Pediatric Surgery
Tonsils & Adenoids
The most common major operation performed in children in the USA is tonsillectomy. While the numbers have decreased over the past four decades it is still a very common operation. It is performed for repeated throat infection, which includes strep throats not responding to antibiotics. Usually four to seven infections in a year make a child a candidate for tonsillectomy. Over the last decade, a more common reason to remove tonsils and adenoids is for labored breathing at night. Gasping for air, choking episodes and restless sleeping may be secondary to enlarged obstructing tonsils and adenoids. Children may have obstructive sleep apnea, which could manifest with cognitive and behavioral problems. Children with OSA require tonsillectomy and adenoidectomy and evaluation by the ENT surgeon
Ear Tubes
Myringotomy and tubes is placing small tubes in children's ears that have recurrent ear infections. Usually antibiotics are treated for the infections, which manifest with ear pain, fever and hearing loss. Speech delay, balance problems and cognitive problems are associated with hearing loss from trapped ear fluid from ear infections. Children most affected are ages one to four years old. Under general anesthesia, a small hole is placed in the eardrum and a small tube is placed through the ear drum to keep the middle ear ventilated to prevent fluid buildup. The tubes are temporary and last six to twenty four months. Sometimes the procedure requires repeating if the fluid builds up after extrusion or removal of the tubes. The drawbacks are the ears have to be kept dry. Earplugs are recommended for swimming or bathing. It requires a general anesthesia but the pros far outweigh the cons in properly selected children.
