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Question:
My son is 5 yrs old and has enlarged adenoids which a local Russian hospital has advised should be removed. However I believe that if there is no history of ear infection then advice in the west tends to avoid removal. Can you advise?
GM
Answer:
Thank you for your inquiry. I can do no better than to refer you to specialists! http://www.entnet.org/indicators/tonsillectomy.html I had occasion to look up this URL a few weeks ago when a similar question was asked by a mother of a slightly older child (whose symptoms have since settled superbly with a change of climate). In brief, if the enlarged adenoids (and / or tonsils) are not symptomatic (i.e. are neither mechanically obstructing the airway, nor acting as a source of or reservoir for infection), the mere fact that they are enlarged is not usually regarded as an indication for removal. Like the tonsils, the adenoids are made of tissue that filter out bacteria and viruses entering through the nose and produce antibodies to help the body fight infections. In some cases their activity becomes counter-productive in the sense that by remaining continuously active, they grow in size and cause problems as a result. Symptoms are not inevitable from enlarged adenoids but the patient may complain of difficulty breathing through the nose (and therefore breathe through the mouth, and / or more noisily than is "normal"); and may snore unduly while asleeping. As a generalization, if this is the first time the diagnosis has been made and there are no associated symptoms, it may be best to wait until the necessity for surgery is more convincing. Hope this helps. As always, we recommend checking with a physician for the applicability of this general advice to your individual clinical situation. Best regards
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