Adenoidectomy

Introduction

Adenoidectomy is a procedure to remove infected adenoids. These are a mass of tissues behind your nose and above the throat. Adenoids constitutes part of the lymphatic system alongside tonsils. The goal of your lymphatic system is to ensure a balance of body fluids. Additionally, the lymphatic system helps to keep infection in check. Infection of adenoids by viruses, bacteria or allergies results in enlarged and inflamed adenoids. The ensuing condition is the medical condition, adenoiditis.

Symptoms of adenoiditis

The conditions also manifest in the following symptoms:

• Sore throat
• Snoring
• Difficulty in swallowing
• Running nose
• Blocked ears
• Swelling of neck glands
• Sleep apnea (This is a condition that leads to a cessation in breathing while asleep, albeit momentarily)

An enlarged adenoid may also lead to eustachian tube blockage. This is the narrow passageway that links the throat and middle ear. The eustachian tube opens every time you swallow, sneeze or yawn. In this way, it avoids the accumulation of fluid and pressure inside the ear.

Adenoiditis usually occurs in children aged between 1 and 7. After the age of 7, there is a shrinkage of the adenoids. It is important to remove enlarged and inflamed adenoids to avoid ear infections and breathing problems. Enlarged adenoids may also lead to chronic sinus infection and congestion. Non-surgical treatment may also help to reduce the inflammation.

Adenoids fall into four classes or grades, based on the percentage of adenoid tissues involved in posterior choana blockage.

Treatment options

Although surgery is the main treatment of choice to treat adenoids, homeopathic treatment and medication have also proven useful in managing the condition. The best treatment is known by the age of your child and the size of adenoids.

Homeopathy

The following homeopathy medicines are useful in treating adenoids:

• Bacillinum: This remedy is helpful to children who are especially susceptible to cold. It is also ideal for children with a family history of tuberculosis or asthma.
• Baryta Carb: This remedy is also helpful to children who are highly prone to colds. Increased exposure to colds leads to enlarged adenoids. The remedy is also helpful in case the enlarged adenoids have caused a blocked nose, dry mouth and pain in the throat.
• Opium: This remedy is ideal for emaciated and lean children who also have enlarged adenoids. It is also helpful in children who are experiencing intense snoring due to enlarged adenoids.
• Tuberculinum: This homeopathic remedy is best for adenoids in which adenoids highly predispose a child to cold.
• Thuja: This remedy is helpful in case of adenoids that have a greenish discharge

Allopathy

Your doctor may prescribe antibiotics to treat your adenoiditis. Antibiotics are especially effective in treating the swollen adenoidal tissues. Amoxicillin is an effective antibacterial agent when used alongside ciprofloxacin and potassium clavulanate. In case your adenoiditis are as a result of a viral infections, your doctor will prescribe a treatment plan that is effective in treating the causative agent. A nasal spray is also useful in reducing the swelling.

Procedures/methods available under surgery

Surgery is the only option in case the above treatment methods fail to cure adenoiditis.

Conventional curettage adenoidectomy

This is the oldest surgical technique for the removal of diseased adenoids. The procedure takes place under general anesthesia. The ENT specialist uses blind curettage to remove adenoids behind your nose. One of the risks associated with this procedure is, while the surgeon is scrapping off adenoids, some part of the adenoid tissues may remain. If the residual adenoid tissues is pathogenic, there is a risk of ongoing infection.  

Endoscopic-assisted adenoidectomy

The NET specialist uses a tubular and slender tool known as an endoscope to conduct the procedure. The endoscope has a camera so that the surgeon has a better view of the adenoids. In this way, the surgeon gets to remove as much adenoid tissue as possible. This procedure is better off with fewer breathing and ear problems, while the recovery rate is also very high.

