For any parent, it's worrying to see their child sleeping with their mouth open at night, snoring, or frequently suffering from throat infections. We often see the same fear in the eyes of parents who come to our clinic: “"Does my child need surgery?"” And “"If we remove the tonsils, will his/her immunity decrease?"”
Tonsils and adenoids are part of our body's defense system. However, in some cases, instead of fighting germs, these tissues themselves become breeding grounds for germs, or they grow excessively, hindering a child's breathing, growth, and development. In such cases, surgical intervention is not an option, but a necessity for the child's health. But on what basis do we make this decision?
In what situations does adenoid enlargement require surgery?
Adenoids are located at the very back of the nose and are not visible from the outside. While some growth is expected during childhood, when this tissue grows large enough to obstruct the airway, it manifests with the following symptoms, and surgery (adenoidectomy) is planned:
- Persistent Mouth Breathing and Snoring: If your child has trouble breathing while sleeping, snores, or, even worse, their breathing stops for seconds at a time during sleep (Sleep Apnea).
- Frequent Middle Ear Infections: When adenoids enlarge, they can block the Eustachian tube, which ventilates the ear. This can lead to fluid buildup in the ear, frequent infections, and hearing loss in children (turning up the TV volume too high, not hearing when called).
- Jaw and Facial Development Disorder: Children who constantly sleep with their mouths open develop a raised palate, crooked teeth, and permanent bone/jaw development disorders that we call "Adenoid Face.".
When should tonsils be removed?
When deciding on a tonsillectomy, we, as ENT specialists, consider certain universal medical criteria (Paradise Criteria):
- Recurrent Infections: If your child has had tonsillitis with fever requiring antibiotics 7 times in the last year, 5 times a year in 2 consecutive years, or at least 3 times a year in 3 consecutive years.
- Difficulty Swallowing and Breathing: If the tonsils have grown to the point of being "kissing tonsils" (meaning they touch each other), this can prevent the child from swallowing solid foods, leading to loss of appetite and weight loss.
- Risk of Heart and Joint Rheumatism: Chronic tonsillitis (especially caused by the Beta streptococcus bacteria) should be removed if it carries a risk of causing permanent rheumatic damage to heart valves and joints in later life.
“"Does removing tonsils reduce immunity?"”
The answer to this question, which is asked most frequently by families, is clear. No‘There are hundreds of different lymphatic tissues in our body that provide the immune system. Removing diseased tonsils and adenoids, which are constantly inflamed, unable to perform their function, and constantly pumping infections into the body, does not weaken the immune system; on the contrary, it prevents the child from constantly using antibiotics and incredibly accelerates their development.
Painless and Fast Recovery with Modern Surgery
Today, pediatric ENT surgery has advanced significantly. Unlike older methods, surgeries performed with modern technologies such as "Thermal Welding" (heat energy) or "Radiofrequency" minimize the risk of bleeding, greatly reduce tissue damage, and significantly shorten recovery time. Your child is usually discharged from the hospital the same day as the surgery or the next morning. The best part is that they get to enjoy plenty of ice cream in the first few days after surgery!
To ensure your child's sleep quality, hearing, and healthy development, you can schedule an appointment at the ENT Clinic of Medical Park Bahçelievler Hospital and contact us for a detailed examination.
