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Is Surgical Removal Of Adenoids Advisable In A 3 Year Old?
Question: hello doctor
my son 3 yrs old has been identifief with stage 4 adenoids and stage 3 tonsils. i checked with 2 ent specialists. one is suggesting surgical removal of only the adenoid while other is suggesting surgical removal of both.
for surgical methods, one is suggesting coblation and other micro-debridation.
he has high crp of 28.5. wbc:14.4k and plateletes:4.6lakhs.
plz suggest what to do.
my son 3 yrs old has been identifief with stage 4 adenoids and stage 3 tonsils. i checked with 2 ent specialists. one is suggesting surgical removal of only the adenoid while other is suggesting surgical removal of both.
for surgical methods, one is suggesting coblation and other micro-debridation.
he has high crp of 28.5. wbc:14.4k and plateletes:4.6lakhs.
plz suggest what to do.
Brief Answer:
Diagnoses and management of two doctors on similar lines.
Detailed Answer:
Thanks for asking on HealthcareMagic.
I have gone through the details as well as the attached reports. Let me assure you that the tonsils (also called adenoids) are lymphoid organs that mediate immunity. In case the tonsils are inflamed and infected, CRP which is a marker of infection, can go up, and the infection would need to be treated with antibiotics. But following the normal physiological response of the body, the size of tonsils regresses with age. In fact 3 years of age is the peak for the size of the tonsils and it should gradually start decreasing on its own naturally. The determinant for requirement for surgery is not stage 3 or 4 but the clinical scenario. If the child is getting more than 7 episodes of cough and cold a year, for a few years, tonsillectomy is advised. But in case the recurrence is lower, it is preferrable to wait and watch. Supportive management is to be given in the meantime.
Gurgling with lukewarm water would constitute the mainstay of treatment in such a case. As I mentioned, the requirement of surgery is to be assessed on how bad the clinical scenario is. Microdebridation means cleaning the small pockets of infection from the tonsils. Coblation is just an advanced way to do the same thing. The following link should help:
http://www.arthrocare.com/our_technology/ot_coblation_explained.htm
If you feel that you need to go for surgery, following the discretion of any of the two doctors should be fine. You also need to keep your budget in consideration.
Hope that helps.
Regards
Dr. Diptanshu Das
Diagnoses and management of two doctors on similar lines.
Detailed Answer:
Thanks for asking on HealthcareMagic.
I have gone through the details as well as the attached reports. Let me assure you that the tonsils (also called adenoids) are lymphoid organs that mediate immunity. In case the tonsils are inflamed and infected, CRP which is a marker of infection, can go up, and the infection would need to be treated with antibiotics. But following the normal physiological response of the body, the size of tonsils regresses with age. In fact 3 years of age is the peak for the size of the tonsils and it should gradually start decreasing on its own naturally. The determinant for requirement for surgery is not stage 3 or 4 but the clinical scenario. If the child is getting more than 7 episodes of cough and cold a year, for a few years, tonsillectomy is advised. But in case the recurrence is lower, it is preferrable to wait and watch. Supportive management is to be given in the meantime.
Gurgling with lukewarm water would constitute the mainstay of treatment in such a case. As I mentioned, the requirement of surgery is to be assessed on how bad the clinical scenario is. Microdebridation means cleaning the small pockets of infection from the tonsils. Coblation is just an advanced way to do the same thing. The following link should help:
http://www.arthrocare.com/our_technology/ot_coblation_explained.htm
If you feel that you need to go for surgery, following the discretion of any of the two doctors should be fine. You also need to keep your budget in consideration.
Hope that helps.
Regards
Dr. Diptanshu Das
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks Doctor for the suggestion and guidance.
My son suffers from Upper Respiratory Track or Throat Infection almost once a month and everytime requires a course of anti-biotics like Azee 200.
He suffers from cold and running nose almost 5-6 times in a year for last 2 years. Also, he currently is breathing through nose and having high snoring during sleep.
My question is if Tonsil should also be removed with Adenoids at this age. Plz guide me.
Also, I understand that Coblation is more recommended apprach compared to micro-debridation. Plz confirm.
My son suffers from Upper Respiratory Track or Throat Infection almost once a month and everytime requires a course of anti-biotics like Azee 200.
He suffers from cold and running nose almost 5-6 times in a year for last 2 years. Also, he currently is breathing through nose and having high snoring during sleep.
My question is if Tonsil should also be removed with Adenoids at this age. Plz guide me.
Also, I understand that Coblation is more recommended apprach compared to micro-debridation. Plz confirm.
Brief Answer:
There are a number of tonsils. Adenoids are the main.
Detailed Answer:
Thanks for asking back.
Although your child suffers from upper respiratory tract infection about once a month, antibiotics are not always essential. Irrespective of use of antibiotics it will take 5-7 days to resolve. The mainstay of treatment will be gurgle with lukewarm water.
Let me clear your confusion between adenoids and tonsils. As I have already mentioned, adenoids and tonisils are the same.
https://en.wikipedia.org/wiki/Tonsil
https://en.wikipedia.org/wiki/Adenoid
When we commonly mention about tonsils, we actually refer to the adenoids. There are a few other tonsils however. I do not think that they need to be removed as well unless they too are causing obstructive symptoms.
Coblation is a more advanced method. But it is not that micro debridation has a problem. Discuss about the options with the doctor who had suggested micro debridation.
Regards
Dr. Diptanshu Das
There are a number of tonsils. Adenoids are the main.
Detailed Answer:
Thanks for asking back.
Although your child suffers from upper respiratory tract infection about once a month, antibiotics are not always essential. Irrespective of use of antibiotics it will take 5-7 days to resolve. The mainstay of treatment will be gurgle with lukewarm water.
Let me clear your confusion between adenoids and tonsils. As I have already mentioned, adenoids and tonisils are the same.
https://en.wikipedia.org/wiki/Tonsil
https://en.wikipedia.org/wiki/Adenoid
When we commonly mention about tonsils, we actually refer to the adenoids. There are a few other tonsils however. I do not think that they need to be removed as well unless they too are causing obstructive symptoms.
Coblation is a more advanced method. But it is not that micro debridation has a problem. Discuss about the options with the doctor who had suggested micro debridation.
Regards
Dr. Diptanshu Das
Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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