When is the removal of adenoids in children prescribed by the laser?

Adenoids in ENT practice are the proliferation of lymphoid tissue of palatine tonsils, resulting in a disruption of normal breathingand a decrease in the protective function of the respiratory tract. If conservative treatment does not bring results, it is recommended to remove adenoids in children with a laser - a modern and low-traumatic alternative to surgical excision of affected tissues.

Removal of adenoids in children by laser - indication for operation

Palatine tonsils are an important part of the immune system. They are the first to encounter microbes and viruses and prevent them from penetrating further into the body. With a cold disease, the lymphoid tissue slightly increases in size - until the inflammatory process passes. With the recovery of tonsils take the usual shape. But if the colds are repeated too often, the recovery mechanism is broken, and swollen tonsils gradually block the nasopharyngeal lumen.

Adenoid growth occurs in 3 stages of

1. Adenoids of the first degree occupy not more than 1/3 of the opener and do not interfere with breathing during the day. The child leads a normal life, and only at night, when the enlarged tonsils move, there are problems with nasal passages. The patient is forced to breathe in his sleep with his mouth, because of what he experiences fatigue, lack of sleep. With the progression of adenoids, the baby develops a persistent nasal congestion in the absence of a cold or small serous discharge.
2. The second degree is characterized by a significant proliferation of tissues - up to 2/3 of the lumen. Nasal breathing is blocked, the child is constantly breathing mouth and nasal. There is a copious rhinitis, deterioration of hearing. The brain experiences hypoxia, which affects the memory, attention, learning ability of the child.
3. At the third degree adenoids occupy the entire volume of the respiratory lumen. The child is always open mouth, chronically inflamed mucous nasal and throat, otitis regularly develops, deafness develops. This stage of the disease is dangerous by serious complications: the risk of bronchial asthma, enuresis, and night suffocation increases.

Parents should pay attention to the initial signs of adenoiditis, the development of which usually takes 3 to 4 years:

• the child during the sleep breathes mainly the mouth, snores;
• no snot, but the nose is still embedded;
• the kid does not get enough sleep, fits, complains of a headache, malaise;
• often has a runny nose, which is difficult to get rid of.

What problems arise with adenoids

With timely diagnosis of adenoids and competent treatment, further growth can be stopped. With age, the volume of the nasopharynx increases, and a slight hypertrophy of the palatine tonsils is no longer terrible. In such situations, it is said that the child has "outgrown" adenoids. However, in some cases, the changes are already irreversible and threaten with serious consequences:

• with hearing problems;
• difficulties with swallowing;
• twitching of the facial muscles;
• by the formation of an adenoid type of face and skeleton( malocclusion, jaw disorders, deformity of the thorax);
• lagging behind in mental development due to chronic oxygen starvation of the brain.

Disease 2 - 3 stages, which provokes frequent recurrences of viral infections, otitis media, attacks of apnea, is an indication for the operation. Laser removal of adenoids in children allows almost without blood and pain to restore patency of nasal passages.

Advantages of laser therapy of adenoids

Classical adenotomy, or surgical excision of adenoids - an unpleasant procedure from which parents try to protect their children. Their fears are justified in something: the operation is painful, requires general anesthesia, it is often difficult to tolerate the baby. In addition, its effectiveness leaves much to be desired. The scalpel does not always manage to completely remove the affected tissue, which means that after some time the recurrence of adenoiditis is not excluded.

The laser technique is devoid of most of the shortcomings of the usual operation:

• is performed under local anesthesia - anesthetic drops are instilled directly into the nose;
• during the procedure, there are no unpleasant sensations - the laser works painlessly;
• damaged vessels are instantly coagulated by a laser beam, thus eliminating blood loss;
• irradiation acts purposefully on pathological tissues, without touching the healthy;
• is suitable for the treatment of all stages of adenoiditis;
• The disinfecting properties of the laser ensure the sterility of the operating field during and after manipulation;
• surgery is done on an outpatient basis, the patient needs minimal care.

Preparing for laser operation

If there are indications for the operation, the ENT doctor appoints additional examinations and consultations. This is done to identify possible contraindications and problems that can make adjustments to treatment tactics. So, with neurologic disorders in the child, any manipulation is recommended to be performed under general anesthesia. The patient may have an allergy to analgesics - the anesthetist must choose an alternative drug. It is impossible to intervene in the presence of inflammatory foci in the nasopharynx.

Before the operation the child must undergo:

• pediatrician;
• surgeon;
• neurologist;
• Allergist;
• clinical blood and urine tests;
• X-ray or computed tomography;
• endoscopic ENT examination.

Contraindications for laser adenotomy are:

• cardiovascular pathology;
• blood disease;
• open form of tuberculosis;
• endocrine disorders;
• acute infectious diseases.

Before laser therapy, the oral cavity and nasopharynx must be sanitized: caries, tonsillitis, rhinitis and other potential sources of pathogenic bacteria are treated. On the day of the procedure, the child is not allowed to eat or drink.

