Paediatrics Leaflets

Adenoid Surgery
Adenoids are petite glands located at the back of the nose in an area known as the nasopharynx (refer to figure 1a). In younger children, these glands play a role in fighting germs. However, around the age of three, adenoids are believed to become unnecessary, as the body can effectively combat germs without them. There is insufficient evidence to suggest that removing adenoids affects the immune system or increases the likelihood of infections. Adenoids are likely beneficial in fighting infections only during the first three years of life. Consequently, if they are causing more harm than good, they can be removed after this period.
After your child’s tonsil surgery: tips for parents
When your child undergoes a tonsillectomy, it’s important to be aware of certain aspects of the procedure. The removal of tonsils can result in a sore throat for your child, necessitating the regular intake of painkillers to manage discomfort. However, this allows them to resume a normal diet, including foods like bread. A recovery period of two weeks, involving time off from school and social activities, is typically required. While there is a one in six chance of post-surgery bleeding, it is advised to promptly seek medical attention at the nearest A&E department if this occurs. In rare cases, one in 100 children may require a second operation to address bleeding. This e-leaflet provides valuable information on what to observe and offers helpful tips for caring for your child’s symptoms after a tonsillectomy, including guidance on emergencies.
Chronic rhinosinusitis in children
Chronic rhinosinusitis is a persistent condition requiring ongoing treatment. The primary effective treatments involve the use of saline rinses and nasal steroid sprays. It’s important to note that there is no evidence supporting the use of antibiotics for children with chronic rhinosinusitis. In some cases, children may undergo adenoid removal through surgery to better manage their symptoms. Additionally, older children with specific conditions may require endoscopic sinus surgery as part of their treatment plan.
Glue Ear (OME)
Glue ear, also known as “otitis media with effusion,” is a common condition, with approximately eight in every ten children (80%) experiencing a brief episode before starting primary school. The precise causes of glue ear are not fully understood, and while it can occur following an ear infection, many children with glue ear have never had such an infection. In some cases, inflammation from infections affecting the adenoid in the back of the nose, often associated with coughs and colds, can lead to the spread of bacteria into the ear, causing the formation of fluid or “glue” in the ear.
Grommets – A decision-making aid for parents
Glue ear, also known as otitis media with effusion (OME), occurs when the space behind the eardrum is filled with liquid instead of air. This condition can develop when there is insufficient airflow reaching the middle ear, often due to the eustachian tubes, responsible for bringing air into the middle ear, not functioning optimally during childhood.
Helping you decide about tonsil surgery for your child
Located on each side at the back of your throat, tonsils can become swollen and inflamed, a condition known as tonsillitis. Typically caused by viral or bacterial infections, tonsillitis is a common ailment in children. In most cases, childhood tonsillitis is attributed to viral infections. Symptoms include a sore throat and fever, contributing to your child feeling unwell during the illness.
Intracapsular tonsillectomy for children
Tonsillectomy is considered for sleep-disordered breathing, and a minimum number of tonsillitis episodes is required for eligibility. The procedure is known to be painful, necessitating regular painkillers, and your child will require two weeks off from school and social activities for recovery. The risk of bleeding after an intracapsular tonsillectomy is 2 in 1000 children. Tonsils, located at the back of the throat, help fight germs and infection. While important in young children, they become less significant and smaller after the age of three, and removal may be considered if they are causing more harm than good.
Juvenile nasopharyngeal angiofibroma (JNA)
Juvenile nasopharyngeal angiofibroma (JNA) is an exceptionally rare, non-cancerous growth found in the back of a child’s nose, predominantly affecting teenage boys. Despite its benign nature, JNA is considered aggressive as it can extend into the sinuses, eye sockets, and the brain. The cause of JNA is unknown, with speculation that it may originate from cells left deep in the nose during early pregnancy. Symptoms include a blocked nose, recurrent nosebleeds on one side, facial swelling, pain, headaches, double vision, reduced hearing, or diminished sense of smell. Given its potential complications, swift medical attention is essential for effective management of JNA.
MLTB – Micro-laryngo-tracheo-bronchoscopy
MLTB, or micro-laryngo-tracheo-bronchoscopy, is a diagnostic procedure aimed at identifying the source of your child’s airway symptoms. During this examination, a specialized instrument called an endoscope, equipped with a light and camera at its end, is carefully inserted through the mouth. This allows for a thorough examination of the voicebox (larynx), windpipe (trachea), and the large tubes leading to the lungs (bronchi). The procedure aids in obtaining a detailed understanding of any potential issues affecting the respiratory system.
Tonsillectomy (taking out your tonsils) because of repeated infections
To be considered for a tonsillectomy, certain criteria regarding the number of episodes of tonsillitis must be met, including seven episodes in the first year, five episodes per year over two years, or three infections annually for three years. Following a tonsillectomy, a recovery period of two weeks is necessary, during which time you should refrain from work and social activities. Tonsillectomy is known to be a painful procedure. In adults, there is a one in five risk of bleeding after surgery, and one in 100 adults may require a second operation to address bleeding, potentially involving a blood transfusion.
Tracheomalacia in children
Tracheomalacia, signifying a “weak or soft windpipe,” describes a condition where the windpipe, typically upheld by cartilage, can lose its normal rigidity. In certain cases, children are born with softer cartilage supporting the windpipe, making parts or the entire windpipe susceptible to collapse. This collapse is most pronounced during exhalation or coughing. When the condition extends to impact the primary air passages leading to the lungs, it is termed tracheo-bronchomalacia.