adenoidectomy for 3 and 5 yrs old. is it safe and advisable?

seekingbless · Apr 14, 2015

My sons were admitted in medical centre on Sunday for prolonged cough and flu. Both were having cough and flu on and off since this year January. We had bought them to various clinics for total about 5 times but the flu and cough kept coming back after few days.
So last Sunday we decided to them to medical centre and the pead suggested for admission for throughout checkups. Blood test, nasal flu and urine samples and xray were taken. Xray result were not so good and blood result showed virus.
And the pead reffered to ENT specialist since both my sons snore during their sleep.
The ENT suggested for adenoidectomy since they are having prolonged cough and flu and also snore.
The prosedure were done today under general anesthesia. Now both have recovered from the surgery and active as per usual. They will be admitted for another one to two days for the other treatment.
But now, my dh is very worried after the surgery is done. His cousin sister who is a doctor in a general hospital said adenoidectomy is not safe for kids below 5 yrs old. And it can treated with medicine. My sil also influenced my dh saying both the pead and ENT specialist have done this for money and my boys are going to suffer a lot because if this.
I have googled and read about adenoidectomy, but I dont see any bad side effect beside nose bleeding in the beginning. I even showed that to my dh but he doesn't seems to convinced.
I was alone in the ward taking care of both boys and my dh only comes after his work finished. I feel like he is going to put the blame on me in future if anything happened.
So im asking for my own peace of mind. Is adenoidectomy is safe since my boys are only 3 and 5 years old. Will there be any bad effects in future?

So for any spelling or grammar error as I'm sending this using my hp.

Swasha · Apr 14, 2015

@seekingbless,

In the wiki, it is mentioned that this procedure is done under 1 year of age. please go through it. I think you shouldn't worry. Your son's are safe and healthy.

Sparkle · Apr 14, 2015

@seekingbless:
Sorry to hear about your situation. I read a little bit about this procedure and it seems like a common procedure done in children.

As you mentioned, the procedure is done and your boys are recovering well. So focus only on their recovery now. Don't think about what your sil is telling your husband. (What is the other treatment you are speaking of here? Getting to know about this other treatment can give you some relief and also help in the recovery of your boys.)

Was your husband involved in the decision making process before procedure was performed? Why didn't your sil inform you and your husband priorly that the procedure is not required and could be treated with medicines? These are some things your husband should think about before blaming you.

Don't worry and pray to God. Your boys and you will be in my prayers. Wishing them a speedy and safe recovery.

sokanasanah · Apr 14, 2015

An adenoidectomy is a commonly performed procedure for children (ages 1 to 6, even up to 18) with recurrent upper respiratory tract infections. Snoring, apnea and breathing problems are indications as well. So, I don't think the surgeons opted for it purely out of greed. Here are the numbers:

An estimated 20% of children experience recurrent upper respiratory tract infections, and many of these children are referred to the ear, nose, and throat surgeon for surgery. Adenoidectomy is one of the most commonly performed surgical procedures in children in western countries. In 2009 in the Netherlands 15 179 children (16.3 per 1000) aged 0-4 and 5573 children (5.5 per 1000) aged 5-9 underwent adenoidectomy. In 60% of these children, recurrent upper respiratory tract infections were the indication for surgery. In 2006 in the United States 129 540 children (1.76 per 1000) up to the age of 18 underwent adenoidectomy. In 12% of these children the operation was performed because of chronic infections. In both countries the figures have remained stable over the past decade.

Although the adenoid is thought to have some immune function in children, this role progressively diminishes with age. In adults it is considered a vestigial organ with no function. So, it is unlikely that your children will suffer long term consequences as long as the surgery was done properly.

The question remains whether an adenoidectomy helps to minimize recurrent upper respiratory tract infections. A 2011 study conducted in the Netherlands on 111 children (54 adenoidectomies and 57 with no surgery) showed that there was no difference in rate of infection between children who had undergone the surgery and those who had not. This paper suggests that the surgery may be ineffective i.e. it does not appear to prevent future respiratory tract infections.

There is no evidence to suggest that it is dangerous. Only one of the 54 children who had an adenoidectomy experienced what may have been a surgery related adverse event (exacerbation of asthma). One of the children without surgery experienced an adverse event too. So, again, there is no evidence that the surgery is dangerous.

The full data from the study, published in the British Medical Journal, can be found here.

Your kids will be fine! Don't panic!:thumbsup

Shanvy · Apr 14, 2015

@seekingbless i just had to tell you as a been there done that mom. my son had both tonsils and adenoids removed and tubes inserted in his ears when he was 5, in another country. he had the same problems, and infact he was losing his hearing with fluids retention. and when i came to india on vacation my paed said i could have waited for some time and seen the response to antibiotics.

we had taken a year of infection, the cough, the persistent side effects from cough and his lack of interest and concentration to childish tantrums..but i do not regret the operation. it was to be done at that point done.

my son is now 17 and he is fine. yes has the occasional cold, and sneezing, and wheeze but nothing more. just wanted to stay strong. give them right food, exercise and they are resilient they will bounce back very well..

take care..and don't keep reading too much.

sokanasanah · Apr 14, 2015

By the way, I neglected to point out that even if the effectiveness of an adenoidectomy for respiratory tract infections may be somewhat equivocal, the surgery may still mitigate the breathing / snoring problems for your boys! Also, don't forget that it takes a long time for studies (such as the one I linked to), to filter down to become the standard of care. The quality of evidence required is fairly high. The surgeons may really have acted in the best interests of your children, based on the standard of care at your hospital. I'm just trying to reassure with the science and the data, but Shanvy's post is better!

