Adenoids & Tonsils

Does my child need tonsillectomy? – Indications for pediatric tonsillectomy

Tonsillectomy is a surgical procedure performed with or without adenoidectomy that completely removes the tonsil, including its capsule, by dissecting the peritonsillar space between the tonsil capsule and the muscular wall. Tonsillectomy is the second-most common ambulatory surgical procedure (first being myringotomy with insertion of tubes) performed on children in the United States. In the

Anatomy and Physiology of Nasopharynx

The nasopharynx is an air-containing cavity at the back of the nose, which occupies the uppermost extent of the aerodigestive tract. It’s like a small cuboidal box about two to three centimeters front to back and about three to four centimeters top to bottom and side to side. The cavity is lined by pseudostratified ciliated

Resurgence of a disease of the past

A 6-year-old boy from a rural area presented to pediatric casualty with a history of throat pain, progressive swelling of the neck and moderate grade fever for the past 2 weeks associated with gradually worsening dysphagia for the past 2 days. Antenatal history was uneventful, born at term by normal vaginal delivery, developmentally appropriate for

Adenotonsillectomy lowers high blood pressure in children with OSA

Obstructive sleep apnea (OSA) is a spectrum of disorders ranging from simple snoring to complete obstruction of upper airways during sleep, which affects both children and adults. The most common cause of obstructive sleep apnea in children is chronic adenotonsillar hypertrophy, and so adenotonsillectomy is considered as the first-line treatment for OSA in children.

Clinical practice guidelines for tonsillectomy

Tonsillectomy is the second most commonly performed surgery in the United States with more than 5,30,000 procedures performed on children younger than 15 years each year. Although tonsillectomy is a routine procedure performed by general and pediatric otolaryngologists, there is significant variation in preoperative, intraoperative, and postoperative patient treatment among clinicians. In order to avoid

Velopharyngeal Insufficiency

Velopharyngeal Insufficiency (VI) is the inability to temporarily close the connection between nasopharynx and oropharynx, due to an anatomical dysfunction in soft palate (velum), lateral pharyngeal wall or posterior pharyngeal wall. This can be due to insufficient tissue to accomplish closure, or due to some kind of mechanical interference with closure. An effective sealing between nasopharynx

Adenotonsillectomy can improve bedwetting in children with obstructive sleep apnea

Bladder control in children usually occurs by the age of 5 years. Nocturnal enuresis (NE) or bedwetting, is the involuntary urination during sleep, in absence of physical disease in a child older than 5 years. Nocturnal enuresis affects children of all racial groups. The estimated prevalence rate is 8% to 20% for 5-year-old children and 1.5% to 10%

Diphtheria

Diphtheria is a life-threatening acute bacterial infectious condition caused by Corynebacterium diphtheriae. The usual site of infection is the tonsils and oropharynx, but the disease can occur in nasal cavities, larynx or the skin also. History The disease was first described in the 5th century BC by Hippocrates and the bacterium was discovered by Edwin Klebs in

Challenging diagnostic nasal imaging

A 5-year-old male child presented with a history of recurrent sore throat, fever, mouth breathing for the past 3 years. The parents also gives history of sleep-disordered breathing including witnessed apneic episodes. History of nocturnal enuresis also present. On examination Adenoid facies present. Mouth breathing present. Oral cavity: Crowded tooth Oropharynx: Grade III tonsils Anterior