Resolved question:
My 3 year old had her adenoid removed last may. she used to snore so much. and now she still snores when shes asleep. I saw a specialist she said that her adenoid is still big. do you think she should have the surgery again?
Submitted:
4 Days
Category:
Pediatrician
Dear parent,
Thanks for your query at DoctorSpring.com
I can understand your concerns. You need to understand a few things related to Adenoid and its removal.
Adenoid is a lymphoid tissue (a store of body's immune cells that help the child fight against infections). Though removal of adenoids have not been shown to lead to any significant immunological consequences for the child (As the remaining lymphoid organs take over its role), it is not required to go for surgical removal with every episode of upper respiratory tract infection.
Adenoidectomy needs to be done when there is significant airway obstruction or difficulty in swallowing or sleep apnea. One needs to differentiate simple snoring from sleep apnea. Noisy breathing may or may not respond to surgery. In fact, snoring may subside even after the acute upper respiratory tract infection, which has caused increased swelling of the adenoid tissue, subsides. Obstructive sleep apnea on the other hand manifests with snoring along with frequent nighttime awakenings, increased sleepiness during the day secondary to poor quality of sleep at night, lethargy and decreased performance during the day. SLEEP APNEA is a definite indication for surgical removal of TONSILS and ADENOIDS.
In your daughter's case, you need to differentiate the two conditions either by yourself or with the help of a ENT specialist. Snoring alone does not constitute a definite indication for surgical adenoidectomy. One could try medical measures such as nasal decongestants, intranasal steroids, antihistamines, anti-allergy medications, etc.
After going through this pathway, if she still continues to have significant airway obstruction (snoring associated with poor sleep quality) or recurrent infections, then you could consider re-operating and removing the adenoid.
Regards
Dr. Saptharishi L G