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Doutor o que são amígdalas e adenóides?

 

Uma breve explicação sobre amigdalectomia e adenoidectomia

 

Amígdalas e adenóides são massas de tecido que são similares aos linfonodos ou "glândulas" encontradas no pescoço, axila, ou região inguinal. As amígdalas são duas massas, na parte posterior da garganta. A adenóide (ou tecido adenoidiano) está localizado na parte superior da garganta, atrás do nariz, e do teto da boca (palato mole) e apenas é visível pela boca com o uso de instrumentos especiais.

 

As amígdalas e adenóide estão bem na entrada da via respiratória onde possa entrar em contato com germes que causam as infecções. Elas apresentam as bactérias e os vírus para o sistema de defesa do organismo, e podem ficar infectadas. Os cientistas acreditam que elas trabalham como parte do sistema de defesa do organismo, filtrando os germes que tentam invadir o corpo, e ajudam na produção de anticorpos.

Isto ocorre nos primeiros anos de vida e se torna menos importante assim que nos tornamos mais velhos. As crianças que devem ter duas amígdalas e adenóide removidas não sofrem perda na sua resistência.

O que afeta as Amígdalas e adenóides?

  O problema mais comum que afeta as amigdalas e adenóides é o de infecção de repetição (da garganta ou do ouvido), e o crescimento exagerado que causa obstrução da respiração e problemas da deglutição.

  Abscesso perto das amigdalas, amigdalite crônica, e a infecção de pequenas "bolinhas" que ficam nas amígdalas e que possuem cheiro ruim, podem também afetar as amígdalas, produzindo dor e dificuldade de engolir. Tumores nas amigdalas são raros mas, podem ocorrer.

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When should I see my doctor?

You should see your doctor when you or your child suffer the common symptoms of infected or enlarged tonsils or adenoids.

The Exam

The primary methods used to check tonsils and adenoids are:

  • Medical history

  • Physical examination

  • Throat cultures/Strep tests

  • X-rays

  • Blood tests

What should I expect at the exam?

Your physician will ask about problems of the ear, nose, and throat and examine the head and neck. He or she will use a small mirror or a flexible lighted instrument to see these areas.

Cultures/strep tests are important in diagnosing certain infections in the throat, especially "strep" throat.

X-rays are sometimes helpful in determining the size and shape of the adenoids. Blood tests can determine problems such as mononucleosis.

How are tonsil and adenoid diseases treated?

Bacterial infections of the tonsils, especially those caused by streptococcus, are first treated with antibiotics. Sometimes, removal of the tonsils and/or adenoids may be recommended. The two primary reasons for tonsil and/or adenoid removal are (1) recurrent infection despite antibiotic therapy and (2) difficulty breathing due to enlarged tonsils and/or adenoids.

Such obstruction to breathing causes snoring and disturbed sleep that leads to daytime sleepiness in adults and behavioral problems in children. Some orthodontists believe chronic mouth breathing from large tonsils and adenoids causes malformations of the face and improper alignment of the teeth.

Chronic infection can affect other areas such as the eustachian tube – the passage between the back of the nose and the inside of the ear. This can lead to frequent ear infections and potential hearing loss.

Recent studies indicate adenoidectomy may be a beneficial treatment for some children with chronic earaches accompanied by fluid in the middle ear (otitis media with effusion).

In adults, the possibility of cancer or a tumor may be another reason for removing the tonsils and adenoids.

In some patients, especially those with infectious mononucleosis, severe enlargement may obstruct the airway. For those patients, treatment with steroids (e.g., cortisone) is sometimes helpful.

Tonsillitis and its symptoms

Tonsillitis is an infection in one or both tonsils. One sign is swelling of the tonsils. Other signs or symptoms are:

  • Redder than normal tonsils

  • A white or yellow coating on the tonsils

  • A slight voice change due to swelling

  • Sore throat

  • Uncomfortable or painful swallowing

  • Swollen lymph nodes (glands) in the neck

  • Fever

  • Bad breath

Enlarged adenoids and their symptoms

If you or your child's adenoids are enlarged, it may be hard to breathe through the nose.

Other signs of constant enlargement are:

  • Breathing through the mouth instead of the nose most of the time

  • Nose sounds "blocked" when the person speaks

  • Noisy breathing during the day

  • Recurrent ear infections

  • Snoring at night

  • Breathing stops for a few seconds at night during snoring or loud breathing (sleep apnea)

Surgery

Your child

Talk to your child about his/her feelings and provide strong reassurance and support throughout the process. Encourage the idea that the procedure will make him/her healthier. Be with your child as much as possible before and after the surgery. Tell him/her to expect a sore throat after surgery. Reassure your child that the operation does not remove any important parts of the body, and that he/she will not look any different afterward. If your child has a friend who has had this surgery, it may be helpful to talk about it with that friend.

Adults and children

For at least two weeks before any surgery, the patient should refrain from taking aspirin or other medications containing aspirin. (WARNING: Children should never be given aspirin because of the risk of developing Reye's syndrome).

  • If the patient or patient's family has had any problems with anesthesia, the surgeon should be informed. If the patient is taking any other medications, has sickle cell anemia, has a bleeding disorder, is pregnant, has concerns about the transfusion of blood, or has used steroids in the past year, the surgeon should be informed.

  • A blood test and possibly a urine test may be required prior to surgery.

  • Generally, after midnight prior to the operation, nothing (chewing gum, mouthwashes, throat lozenges, toothpaste, water) may be taken by mouth. Anything in the stomach may be vomited when anesthesia is induced, and this is dangerous.

When the patient arrives at the hospital or surgery center, the anesthesiologist or nursing staff may meet with the patient and family to review the patient's history. The patient will then be taken to the operating room and given an anesthetic. Intravenous fluids are usually given during and after surgery.

After the operation, the patient will be taken to the recovery area. Recovery room staff will observe the patient until discharged. Every patient is special, and recovery times vary for each individual. Many patients are released after 2–10 hours. Others are kept overnight. Intensive care may be needed for select cases.

Your ENT specialist will provide you with the details of pre-operative and postoperative care and answer any questions you may have.

After surgery

There are several postoperative symptoms that may arise. These include (but are not limited to) swallowing problems, vomiting, fever, throat pain, and ear pain. Occasionally, bleeding may occur after surgery. If the patient has any bleeding, your surgeon should be notified immediately.

Any questions or concerns you have should be discussed openly with your surgeon, who is there to assist you.

To locate an otolaryngologist in your area, please visit our Find an Otolaryngologist search engine.

© 2001 AAO-HNS, Inc.