It is part of the anatomical structures in the upper respiratory tract called Waldeyer’s ring, colloquially called tonsils.
When we look at the mouth in the open position, they are sometimes non-symmetrical structures located in the lateral regions of the opposite wall.
DUTIES
In early life, it is to produce secretory antibodies (Ig) against microorganisms found in the food we eat. In the natural course, they reach maximum size around 3 years of age and are predicted to decline after 6 years of age.
However, reasons such as frequent infections, differences in the immune system, widespread and unnecessary use of antibiotics can change the regression seen at the age of 6.
In recent years, we have been living in more congested environments (schools, kindergartens, shopping malls, public transportation) than in the past, which increases the risk and transmission of infections and causes frequent recurrence, causing the tonsil to remain large and block the respiratory tract, as well as acting as a constant focus of infection.
Tonsil infections (tonsil infections) can be both bacterial and viral. In bacterial infections, fever, joint pain, abdominal pain, weakness are usually present. The pathogen called group A beta-hemolytic streptococcus (beta infection) is the most common causative agent.
The use of narrow-spectrum antibiotics (e.g. penicillin) as much as possible in the treatment can both facilitate treatment and reduce recurrences. Depot penicillin treatment to be administered at certain intervals may be a good alternative for recurrent throat infections despite ideal treatment.
TONSILLECTOMY (TONSILLECTOMY)
The operation can be performed for several purposes.
- Due to infection: 7 tonsil infections in 1 year, 5 in 2 years, 3 in 3 years is enough number of tonsil infections for the operation. Even if it is not a full criterion, the fact that the Aso value is not reduced to normal limits can also be taken as a supportive factor.
- Because of the problems caused by the size of the tonsils. As we mentioned above, Adenoids (adenoid), Tonsil (tonsil) are parts of the area we call Waldeyer. Even if there is no infection, if they grow to a level that causes obstruction of the airway, it may also be a reason for operation.
To elaborate a little bit;
We breathe air through the nose and mouth. Nasal breathing is more ideal for quality air intake as it warms, humidifies, removes foreign particles and circulates the air.
However; Adenoid (adenoid) and Tonsil (tonsil) sometimes grow so large that breathing can become difficult. During the day, our muscle tone is more tense when we are conscious. Relaxation of the neck muscles during sleep causes the airway to narrow. The result, especially in childhood, can be sleep breathing pauses, snoring and changes in the chest muscles secondary to this effort.
Sleep is an indispensable factor for human physical and mental development and metabolism. In sleep due to obstructions, a number of problems may arise because there will be no sleep integrity.
We can perceive sleep as combing a messy hair. Evaluating, analyzing and transferring the events we experience during the day to a place in our brain is one of them;
You have a shoe store and you sell during the day. Think of sleep as sorting and putting the boxes back on the shelves. If your sleep is not adequate and healthy, the boxes will not be placed on the shelves in a certain order, and when you start working the next day, you will be faced with unfinished work and clutter, and the consequences of the repetition of this vicious cycle should be considered with this logic.
The growth hormone, growth hormone, is produced during the deepest part of sleep, the III phase. It is maximally secreted during the period.
Adenoids and tonsils narrow the airway, and since children are frequently awake due to obstruction, this period occurs very little and can affect physical growth. Again, think about the day after a night when we wake up very often and how irritable, cooperative and low your concentration is, we can understand the effect of a child who has been interrupted by respiratory problems being restless, maybe anorexic and unhappy when he wakes up. Facial shape changes due to adenoid and tonsil size, secondary changes in facial bones accompanying long-term difficult breathing can occur.
The rising dome of the palate can cause the face to elongate, the part between the nose and the lip, which we call the filtrum, to increase and the facies adenoid, which we actually see frequently, may not form. When the changes in the face continue, it causes deformations in the jaw and closing defects in the teeth. Most importantly, permanent palate heights and changes in facial bones carry the risk factor for SLEEP APNESIS in advanced ages.
HOW TO RECOGNIZE AIRWAY OBSTRUCTION
Excessive sweating, especially in the neck and head area at night, frequent tossing and turning in bed, and difficult rising and falling of the rib cage are a few symptoms that can be suggestive.
In summary, operations applied for adenoid and tonsil can be grouped under two headings.
- Elimination of frequent foci of infection
- Respiratory problems caused by their size and facial deformities that can be seen secondary to this do not occur
AT WHAT AGE SHOULD TONSILLECTOMY BE PLANNED
Tonsillectomy (tonsillectomy) can be performed between the ages of 3 and 60. Just as each age group has higher age-specific rates, adenoids and tonsils most often pose a high risk between the ages of 3-6.
If the symptoms I have described are present, postponing it will only increase the damage to the child. As with all health problems, information pollution on the subject is at an all-time high.
Aunts who know everything, family elders, physician friends who do not know the subject with different perspectives, no surgery at this age, our neighbor’s son was like this, he had nothing left at the age of 12, now he is a commando, our pediatrician, we need to wait for the age of 7…
Believe me, for myself, every day I am stressed by a new one with different and unscientific approaches.