Why does your child snore?

Dr. Sushmita Pal

ADENOIDS

Answer:

Aurals & Nasals : Dr. Sushmita Pal

Other medical terms

• Pharyngeal tonsil• Naso-pharyngeal tonsil

Aurals & Nasals : Dr. Sushmita Pal

Definition:

•These are a bunch of lymph nodes in the throat behind the nose.

Aurals & Nasals : Dr. Sushmita Pal

Functions of adenoids

• They are the warriors against body infections; because they are Antibody producing organs.

• Adenoids & Tonsils are the “first line of defence”.

• Normally, they shrink by the age of 8-10 yrs; and further disappear in adulthood.

Aurals & Nasals : Dr. Sushmita Pal

Aurals & Nasals : Dr. Sushmita Pal

Patho-physiology: how an useful organ becomes a diseased organ?

Frequent bouts of throat infection

Adenoids enlarge in size; even upto the size of a ping pong ball

Blocks the Nose and the Eustachean tubes(ear tubes)

Aurals & Nasals : Dr. Sushmita Pal

Blocked Nose

Inadequate air entry through nose leads to:

• Mouth breather• Dry mouth• Stunted growth of the child• Sinusitis in adulthood• SNORING

Blocked Ear tubes

Clogged Ear tubes leads to:• Recurrent Middle Ear

infections• Glue Ear• Hearing loss

Aurals & Nasals : Dr. Sushmita Pal

Patient Presentations:• Sore throat• Stuffy nose• Swollen glands• Ear pain+/- ear discharge• Dry mouth• Adenoid facies(pinched up nose,

crowded & prominent upper teeth,high arched palate, short upper lip)

• Speaking with a nasal tone.

Aurals & Nasals : Dr. Sushmita Pal

Complications of Long standing Adenoids

• Middle ear infections• Glue ear• Hearing loss• Sinusitis ( in adulthood)• Stunted Growth of the child• SNORING & SLEEP APNOEA

Aurals & Nasals : Dr. Sushmita Pal

Why and what investigations are required?

• Purpose of various tests are : to validate and confirm the diagnosis.

• Required Tests are:i. X-ray of the Nasopharynx lateral

viewii. Diagnostic endoscopy Both tests are essential .

Aurals & Nasals : Dr. Sushmita Pal

Treatment protocol• Conservative treatment focusing on:a) Stop the infection and further prevent it.b) Medicines for reducing the size of adenoids (decongestants)c) Improving the child’s immune status

• Surgical treatment methodsa) Conventional method using adenoid currette and/or adenoid

punch.b) Electrocautery with suction Bovie.c) Surgical microdebrider.d) Laser Nd-YAGe) Coblationf) SUCTION MICRODEBRIDER

Aurals & Nasals : Dr. Sushmita Pal

PROBABLE COMPLICATIONS AFTER SURGERY

•Stenosis : occurs as a secondary to Nasopharyngeal scarring•Eustachean Tube Injury•Grisel Syndrome( atlanto axial subluxation): occurs if Infection occurs in Nasopharynx after the surgery.

•Bleeding•VPI: Velo Pharyngeal Insufficiency: due to loss of tome of palatal muscles.•Torticollis: due to injury to Superior Constrictor Muscles•Nasopharyngeal

Aurals & Nasals : Dr. Sushmita Pal

Aurals & Nasals : Dr. Sushmita Pal

Thank you….for reading.

Take Care