Procedures
Paediatric surgeries
- Tonsillectomy
The tonsils and adenoids are part of the body’s immune system. Tonsillitis is an infection of the tonsils, which causes inflammation, swelling, ear pain, difficulty eating or drinking, sore throat, fever, headache and stiff neck. Generally, the tonsil's functioning declines after puberty, but since the tonsils and adenoids play a role in the immune response, they are particularly vulnerable to infection during childhood.
In cases where tonsillitis fails to respond to other treatments or is frequently recurring, surgery may be done to remove the tonsils. This is known as a tonsillectomy. A tonsillectomy is also commonly done when tonsils are enlarged causing breathing and snoring difficulties, or when people produce tonsil stones leading to bad breath (halitosis).
A tonsillectomy is usually done in hospital, under general anaesthesia. Once asleep, the tonsils are removed with cold steal instruments or cautery. The procedure itself takes about 30 minutes. You may wake up with a sore throat and slight earache. Patients are generally allowed to go home on the day of surgery unless the child is very young, in which case a night in the hospital may be needed for observation. Complete recovery after a tonsillectomy generally takes a week or two.
- Adenoidectomy
The adenoids are a mass of lymphoid tissue located high in the throat, behind the nose and soft palate. Together with the tonsils, the adenoids are part of the body’s immune system. Infection of the adenoids, called adenoiditis, is more common during childhood, but when they remain enlarged or chronically infected, it can lead obstruction of the airways. This may be problematic for breathing and sleeping, causing sleep apnea, and due to their location, removal of this tissue may also be advised to treat those with frequent ear infections or recurrent nasal infections. In such cases, an adenoidectomy may be advised to remove them.
An adenoidectomy is done in the hospital. This procedure is generally done at the same time as a tonsillectomy. Once the anaesthesia has taken effect, Dr van Lierop will remove the excess tissue through the mouth, so there is no need for external incisions. The procedure itself takes about 15 minutes. After surgery, your child may have a sore throat, but you should be able to take him or her home immediately after surgery once the anaesthetic has worn off. You can expect a full recovery in a few days.
- Grommets
Grommets are tiny plastic tubes inserted into your child's eardrum to allow air into the middle ear. Because hearing problems during childhood can lead to problems with speech and language development, treatment is essential. Children who get more than three ear infections a year could benefit from grommets. Your ENT specialist may advise grommets for your child as a treatment for glue ear that won't clear up, or for frequent ear infections.
By allowing air into the middle ear from the outside, grommets reduce the risk of fluid building up in the middle ear (preventing ‘glue ear’) and maintain normal ear pressure. If an infection does occur, the pus can flow out through the grommet. Grommets are a temporary measure that allows your child's eustachian tubes to mature, treating recurring infections. Grommets usually stay in place for 6 to 18 months, falling out by themselves when the Eustachian tubes have begun to work naturally.
A grommet is a small ventilation tube inserted into the eardrum. Your surgeon will make a tiny hole in the eardrum, and the fluid in the middle ear will be sucked out before inserting the grommet into the hole. The placement of grommets takes a mere 10 minutes under general anaesthesia