Tonsillectomy, Adenoidectomy and Ear Ventilation Tube Insertion Operations

Three common operations in children: tonsil removal operation, adenoid removal surgery, tympanostomy tube placement

Tonsillectomy, Adenoidectomy and Ear Ventilation Tube Insertion in Istanbul

In children with tonsil and adenoid hypertrophy for a long time, middle ear fluid accumulation disease (serous or effusive otitis media) may be present due to poor functioning of the eustachian tube that ventilates the middle ear and opens into the nasal region. In the event that medical treatment of middle ear fluid does not improve, fluid accumulation in the middle ear (chronic serous otitis media) and collapse of the eardrum can be placed in addition to tonsil and adenoidectomy surgery. These tubes can be of very different kinds and sizes. Depending on the condition of the eardrum of the patient, hearing loss and the shape of the fluid accumulated in the middle ear, different types of tubes can be used for several months to several years.

Tonsillectomy and adenoidectomy

Tonsil (Tonsilla Palatina) and adenoids (Tonsilla Pharyngealis-adenoid) are tissues in the lymphoid tissue group located behind the throat and nose. They are involved in lymphocyte production.

Adenoid is located on the back of the nose. During breathing, the turbulent air flow hits the nasal concha (concha) in front and continues to leave bacteria and particles in it by hitting the nasal turbinates. Adenoid and tonsil tissues tend to grow until the age of 6, starting from the first 6 months of life, which is the period when antibody levels passed from the mother fall. In this period, when factors such as genetic predisposition, contact of cigarette smoke, being in the nursery environment are added, excessive growth and infection can be seen in these tissues. Since the adenoid is located at the back of the nose and next to the eustachian tube that allows the ear to vent, findings such as nasal congestion, open mouth sleep, fluid accumulation in the middle ear or collapse in the eardrum can occur in adenoids. In tonsil growths and inflammations, complications such as respiratory arrest during sleep, swelling of lymph nodes in the neck and rarely rheumatic fever can be seen.

Hypertrophic tonsils

In children with large tonsils, adenoid growth and problems in the eardrums can also be seen. In this case, tonsil surgery, adenoid surgery and ear tube surgery can be performed together. Unlike the old tonsil surgery guide, in patients with tonsil enlargement (tonsil hypertrophy), half tonsil surgery with laser instead of tonsil reduction with radiofrequency; It is mostly recommended to completely remove the tonsils with modern methods such as thermal welding.

Adenoidectomy is performed under general anesthesia. When the patient's mouth is open, the adjacent nasal tissue is scraped with sharp curettes, called adenotoma, which are seen in the photo on the side. It is not a curative surgery. Deep parts of the nasal flesh are usually left in place. Especially in children with allergic structure, frequently recurring infections, living in crowded environments and smoking houses, nasal enlargement may be seen again after adenoidectomy operation.

Adenoidectomy is performed under general anesthesia. When the patient's mouth is open, the adenoid curettes / an adenotome, seen in the photo on the side, are scraped with sharp curettes and the nasal tissue located behind the soft palate. It is not a curative surgery. Deep parts of the nasal flesh are usually left in place. Especially in children with allergic structure, frequent recurrent infections, living in crowded environments and smoking houses, nasal enlargement may be seen after adenoidectomy operation.

Adenoid Hypertrophy

Adenoid Hypertrophy
Adenoid hypertrophy is a common cause of nasal congestion, especially in children. Recurrent throat infections, serous otitis media, seizure attacks and open mouth sleep (long-term changes in dentofacial bone structure) can cause many symptoms. Links to adenoid hypertrophy and adenoidectomy >> Adenoid Removal Surgery (Adenoidectomy Operation) Video / Enlarged Adenoids - Symptoms, Causes, Diagnosis and Treatment

Adenoidectomy video 1:

Adenoidectomy video 2:

Some Important Information About Ear Tube Surgery

Ear Tube Surgery - Ear Ventilation Tube Placement

There are ear tubes of different structure and size that can be placed on the eardrum. The above photographs show "T-tubes" placed on the anterior lower quadrant of the eardrum. Before surgery, light brown ear fluid relief behind the eardrum and increased vascularization in the membrane are observed. It is also seen in the photographs that the ears of the ear bee have returned to the normal appearance of the pearl color after surgery. In addition to tonsil and nasal flesh surgery, patients who have undergone ear tube surgery should be careful not to leak water to their ears. Cottons and silicone ear plugs prepared by impregnating vaseline during bathing can be used for this purpose.

Tympanostomy tube - The T-tube -  Ear ventilation tube

Tympanostomy tube - The T-tube -  Ear ventilation tube

In the photo above, T tubes of 1.14 mm diameter are shown in green color. These tubes are placed with their legs under the membrane. The part outside the membrane is shortened after insertion. These tubes are much less likely to exit than other ventilation tubes.

Once the ear tubes have been removed, the hole in the eardrum may not seal well.

The type of tube to be used can be selected according to the condition of the eardrum, hearing loss, and fluid characteristics in the middle ear. Above, the T-tube, which can be kept in the eardrum for about 2-3 years, is seen placed on the membrane.

There are grommet type ear ventilation types that can self-discharge within 6 months.

Anesthesia is rarely required when removing the tube in the eardrum. In polyclinic conditions, it is usually sufficient to pull the tube with a tool only.

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul

Private Office:
Address: İncirli Cad. No:41, Kat:4 (Dilek Patisserie Building), Postal code: 34147, Bakırköy - İstanbul
Appointment Phone: +90 212 561 00 52
E-Mail: muratenoz@gmail.com
Mobile phone: +90 533 6550199
Fax: +90 212 542 74 47


  

 


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