Procedure for laser removal of adenoids

The operation to remove adenoids by laser is performed in several ways, depending on the volume of hypertrophied tissues:

1. Vaporization is a method of laser therapy based on the gradual evaporation of lymphoid tissue. Working with a carbon dioxide laser, the doctor achieves a phased reduction in adenoids. Already after 2 - 3 sessions the baby's nasal breathing improves, and full recovery occurs in 7 to 15 procedures. The method is used only to remove small formations.
2. Coagulation - complete excision of adenoids with a focused laser beam at a time. Removes proliferation of any size with simultaneous cauterization of damaged vessels.
3. Combined operation is shown in the most severe cases. At the first stage, endoscopic removal of the maximum possible volume of lymphoid tissue is performed, on the second stage - the remains of adenoids are coagulated by a laser.

Manipulation lasts 15 - 30 minutes, after which the child can go home. Already on the second day, the effect of the operation becomes obvious, and a full recovery lasts up to 14 days.

Rehabilitation period after laser removal of adenoids

The next 2 weeks after removal of adenoids the child and his parents will have a rehabilitation period. There are no special procedures for recovery, the patient simply needs to rest more and follow medical recommendations:

• temperature rise in the first day - an acceptable phenomenon, it is not necessary to shoot down if the thermometer does not show above 38 °;
• if necessary, take antipyretic - choose a medicine that does not contain aspirin;
• exclude physical activity for all 2 weeks, or better - for a month;
• to cancel walks in the first 7 days;
• not swim for at least 3 days, next week you can take a warm shower;hot water and steam are contraindicated;
• adhere to liquid and semi-liquid food: mashed potatoes, cereals, broths in a warm form;
• vasoconstrictive drops to remove swelling and fast healing of wounds apply no more than 5 days;
• Bury in the nose preparations with silver( Protargol);
• do respiratory gymnastics.

From the negative consequences of laser surgery, there are also:

• bloody vomiting when blood enters the gastrointestinal tract;
• burns the mucous membrane of the nasopharynx;
• allergic reaction.

Experience in laser adenoid removal: reviews and prices

Laser adenotomy is not the most common operation in ENT practice. The fact is that this procedure is not included in the list of free( for compulsory medical insurance), and for its carrying out special equipment is required. Not every medical center can afford such equipment, not to mention ordinary children's polyclinics.

If there are indications, the doctors of state institutions offer classical surgery, and such an alternative, how to remove adenoids to a child by laser, is available only for fee and mainly in private clinics. The cost of treatment varies on average from 10,000 to 25,000 rubles, depending on the level of the center, the volume and complexity of the intervention. With the use of general anesthesia the price increases: judging by the reviews, many parents prefer not to expose the child to stress and "lull" him for the duration of the operation.

Feedback on operation

Review No. 1

With 2.5 years of age, we suffer from adenoids. At first they tried to treat all kinds of drops and washes, but the effect, it can be said, was a minimum. The most unpleasant thing is that my son's ears began to hurt. What is not a cold is otitis media, hearing problems and terrible pain.

In general, the ENT scolded me that I am pulling with removal, there already a long time ago 2 - 3 stage, it is necessary to cut. Have handed over analyzes and were already prepared for operation, but here to me one mummy on a platform has advised to try or taste the laser. We went to the only clinic in our city where they conduct such operations. We were offered the most "soft" version - laser reduction.

This is when the adenoids are not completely cut out, but slightly cauterized so that they do not interfere with breathing, and the tonsils continue their protective functions. I regret very much that I agreed. First, it's expensive. We managed in 17 thousand. Secondly, my son was scared and very hurt. Immediately made shots in the ass( from allergies), and already at this stage the child was frightened and then it was only worse. He screamed like a scabbard when a doctor guided him with a laser tube.

Third, about bloodless removal - also nonsense. We are unlucky, the doctor says that the curved septum is to blame, but there was a lot of horror. Well, the last - the effect was enough for six months. Infinities and otitis started again. Our district ENT was initially against such an operation.

This time decided to listen to an intelligent person, again went to the laser, but with a radical removal of adenoids and asked for general anesthesia. The second time my son would not have survived this execution, but under anesthesia everything went well. But it was very expensive, it was necessary to do at once and all

Galina, SPB

Review No. 2

I myself had adenoids in my childhood. I remember my mother treated me with some herbs, somehow drove to the grandmothers, horror! Always open mouth, buzzing head, ears embedded. Already in my teens I finally had an operation.

Then they pulled directly at the living, I do not even remember how I survived this hell. But when everything healed, I forgot about the disease in general! From the nose does not flow, in the ears it became clear, if you catch a cold, then it goes without any complications.

When my child had symptoms of adenoids - congestion, snoring, frequent illnesses - I did not hesitate to do surgery for him. We went to a good expensive clinic in another city, without any anesthesia they removed everything clean, only droplets in the nose were dripped.

The child suffered a normal, then slept long after a sedative. I'm very glad that I did not torture him with useless treatment. On drugs for a few years, we still would have spent more money than on the operation.

It only seems that it's expensive, but if you count how much you saved on the pharmacy and the regular hospital? Once they suffered, and that's all, but now they forgot the way to LOR.

Lina, Moscow