Polyp surgery in babies and children: when, why?

What are adenoids called?

the polyps – better known by the abbreviated designation of “Vegetations” – designate the lymphatic tissue located on the back of the nose, in which nasopharynx, where the nasal cavities meet. “This sheet of lymphatic tissue under the mucous membrane of the nasopharynx helps the body defend itself against viruses and bacteria, explains Pr. Nicolas Leboulanger, ENT doctor. However, with some children it happens that the The vegetation increases in volume and cause a chronic nasal congestion – with something snoringa breathe mouthfrom infectionsetc – which may require surgery”.

what is her role

The role of vegetations is of defend the body against the viral and bacterial infections. “This lymphoid tissue – same as that of almonds – provides a first line of defense against pathogens, confirms the specialist. However, if the Vegetation is too voluminousB. after repeated infections, and they bother the child on a daily basis, it may be necessary to reduce them.” Parents can rest easy: the intervention in the vegetation produces nothing immunodeficiency Or from increased susceptibility to infection.

Adenoidectomy: why should the adenoids be removed?

Widespread twenty years ago, the management of vegetation is less systematic today. ” In some cases moderate hypertrophya drug treatment with topical corticosteroids can be prescribed, confirms Pr. Leboulanger. It is also recommended to do daily washing nose with saline solution reduce inflammation and increase the comfort of the child ».

adenoidectomyWhere from Reduction in vegetation volumeis today recommended :

  • especially in Cases of chronic nasal congestion affecting the general condition of the child: breathe mouth, snoring, impaired sleep qualityEtc.

  • sometimes as part of a serous otitis (also called seromucosa), which is lengthened over time and as the adenoids increase in volume and symptoms. “The increase in volume of the vegetations can block the lower orifice of the Eustachian tube and lead to a lack of ventilation of the middle ear, which favors the formation of serous otitis,” explains the specialist.

What Are the Symptoms of Enlarged Adenoids?

The hypertrophy of vegetation is generally manifested by:

  • a chronic nasal congestion with currents

  • a breathe mouthie through the mouth, diurnal and nocturnal

  • from snoringa restless sleepwhich can sometimes go as far as a syndrome obstructive sleep apnea (OSAS).

« The hypertrophy of vegetation also promotes nasopharyngeal infections and recurrent ear infections. For example, it can be assigned to a serous otitis, says Prof. Nicolas Leboulanger. For this reason, the reduction of vegetation is sometimes coupled with the installation ofEardrum vents, also called yoyos ».

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What are the causes of enlarged adenoids?

The hypertrophy of vegetations often results from a persistent inflammation punctual. “It occurs in the context of repeated ENT infections, confirms the specialist. When the immune system is stressed too much, the adenoids increase in volume and cause chronic nasal congestion.

What are the risk factors?

Several factors can favor the occurrence of vegetation hypertrophy: for example community life (Nursery mode), which accentuates the spread of viruses during epidemics or even the passive smoking which tend to irritate the mucous membranes of the baby’s airways.

When should polyps be operated on in children?

In general surgery (adenoidectomy) is performed in children from 18 months to 4/5 years. Then the volume of the adenoids decreases, which often allows resolution of the symptoms associated with them. As a rule, the young patient is referred to the ENT by the pediatrician or general practitioner.

During the appointment, in addition to the clinical examination, the specialist conducts a Nasofibroscopy to explore the nasal cavities. “This examination with a small, child-friendly fiberscope is not painful,” specifies Prof. Leboulanger. The feeling can be a little uncomfortable, but it only lasts a few seconds. This makes it possible to visualize the vegetation, verify its volume and confirm the indication for surgical intervention or not.”

How is the operation performed?

removal of vegetation takes place under General anesthesiamostly inside outpatient (day hospital stay). “The gesture is now very well mastered,” says the specialist. We remove part of the lymphatic tissue by curettage to reduce its size. It also happens that the vegetation grows back. It’s rare, but if these have functional repercussions on the child again (nasal congestion, etc.), a second operation can be considered.” Sometimes the surgical intervention is also coupled with a gesture on the hand almonds (tonsillectomy) or Installation of an eardrum ventilator in the context of serous otitis.

What are the postoperative consequences of removing polyps?

The postoperative course is simple. “For a few days there has sometimes been one light pain easy to swallow Relief from painkillers how paracetamol, reassures the ENT. Bleeding can also occur rarely. The specialist recommends not to eat too hot or spicy food in the first days after the operation and to rinse the nasal cavities with saline solution. “The advantages of the operation are very rapid: the child breathes better and thus sleeps better, which affects its general condition,” concludes Prof. Leboulanger.

Tonsils versus polyps

The operation of the vegetations can be coupled with the ablation of the almonds. Tonsillectomy is indicated in connection with:

  • Oversized tonsils: Hypertrophy of the tonsils can actually lead to persistent mouth breathing and the onset of obstructive sleep apnea syndrome (OSAS) in children.

  • recurrent angina or chronic tonsillitis leading to throat pain, inflammation of the tonsils and cervical lymph nodes that persists over time.

And in adults?

As they grow, vegetation withers away. “Removal of adenoids in adults is rare, confirms Prof. Leboulanger. When we intervene, it is more about checking that there is no underlying tumor pathology.”

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