Severe swelling of the adenoids and tonsils

Severe swelling of the adenoids and tonsils (youtube.com)

 

When my son was three years old, about a year ago, he suffered from severe adenoid hypertrophy, requiring weekly emergency room visits. A common cold that would be mild for other children always turned into croup for him. During frequent hospital visits, his snoring worsened, he woke up often at night, and he mostly tried to sleep on his stomach. After discussing these symptoms with a doctor, an emergency room physician examined him and recommended surgery due to his enlarged adenoids and tonsils. This prompted me to research extensively and compile the information into a video.

Adenoid hypertrophy is relatively common in infants and young children. Adenoids develop mainly in preschool children and can cause breathing problems and other symptoms if abnormally enlarged. Adenoids typically grow significantly in early childhood, while tonsils start enlarging from birth, peak around ages 8-9, and gradually shrink after age 11. Immunologically, they are most active between ages 4-10. Tonsillitis refers to inflammation of the tonsils and surrounding areas. Severe adenoid hypertrophy can lead to otitis media with effusion, causing fluid buildup behind the eardrum.

I included an article by Haeri Lim from Chosun Ilbo Health Korea in the video. If a growing child has difficulty breathing through the nose, snores continuously while sleeping, or tosses and turns frequently, even without snoring, adenoid or tonsil hypertrophy should be suspected. If left untreated, it can lead to pediatric sleep disorders, affecting growth and potentially impacting the heart and lungs. Specialists suggest that using the PITA (Partial Intracapsular Tonsillectomy and Adenoidectomy) surgical method can reduce pain and speed up recovery compared to traditional surgery. Professor Geonhee Lee from Kangdong Kyung Hee University Hospital’s ENT department provides more details.

Adenoid and Tonsil Hypertrophy: Hindering Child Growth

Adenoid and tonsil hypertrophy is primarily found in children. The condition involves the excessive enlargement of the palatine tonsils, visible when the mouth is open, and the adenoids behind the nose. Symptoms include nasal congestion, snoring, and negative impacts on sleep. Allergic rhinitis can also cause nasal congestion and snoring, but it mainly involves swelling of the nasal mucosa. Symptoms can worsen when both conditions occur together, necessitating proactive surgical decisions and treatment.

Impact on Growth and Emotional Development Due to Poor Sleep Quality

Adenoid and tonsil hypertrophy mainly affects children and adolescents, with over 95% of patients being in this age group. While tonsils develop rapidly in childhood, they naturally regress in adulthood. Hypertrophy can cause chronic nasal congestion, mouth breathing, and reduced sleep quality. Poor sleep quality can lead to accumulated fatigue, increased irritability, and hindered growth due to decreased secretion of growth hormones during deep sleep. In severe cases, it can cause behavioural disorders such as hyperactivity, attention deficit hyperactivity disorder (ADHD), and aggression.

Suspected When Frequent Waking or Apnea Occurs During Sleep

Observing sleep patterns closely is essential since sleep disorders are the main symptoms. If a child snores heavily, experiences sleep apnea, wakes up frequently, or sleeps in a “Superman” position (with the neck bent), adenoid and tonsil hypertrophy should be suspected. During wakefulness, chronic mouth breathing can lead to an “adenoid face,” characterized by a vacant, open-mouthed expression.

Considering Surgical Treatment When Adenoids and Tonsils Are Too Large

When adenoids and tonsils are excessively large, surgery is the only treatment to remove the hypertrophied tissue. Professor Lee explains that while traditional tonsillectomy removes the tonsils, capsule, and muscle layer, the PITA surgery preserves the capsule and only eliminates the tonsil tissue, minimizing postoperative pain and bleeding. The surgery takes about 10 minutes, with a hospital stay of 1-2 days. Most pediatric patients undergo surgery during school holidays. Post-surgery, avoiding large, complex, hot, spicy, and salty foods for 5-7 days is essential to prevent bleeding. Professor Lee reassures that although there might be a temporary increase in voice pitch post-surgery, it returns to normal within a month. He also clarifies that the risks of general anesthesia and surgery differ, and PITA surgery is relatively safer with its shorter anesthesia time.

Thanks to the quick judgment of excellent doctors, my child was able to undergo surgery and has since grown into a healthy child without any colds. Witnessing my child’s recovery, I created this video to help other parents. I hope we can promptly provide the necessary treatment by closely observing our children’s behaviours.