery, because at this time they are likely to be enlarged. If the inflammation of the tonsils and surrounding skin folds persists for several weeks, the tonsils are suspected. Sometimes chronic inflammation of the tonsils causes a general malaise, or chronic temperature, or a prolonged swelling of the glands on the neck, or other troubles. Only a doctor can decide whether the tonsils are affected by chronic diseases.
Another reason for thinking about removing tonsils is repeated tonsillitis attacks. The same question arises in acute paratonsillitis( an abscess behind the tonsils).
The tonsils are also removed for other reasons, for example due to frequent colds, ear diseases, rheumatism and chorea, even if the amygdala itself is not affected. But the probability of improvement in such cases is small. There is no need to remove tonsils, even if they are enlarged, when the child is completely healthy and rarely has a cold or sore throat. There is no need for surgery for problems with food, stuttering or nervousness: in fact, after the operation, the child may become worse.
Adenoids. Adenoids are clusters of lymphoid tissue located behind a soft palate, in the place where the nasal cavity connects with the pharynx. Increasing in size, they block the passage to the nose. This causes breathing through the mouth and snoring. They can also prevent the free release of mucus and pus from the nose and thus contribute to the continuation of colds and sinus inflammation. Increased adenoids can block access from the nose to the ears and contribute to ear infections.
Therefore, adenoids are usually removed due to mouth breathing, chronic diseases of the nose and sinuses, repetitive or persistent abscesses in the ears. Removal of adenoids does not necessarily return the child to breathing through the nose. Some children breathe through their mouths out of habit( they were born with this habit), and not because of obstacles. And in others, the obstructions in the nose are caused not by adenoids, but by swollen tissues in the front of the nose( for example, due to hay fever or another form of allergy).Removal of adenoids only slightly reduces the likelihood of inflammation of the ears.
When tonsils are removed, the adenoids are cut out almost simultaneously, because it is much easier to do this. On the other hand, it is often necessary to remove only the adenoids, if they create obstacles, and leave tonsils if they look healthy and do not cause trouble.
Adenoids always grow back to specific sizes, and in place of the removed tonsils the body always tries to grow new lymphoid tissues. This does not mean that the operation is unsatisfactory or that it needs to be repeated. This means only that the body needs lymphoid tissues in this place and it tries to return them. If the secondary adenoids grow to such a size that they begin to cause trouble again, the operation can be repeated. New tonsils rarely need to be removed because they do not cause chronic infections or true tonsillitis.
Doctors usually try to delay the operation of removing tonsils and adenoids, if there is any doubt, up to seven years. There are several reasons for this. After seven years, there is a tendency to reduce tonsils and adenoids, and the size of the larynx increases. Another reason is that tonsils and adenoids up to seven years grow again much faster. The third and most important reason is that a small child may become frightened of surgery and become nervous for a long time. In general, timid and sensitive children perceive the operation more difficult. However, if there are serious reasons for the operation at an early age, it must be done.
If there is no particular urgency, it is best to perform the operation at the end of autumn or spring, when the infections of the throat are less common. After a cold or sore throat, the operation is postponed for several weeks for fear that the infection will resume. Avoid it also during epidemics of poliomyelitis, because in this case the child becomes susceptible to this dangerous disease.