Your little ones suffering from snoring, mouth breathing or nasal block ? Read to know Why !

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All of you might have heard about tonsils. Adenoids are similar kind of tissue which is a part of our immune system, located at backside of the junction between our nose and oral cavity. 
So like tonsils, adenoids are also there for everyone during childhood. Unlike tonsils, adenoids shrink with age and usually regress completely by around 12 years. However it keeps growing and reaches maximum size by around 6-7 years. Then it shrinks normally.
So what is the problem???
Sometimes due to repeated infections or other factors the adenoids become unusually enlarged and narrows the normal airway. When this happens child starts facing difficulty in breathing  through nose (nasal block) and becomes a frequent mouth breather. Snoring develops. 
Repeated infections can cause inflammation of adenoids and can lead to nasal bleeding occasionally. 
The eustachian tube which is a connection between backside of nose and middle part of ear, is located in the premises of adenoids. Hence and enlarged adenoids will block eustachian tube and can potentially cause middle ear problems.
Child can develop earache, hearing loss, ear blocked sensation, heaviness in ear, etc.
Apart from these, due to frequent mouth breathing leading to abnormally increased air passage through mouth leading to poorly aligned teeth and highly arched palate( roof of mouth). Less air passage through nose can lead to weakening of nasal cartilages and can cause a pinched nose appearance. Child keeps mouth open and lower jaw will be narrow and recessed. All these physical appearance together will lead to a typical look of the child which is medically called as " Adenoid facies ".
How is it diagnosed ?
The best method to analyse the extent of Adenoid enlargement is to do a nasal endoscopic examination. However it is quite difficult to do in case of very young child as they won't be cooperative for such a procedure. Eventhough endoscopy can be attempted by restricting head and neck movements forcefully, a slight movement by child can cause trauma. Routinely an x-ray of neck from sideways is taken, which will show significant enlargement of adenoids.
So what to do ?
Your ENT Doctor will tailor the treatment according to your child. Initially there can be a course of topical steroids, antihistamines, decongestants, etc to shrink enlarged adenoids. 
If the medical treatment fails, surgery will have to be considered.
Many a times, it has been noticed the tonsillar enlargement and Adenoid enlargement coexits. Hence both should be checked during evaluation.
If there is middle ear problems, it is managed either with medications or if there is too much fluid in middle ear which is not resolving with medications, your ENT Doctor will suggest draining the fluid by putting a small incision in your ear drum ( Myringotomy).

How complicated is the surgery for Adenoids removal ? 
There are different methods available for surgery at present. From conventional cold methods to coblation methods are available in different centres. Your doctor will choose the best one for your child.
Under expert hands this surgery has very minimal risks. As tonsillar enlargement is usually seen together, many a times this surgery is done along with tonsillar removal.

After surgery ?
Once a proper removal of adenoids has been done, you can notice significant change in your child.
Snoring will dramatically decrease or stop. Child will become more active in general. Will start taking feed properly and growth will also increase if it was earlier affected because of repeated nasal or throat infections.
Surgery is performed under General anaesthesia. After surgery you will be advised not to give anything orally for approximately 6 hours. Then slowly liquids are started. If no issues, may be after another hour or two, semisolids can be started orally. Next day onwards routine diet can be started. Medicated gargles will have to be done after surgery as well. Your doctor will advise regarding the frequency of gargles.
Usually by same day evening or next day, your child will be discharged depending upon institutional policies.
May be after 5-7days, you will have to take your child for review checkup.

So dear readers, if there is anyone with any of the above classical symptoms, do recommend them to get an E.N.T consultation at the earliest.

Please do share the article and spread ENT Awareness.
Thank you.



Hi friends. In this blog, you will find some interesting articles related to Ear, nose and throat diseases. Do share if found useful. Thankyou.

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