when to have surgery? Paediatricians’ guidelines

Voice: Can removing tonsils change that?

The tonsils occupy the area of ​​the oropharynx between the anterior and posterior pillars of the palate.

The oropharynx contributes to voice amplification, with voice being different depending on whether or not the oropharyngeal area is occupied by tissue that changes its size and volume, such as when speaking in a large furnished or unfurnished room .

So what changes is not the “harmonics” that result from the vibration of the vocal cords, but the overall amplification of the voice and its subjective perception, which results from the air spaces above it, the pharynx and the paranasal sinuses.

Tonsils and adenoids: are their functions related?

Tonsils and adenoids as well as the base of the tongue are part of Waldeyer’s lymph ring.

In early childhood, they complement the activity of the immune system and protect us from infections.

The adenoids, located in the nasopharynx — the air space behind the nasal passages — can cause airway obstruction when excessive in size — adenoid hypertrophy; restrict the regular passage of mucus from the sinuses to the nasal passages, and then to the pharynx, leading to rhinosinusitis; restrict the regular passage of mucus from the middle ear to the pharynx, resulting in seromucous otitis media; Modify palate development and correct dentition.

In the course of growth, not only does the nasal and oropharyngeal air space expand, resulting in less stressed adenoids and tonsils; the immune system also acquires autonomic competence and usually adenoids and tonsils become functionally rolled back and atrophy.

Thus, when the natural history of adenoids and tonsils is destined to regress over time, and waiting is indeed changing a premature surgical indication, one often finds the decision to operate in relation to the impact on the child’s quality of life met by repeated infections. repeated antibiotic treatment, missed school days, poor night’s sleep and quality of life during play and study hours.

In both school age and adulthood, sleep quality plays a crucial role in recovering from psychophysical daytime sleepiness.

Hypertrophied adenoids and tonsils may be involved in the development of obstructive sleep apnea syndrome.

Polysomnography certifies the presence, type, and extent of nocturnal apnea, leading to possible therapeutic indications.

Plaques in the throat: what about the tonsils?

The appearance of the almonds is reminiscent of that of the Norwegian fjords, ie the surface is not regular but broken.

In the age of functional activity, this aspect increases the effective surface of the tonsil, but it is also the ideal nest for bacterial proliferation, as evidenced by the presence of “plaques”.

However, care must be taken not to confuse plaques with the accumulation of food particles – casei or tonsilloliths.

In this case, it would be overkill to treat a problem with antibiotics that, although it can be uncomfortable, can be controlled by improving oral hygiene after meals.

Also read:

Obstructive sleep apnea: what it is and how to treat it

Sore throat: how to diagnose a sore throat?



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