Pediatric ENT Surgeries

Pediatric ENT surgeries are the surgeries of the pediatric department opened within the Ear-Nose-Throat Department, especially for the treatment of ear, nose and throat diseases seen in infant and child groups.

Pediatric ENT surgeries:

  • Tonsil
  • Adenoid
  • Ear tube

There are areas of treatment such as the treatment areas and a high rate of success is achieved.

What is Tonsil Surgery in Children?

Tonsil surgery in children is the removal of the tonsil called “lymphoid tissue”, which is present in every child and secretes secretions to build resistance against germs.

Since the tonsil is a tissue found in both infants and children, it is not expected to be removed surgically under all circumstances. However, when it causes excessive infection, it is acted upon with the approval of the doctor when the necessary examinations are performed.

When a throat infection starts, you should go to the doctor and take ten days of medication with antibiotics prescribed by the doctor.

Which Symptoms Require Surgery?

Symptoms that necessitate surgery:

  • Tonsil tumor
  • Enlargement of the tonsils to the extent that sleep is interrupted (sleep apnea)

These are reasons that absolutely require surgery. Also in children with abnormal growth of the tonsils:

  • Growth retardation
  • Serious impairment of tooth and jaw structure
  • Decreased school success

As such, it brings consequences that cannot be ignored. Other reasons for surgery:

  • Sore throat lasting 3 months or more
  • Bad breath
  • Difficulty swallowing
  • Diphtheria carriage
  • Throat infections
  • Size difference between two tonsils
  • The possibility of tumors in people undergoing cancer treatment
  • Children with fever at least four to five times a year

It is sorted as follows.

What are the Techniques of Tonsil Surgery in Children?

The techniques of tonsillectomy in children vary according to cases and hospitals. The most known techniques:

  • Classic Method The tonsils are cut and removed from their sheath with a knife.
  • Cautery In tonsil surgery in the form of cautery, which is divided into two as monopolar and bipolar; While monopolar gives electricity from two separate ends, bipolar gives electricity from one side. Bipolar cautery is used to close the cut vessel by burning. In the classical method, it is a method used to close the vein.
  • Microdissector: It is a surgical technique that cleans the adenoids, although it is a method mostly used by doctors in the United States for treatment purposes. It is also used in sinus surgery.
  • Radiofrequency It is applied by affecting a small area with slightly different methods than the cautery technique. On the plus side, the postoperative painful process is quite low. Standard use is not recommended as there is some hesitation in the process of widespread use.

How is Tonsil Surgery Performed in Children?

Before tonsil surgery is performed in children, examinations are performed and the day is determined according to the results of the examinations.

On the day of surgery, you should fast for a minimum of 8 hours and dehydrate for a minimum of 3 hours. The operation is performed under general anesthesia.

What Happens After Tonsil Surgery in Children?

In children, there is severe pain in the tonsils after tonsillectomy . The reason for these pains is the openness of the cavities from which the tissues are removed and it takes about 10-15 days until the healthy mucosa closes the cavities.

In order to make this period of pain comfortable, a diet program with cold and soft foods is started.

There is no age limit for surgery. If necessary, it also performs surgical interventions in the 1-1.5 age group. The common age limit of 7 years does not apply to medicine.

One day after the surgical intervention is spent under hospital supervision. It is then discharged on doctor’s recommendation.

Adenoid in Children

The problem of adenoid in children is generally seen in children between the ages of 4-7 in the pediatric ENT surgery clinic .

The nasopharyngeal region reaches its maximum size between the ages of 4 and 7 and begins to shrink after this age. By the age of 14, the shrinkage is complete.

The adenoid area contains many secretions and microorganisms to fight against viruses and germs from the nose.

What are the Effects of Adenoid in Children?

The effects of adenoids in children are mainly listed as follows:

  • Sleep Apnea
  • Filling the adenoid with germs
  • Sinusitis
  • Various infectious diseases
  • Growth retardation
  • Deterioration in dental health
  • Breathing through the mouth.
  • Attention deficit

In addition, sleep apnea in children seriously affects the development of intelligence in children.

How is adenoid surgery performed in children?

Adenoid surgery in children is first investigated with endoscopic devices in the presence of a specialist. Depending on the cause found, the decision for surgery is taken and the process begins with the necessary examinations.

General anesthesia is applied. Although it can be performed at any age, according to the World Medical Literature, the limit for infants is 1 year of age. The age limit is considered to be 3 years old unless it is not necessary.

Are There Risks of Adenoid Surgery in Children?

The risks of nasal surgery in children are the same as the risks of any surgical intervention. The most important risk is bleeding due to children’s inability to express bleeding. For this reason, he/she is hospitalized for one night after the operation. The surgical intervention takes 8 or 10 minutes.

In addition to the anesthetic risks, the operation is not performed if the tests performed on the child show a blood clotting disorder.

What Happens After Adenoid Surgery?

Sleeping-waking time after adenoid surgery takes between 30-45 minutes on average. About five hours after waking up, food is not restricted as long as the balance of hot and cold and softness are taken into account.

You may have a sore throat for 2 days, not because of the surgical wound but because of the anesthesia tube. The healing process takes 4 or 5 days, during which time rest at home is considered appropriate.

Ear Tube in Children

In children, an ear tube is inserted when the ear is covered with water or a substance produced by the ear itself, resulting in decreased hearing or no hearing. This hearing impairment is called “catarrh of the ear”.

In Which Situations Should Ear Tubes be Inserted in Children?

In children, an ear tube should be inserted in the following cases:

  • In those with persistent otitis media
  • If the middle ear fluid does not go away with treatment
  • Collapse of the eardrum
  • Eardrum wear due to flying and diving
  • Children with Down syndrome
  • Congenital causes

How to Insert an Ear Tube?

If deemed appropriate by the doctor, the ear tube is inserted into the eardrum using a microscope. Special tools are used.

What Happens After Ear Tube Placement?

After the ear tube is inserted, the following benefits are seen:

  • The risk and recurrence of otitis media is eliminated.
  • Healthy sensation is provided.
  • Problems with balance and speech are solved.
  • Sleep and behavior problems are solved.

The ear tube is temporarily inserted but comes out on its own. In cases where it does not come out spontaneously, the removal procedure is simply performed by the doctor.

How Long Should Ear Tubes Stay in Children?

Children stay for a minimum of 4 and a maximum of 12 months after the ear tube is inserted. The duration of the ear tube is carefully monitored. It comes out spontaneously within a minimum of 4 and a maximum of 6 months, but when it does not come out, it is removed with the approval of the doctor. The duration of use may be prolonged if problems in the ear persist. This period is decided by the doctor performing the surgery and follow-up.

What are the Factors to Consider While Wearing an Ear Tube?

The factors to be considered while wearing an ear tube are listed as follows:

  • Ear plugs should be used wherever there is contact with water to prevent water from entering the ear and causing pain.
  • It should be used away from diving sports for a while.
  • Depending on the patient’s condition, the use of plugs should be on doctor’s advice according to a specific schedule. It is important to adapt to this program.
  • Flights should be suspended.