Laks09 · Apr 15, 2015

@seekingbless - I got the adenoidectomy for my son. He was not yet four when we did it. He had multiple ear infections and upper respiratory infections as a result of fluid accumulation in the ears and upper respiratory tract. He has had antibiotics every month for an infection. Sometimes he needed double course and then injections for the infections to clear. Even so his infection came back every so often. He has terrible allergies and when his allergies flare up, his upper respiratory tract gets filled with fluids. Anyway, after multiple attempts with all sorts of meds, he got bilateral ear tubes. Despite the tubes he got upper respiratory infections but thankfully his ears were spared. His tubes fell off last fall at the height of the allergy season and again his ears were a mess. His upper RI flared so badly that we again had to give him antibiotics twice. His ENT then decided to re insert his ear tubes and also suggested adenoidectomy. We went to three different docs. All of them felt his adenoids were actually hurting him by retaining fluids in his upper respiratory tract making it a fertile ground for bacteria and infections. We got his adenoids out along with getting bilateral ear tubes. He still has horrible allergies but finally we are able to control the allergies by allergy meds alone. I've not had to give him steroid nebuliser ever since the fall.

Btw, after the adenoids came out is when we realised the amount of fluids he had back there. He expelled phlem like gunk from his nose/mouth for three weeks. That's when I knew the amount of stuff he had back there. That was despite the surgeon removing as much fluid as he could during the procedure.

seekingbless · Apr 15, 2015

Thank u to @Swasha , @Sparkle , @sokanasanah , @Shanvy ma'am, and to @Laks09 ,
Thank u to u replies. I feel better and getting panic too with @sokanasanah's second reply. That adenoidectomy won't prevent future recurrence of respiratory tract infection again. The prevention was the main reason I agreed for this surgery.

Answering to @sparkle , I don't speak with my sil. That's why she called my dh directly.
And the ent specialist did told me about the surgery. But he said "let's check if there are tissues blocking your boys breathing passage and if its enlarged and blocking, we will remove it. " so for that I said OK. My dh was not with me that time and i told the same to him. I didn't know that it will done under general anesthesia and I didn't know the term of adenoidectomy until then.
When the surgeons were preparing, I told my dh what is happening he urged me to tell them to stop the surgery. He called his cousin sister to get her opinions. And I'm not sure if he had his sister or his cousin sis passed the msg to my sil.
I consulted the ent again fully and dh's cousin sis too. Only when I felt that adenoidectomy is safe for my boys I agreed.

Sorry to hear about ur boy @laks09 , my prayers will be for your son for speedy recovery too.

Laks09 · Apr 15, 2015

@seekingbless - Sorry you didn't know about the details of the surgery before hand. It is tough to take care of two kids recovering from an adenoidectomy. I hope you get all the instructions on post surgical care before leaving the hospital.
In my opinion, no surgery or treatment is a 100%. You talk to the docs and make a decision and move on in life. They may still get upper respiratory infections but they may breathe easier and not snore anymore. Breathing better itself will be a relief for the kids.
Think about it that way.
Yes, like everything in the world, even this surgery has a risk associated with it. Since the kids are now awake and are behaving normal, the worst risk is passed. Now, concentrate on their recovery. Don't give them crackers, pop corn, things with small seeds in it so they don't hurt their throat. Don't give them things that are very hot/cold. Watch them for three weeks and they should completely heal. Think positive. Let's hope their colds and coughs get better. Fingers crossed.

sokanasanah · Apr 15, 2015

seekingbless said: ↑

... I feel better and getting panic too with sokanasanah's second reply.
Click to expand...

Oh dear, I was worried about that! The idea behind my post was to assume that a thoughtful, educated, responsible adult is best served by reliable information. I did not want you to be reading all sorts of dubious web info. I tried to point you to scientific information, as a starting point, so that you can knowledgeably discuss follow-up with your physicians. It is not to add to the panic. You are the adult here. So use all available quality information to provide the best care for your children. Forewarned is forearmed. You are ignoring the main point - that this is one of the most common surgeries performed on children in the west (> 150,000 children in the USA and the Netherlands alone) and choosing to worry needlessly. I know this is your prerogative as a mother, but still - how does it help?

... my boys are going to suffer a lot because of this.
Click to expand...

The crucial point to remember is that there is absolutely no evidence for this statement.

Look at what the ENT specialist said: he said "let's check if there are tissues blocking your boys breathing passage and if its enlarged and blocking, we will remove it." So, the surgery was done to improve the breathing as well, not just for the infections. Some kids are just prone to respiratory tract and ear infections. I was - well into my teens. Eventually it just goes away. So, it will for your boys. Stop worrying!
:thumbsup