The tissues known as tonsils and adenoids are composed of lymphoid cells and play a role in the production of lymphocytes. In newborns, they are small due to the presence of maternal immunoglobulins. They tend to enlarge due to infections, especially around the ages of 4-5. As one ages, they generally tend to shrink. Enlarged adenoids can obstruct nasal breathing. They can also cause various problems by disrupting the drainage of the ears and sinuses. In such children, hearing loss, snoring, mouth breathing, night coughing, and nasal discharge can be observed. Chronic inflammation or enlargement of the adenoids can lead to orthodontic problems, facial development issues, and speech disorders.
When the enlargement of the tonsils and adenoids narrows the upper respiratory tract, it can cause serious problems such as snoring and sleep apnea. In such cases, it is beneficial to consult with an ENT specialist.
The disease known as rheumatic fever is a complication caused by antibodies produced against group A beta-hemolytic streptococci. It can lead to abnormalities in the heart valves.
When Should Tonsils and Adenoids Be Removed?
Tonsil and adenoid surgeries are frequently performed in ENT clinics. When medication therapy does not yield benefits, surgical removal is considered. Two criteria are used to decide on this surgery.
The necessity for surgery is determined as absolute or relative.
Absolute indications for surgery:
Obstruction of the upper respiratory tract due to enlarged tonsils and adenoids
Abscess around the tonsils (Peritonsillar abscess)
Suspicion of malignant tumor
Tonsil and adenoid enlargement that disrupts jaw structure
The most prominent relative criterion is the frequent recurrence of tonsil infections, which accounts for 40% of tonsil surgeries. This includes experiencing feverish tonsillitis 7 times in the last year, 5 times per year in the last two years, or 3 times per year in the last three years.
Other relative indications include:
Carriers of the diphtheria microbe
Individuals with heart valve disorders
Frequent middle ear infections due to tonsil and adenoid inflammation
In such cases, it is referred to as chronic tonsillitis, and surgical treatment is recommended and planned.
At What Age Are These Surgeries Performed?
While tonsil diseases are known to be a problem in the pediatric age group, the same rules apply to adults. Tonsil surgery is performed on adults who do not have any serious health problems that would prevent surgery. The minimum age limit is generally set at 4-5 years, except in mandatory cases. There is no upper age limit. Generally, the incidence of this disease decreases in older age, and simpler solutions are often preferred.
Is Tonsil Surgery Risky?
The risk of tonsil surgery is quite low. Statistics indicate that serious complications related to anesthesia or surgery occur in 1 out of 14,000 surgeries. The rate of serious postoperative bleeding is also low, at about 5 per 1,000. Many scientific studies have been conducted on the body’s defense system after tonsil surgery, but no definitive results have been obtained. A decrease in the number of certain types of lymphocytes has been observed in people who have had their tonsils removed, but this has not been found to cause clinical problems. There is a belief that people are more prone to pharyngitis after tonsil removal. However, the incidence of pharyngitis is the same in people with or without tonsils. Removing the tonsils does not increase the rate of pharyngitis.
Source: http://www.kbb.org.tr
