As autumn ushers in colorful leaves and crisper temperatures, it’s also the time of year when certain illnesses begin to peak — especially in children.
According to the Center for Disease Control and Prevention, pediatric upper respiratory illnesses increase during the colder months and can range from the common cold to more serious conditions involving infections of the tonsils and adenoids, the tissue located in the back of the nose.
“We do see an increase of infections like tonsillitis and adenoiditis that cause fever, sore throat, swollen glands, facial pain and nasal drainage,” said Dr. Bart Dickson of Southfield-based Ear, Nose & Throat Consultants. “Most of these infections are caused by viruses that don’t respond to antibiotics, so common treatment is over-the-counter analgesics (ibuprofen and acetaminophen) and fluids. If the infections become chronic or recurrent, we look to other solutions such as tonsils and adenoids removal.”
Tonsillectomy (and typically a simultaneous adenoidectomy) is the third most common surgery performed on children in the U.S., with 530,000 procedures done each year. “Tonsil and adenoid problems typically require surgery for these three reasons: frequent infections, hypertrophy (large size) that becomes obstructive and abscesses,” Dickson said.
“We have a major concern about the obstruction caused by enlarged tonsils and adenoids because, left untreated, it can lead to childhood obstructive sleep apnea,” said Dr. Jeffrey Weingarten of Ear, Nose &Throat Consultants. Children with OSA briefly stop breathing during sleep and lose oxygen. Their bodies react by partially waking up to jump-start the breathing process and they generally snore loudly.
OSA can affect the child’s overall health, causing sleep deprivation, memory loss, enuresis (bed-wetting), growth delay, cognitive and social development issues. There are also behavioral problems that tend to arise because of the lack of restful sleep.
“The lowered oxygen levels and constant night awakenings leave children tired and cranky," Dickson said. "In fact, some children with OSA are misdiagnosed with attention deficit hyperactivity disorder, since many of the symptoms — distractability, excessive fidgeting, aggression and irritability — are so similar. In these cases, tonsillectomy and adenoidectomy are often the cure.”
How do you know when your child is a candidate for a tonsillectomy and/or adenoidectomy?
According to the American Academy of Pediatrics, some of the general guidelines for removal of tonsils and adenoids are as follows:
- In the case of recurrent infections: If your child experiences five to seven tonsillitis infections in one year with fevers more than 101ºF; 90 days of persistent tonsillitis; or four culture-documented strep tonsillitis infections in one year.
- In the case of obstruction caused by enlarged tonsils and adenoids: If your child experiences loud snoring on a regular basis; obstructive sleep apnea; frequent throat infections; dysphagia (difficulty swallowing from large tonsils); mouth breathing; hyponasality (stuffy nose sounding speech).
- And surgery is also recommended if children have recurrent middle-ear infections, mononucleosis or similar illnesses — particularly if they don't respond well to antibiotics.
“The tonsil-adenoidectomy is often done at an ambulatory surgery center or a hospital as an outpatient and requires about 45 minutes of general anesthesia,” Dickson said. “After surgery, pain can be anything from mild to more severe, but with today’s more advanced pain medications, the discomfort is more manageable.”
One thing hasn’t changed when it comes to tonsil-adenoidectomy surgery. "We still recommend lots of ice cream after the procedure,” Dickson said. “We like the throat to stay moist for healing, so be prepared to push liquids, jello, frozen drinks, milkshakes — the more the better.”
A tonsillectomy is considered extremely safe but, like all surgeries, involves risks. But when done with careful consideration, it can be the answer to your child’s better health. Said Dickson: “I see it time and time again — parents tell me that the children undergoing these procedures have a dramatic improvement in their health and behavior. That, in turn, has a positive effect on the entire family.”
Source: Hometown Life