Plasma adenoidectomy

This is one of the gentlest techniques of adenoid removal. The procedure occurs under general anesthesia. The surgeon uses a plasmid sonde to create a 40-70 °C plasmatic field. This is essential for the removal of swollen adenoid. This is usually achieved by a breakdown of the proteins in the hypertrophic tissue. The technique also aids in tissue drainage. Plasma adenoidectomy allows for the removal of hypertrophic tissues in situations where neither the laser technique nor the standard curette can be used. Another benefit of plasma adenoidectomy is that the adenoid base is not traumatized by the use of sharp instruments. Moreover, the technique avoids exerting pressure in your cervical spine. Consequently, the post-surgery risks such as pain and bleeding is minimal. Plasma adenoidectomy is therefore associated with a quicker recovery. For example, you are likely to resume your normal activities after 7 days following surgery.

The procedure also leads to speech improvement. It also causes an improvement in basal breathing while recurrent ear infections are greatly minimized.

Laser adenoidectomy

The procedure uses fiber laser to remove hypertrophied tissues by as much as 90% of the swollen adenoid. The remainder of the adenoid is vaporized using laser energy. Consequently, laser assisted adenoidectomy ensures that the problem does not recur. Laser assisted adenoidectomy takes place under general anesthesia. The procedure is minimally invasive while it only takes 30 minutes. In addition, recovery after laser assisted adenoidectomy is faster than all the other procedures.

Surgery options

You can either choose to have the surgical procedure at your doctor’s office, a small clinic or at a large private or public hospital. The choice amongst either of these  options is determined by the following factors:

Small clinics

One of the benefits of having an adenoidectomy at a small clinic is that you are almost guaranteed of receiving personalized care and attention. Besides, such personalized care and attention gives you a sense of familiarity that is useful in reducing the fear associated with surgery. Another benefit of having surgery at a small clinic is that you are not likely to get delayed as only a handful of such procedures are conducted each week. This is unlike large hospitals that deal with hundreds of procedures each week.

Large hospitals

One of the benefits of having an adenoidectomy is that an ENT specialist with good experience is likely to attend to you in performing such procedures. This will ensure that the surgery is safer and efficient.

Another benefit of having your surgery at a large hospital is the availability of the equipment needed to perform the procedure. Also, in case of any complications, you can be assured that the facility is capable of handling such events.

Besides, large hospitals have a well-equipped recuperating facility just in case you need to remain in hospital for a few days after the procedure. However, having surgery at a large hospital may lead to delays in the procedure, especially when there are emergency cases to handle. Another limitation of large hospitals is that you may not get personal care and attention as the surgeon and the medical staff also need to attend to many other patients simultaneously.  

Cost of adenoidectomy in different setups

The cost of adenoidectomy also differs based on the healthcare setup where the procedure takes place. For instance, public hospitals charge significantly less for the procedure in comparison with private hospitals or small clinics. Also, charges for laser adenoidectomy differ from endoscopic assisted adenoidectomy or plasma adenoidectomy.  You are also likely to pay more for the procedure depending on your duration of stay in hospital.

The least cost for adenoidectomy in Bangalore is Rs. 18,200 while the highest cost is Rs. 56,000. In New Delhi, the lowest cost of Adenoidectomy is Rs. 19110 while the procedure can go as high as Rs. 58,800.

Post op care and things to keep in mind

• Allow your child to get enough rest after adenoidectomy. This can take several days, depending on the procedure that the child underwent. Your child should not engage in strenuous activities for at least one week. However, your child may resume light activities depending on how he feels.
• There are no dietary restrictions after adenoidectomy.
• It is quite normal for your child to feel pain around the throat a few days after surgery. The doctor may prescribe ibuprofen or liquid acetaminophen to control such pain. Your child may also experience a stiff neck from time to time. In case your child cannot move his neck or if it becomes excessively painful, make sure to call your doctor immediately
• Your child may also experience low-grade fever following surgery. Doctors treat this using acetaminophen.

At goficure, we assist you right from booking your first appointment with the doctor all the way to post-op care. We will assist you in getting an appointment with an ENT specialist at a discount. goficure also helps you with booking for diagnostic tests, filling out all the paperwork, arranging for transport to and from hospital on the day you are to undergo surgery.   

References