Prof. Dr. Şenol Polat

Adenoid And Tonsil Diseases

What is adenoid?
Adenoid (adenoid tissue) and tonsils (palatine tonsils) are tissues located on both sides of the throat and behind the nose (nasal passage). These structures, which belong to the immune system, are the first tissues that come into contact with microbes. They have similar functions to the lymph nodes and are more active in early life. However, in some cases there may be a disruption in their function or growth in their tissues causing damage of the body.

Which situations can occur after adenoid hypertrophy?
When the size exceeds a certain threshold, the patient may experience a feeling of stuffiness and fullness in the nose, discharge, snoring, sleep apnea and some complications that can be caused by them. It can cause the occlusion of the eustachian tube, which ties the middle ear and the nasal region together. In this case, fluid accumulates in the middle ear, hearing loss begins in the patient, and if it is untreated, the middle ear tissues, including the eardrum, may be damaged in the patient in the long term. In addition, this hearing loss in early childhood may affect the intellectual education and social development of the child. Sleep apnea is not an innocent clinical picture and may cause some consequences in the person’s body within a long period. Another disease we encounter in adenoids and tonsils is common infections. If dysfunction begins in these tissues, they become a culture medium (an environment where they can live and multiply and make diseases), especially for bacteria. They often cause infections, especially in children who start nursery and kindergarten.

At which stage surgical procedure can be required?
If these infections require antibiotics each time and their frequency is higher than a certain number per year (eg 7 times or more per year, 6 times or more for two consecutive years, 3 times or more for three consecutive years), surgical procedure of adenoid and tonsils may be required. Adenoid and tonsil surgeries are the most common surgeries in the world. Studies conducted so far, it has not been observed that the surgeries of adenoids and tonsils causes any deficiency in the immune system. On the contrary, it has been proven that some immune system values in the blood return to normal.

What are the most preferred methods in adenoid and tonsil surgery?
Many techniques and devices are available for adenoid and tonsil surgeries. The main purpose is to remove these tissues. Today, the most preferred methods are; ‘classical cold techniques, ‘thermal welding’ method and ‘coblation’. The superiority of these 3 methods to each other in removing all tonsils has not been fully defined. However, in cases where there is no frequent infection, tonsil or nasal flesh is only large (in tonsillar hypertrophy), it is much easier to reduce the tonsils as surgically by coblation. Postoperative pain is less, starting a normal diet is earlier and the risk of bleeding is lower. But very rarely, re-growth of the tonsils can be seen.

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