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‘Show Concern for Early Child Health’

25 Jul 2013

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Some health defects most parents ignore at the early part of a child’s life could have debilitating social consequences later in life. Medical practitioners counsel that parents should seek immediate medical intervention, when such is observed, Steve Dada writes   


Medical practitioners suggest that there are certain medical complications, which the child could exhibit, and parents would discard by mere wave of hands, but which could have dangerous consequences on such children later in life. One such complication is Adenoid, also known aspharyngeal tonsil.In medical parlance, it is referred to as a mass of lymphatic tissue situated posterior to the nasal cavity, where the nose blends into the throat.


The adenoids are a patch of tissue that protects kids from getting sick. They sit in the back of the nasal cavity. Like tonsils, adenoids help keep the body healthy by trapping harmful bacteria and viruses, that a child breathes in or swallow.


Adenoids do important work as infection fighters for babies and little kids. But they become less important once a kid gets older and the body develops other ways to fight germs. They usually shrink after about age five, and by the teenage years they often practically disappear.


Because adenoids trap germs that enter the body, its tissue sometimes temporarily swells (gets puffier) as it tries to fight off an infection. The swelling sometimes gets better, but sometimes adenoids can get infected themselves.


Swollen or enlarged adenoids are common. When this happens, the tonsils may also get swollen, too. Swollen or infected adenoids can make it tough for baby to breathe and cause problems, such as: stuffy nose, so a kid can breathe only through his or her mouth, snoring and trouble getting a good night's sleep, sore throat and trouble swallowing, swollen glands in the neck and ear problems.


Adenoid removal is often recommended for children who have chronic nose drainage or sinus infection, chronic ear aches or multiple sets of tubes, or breathing problems like sleep apnea.  When adenoids are swollen or infected, they can inhibit normal breathing, leading children to mouth breathing.


Ear tubes are meant to help promote normal draining of the middle ear, and enlarged adenoids can get in the way of this drainage. Additionally, if problem adenoids are not removed, they can harbour infection and their biofilms, or areas of bacteria growth, can reduce the effectiveness of antibiotics.


In a recent interview with THISDAY, a Consultant with the Lagos State University Teaching Hospital (LASUTH), Dr. Vincent Adekoya described adenoid as one of the lymphoid tissues that guide the airways and food passage. He noted that two of such tissues are located at the back of the nose and four in the mouth (pharynx).


According to Adekoya, adenoid main function is for defence, which he describes as immunological function, stressing that adenoid is present at birth of a child and very small, but as a child is getting older, the adenoids are also getting bigger and at age eight, nine, ten and eleven, they get removed completely and not seen in adult, noting that any adult that has them is abnormal.


He explained that, adenoid can get abnormally big during the time it is present and that is when its presence can cause obstruction to the airways and further explained that when adenoids get very big, the situation is caused by allergy or infection.


The expert explained that when adenoids cause obstruction, the child now develops snoring (noisy breathing) because of the obstruction of the passage of the nose at the back, which will make the child to snore and will make them have frequent catarrh, will need to open his mouth to breath since the nose is blocked and will not gain weight as expected since he uses a lot of energy to breath.


He said such child can develop ear problem or ear discharge because of the closeness of the adenoids to the tube that connects the nose to the ear and they can as well have recurrent chest infection such as cough due to the secretion that comes from the back of the nose.


Adekoya warned that if the adenoid is not taken care of or attention is not given to the condition early enough, it may affect the facial appearance of the child which in medical terms is referred to as adenoid faces, (in this case the child may always be opening the mouth which can result into his upper lip getting very tick, while the nose can be pinched and develop high arched palate.


He said the child might also have apnoea, which is cessation of breathing during sleep. He advised that when this is noticed, it should not be handled with kid’s glove, but should be immediately reported to the health care institution for necessary medical intervention.


Talking about the treatment of the condition, Adekoya said there are both medical and surgical treatments, noting that if the medical treatment does not make the patient to get better, the surgical may be an option.


Part of the medical treatment, he noted will be prevention, meaning that “since we know what can make adenoid to get bigger are allergy, infection, we have to prevent dusty environment and things like smoking, frying things, sweeping, sharing of items with mates in the school.”


He also said doctors also give drugs such as vitamins, anti-biotic, anti-histamine (drugs for allergy), decongestants. At this point, if despite medical treatment the child is not improving, we now have to remove the adenoids with surgery, which is not done earlier than 18 months of age.


“The greatest problem with adenoids is the issue of removal with surgery, as most parents are not comfortable with surgical procedure to solve adenoids growth. Most parents need whole lots of explanation and persuasions to convince them of the importance of removal with surgery,” he said.


To allay the fears most parents entertain with surgery, he said it does not involve the cutting of the face where the face would be opened up, but the surgery takes place in the mouth and it could be as simple as possible.


For most healthy children, this is an outpatient procedure. It is a little more involved than some outpatient procedures, however, since it requires anesthesia and a breathing tube. The removal is all completed through the mouth, using a mirror tool to view the adenoid area.  Different surgeons prefer different tools which may involve suction, scraping or electric heat to remove the tissue and reduce bleeding. The procedure itself takes only five minutes.


Most often, children do very well after the removal, only taking basic amounts of ibuprofen or acetaminophen to reduce pain for a few days if necessary. Because of the location of the adenoids, children will often complain of either a head or ear ache, or occasionally both, not knowing exactly where the sensation is coming from.


“It is, however, important for parents to release their wards for necessary surgery that may be beneficial to such children at adulthood, the failure of which may present an everlasting sorrow and regrets,”Adekoyaadvised.
 

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