PAEDIATRIC SURGERY
PAEDIATRIC SURGERY
Adenoidectomy
Adenoids are glands in the throat situated at the back of the nose. Along with the tonsils, they help fight infections. A common issue is enlarged adenoids, which can cause nasal blockage, snoring at night, and even sleep apnoea. Your body can still fight infections even without your adenoids, so an adenoidectomy may be recommended.
Swollen adenoids can also worsen glue ear, a build-up of sticky fluid in the ear that affects hearing. Sometimes, alongside an adenoidectomy, it may be recommended that you have grommets inserted at the same time. These are tiny plastic tubes that help children with glue ear hear better. If both the tonsils and adenoids are affected, it may be recommended that your child undergo an adenotonsillectomy.
An adenoidectomy is performed under general anaesthesia and usually takes about half an hour. Specially designed instruments are used to remove the adenoids and/or tonsils. The surgeon stops any bleeding using diathermy to prevent.
Most children are treated as day cases, but you may need to stay overnight in hospital. Common side effects are nausea, sore throat, blocked nose, and earache, and children will need a week off school.
PAEDIATRIC SURGERY
Sinus Surgery
Sinus infections can be common in children, but in cases of recurring or chronic sinusitis that does not respond to medical treatment, sinus surgery may be appropriate. Children who develop nasal polyps from allergies may also require surgery.
The sinuses are air-filled, mucous-lined cavities that help trap foreign objects and bacteria. They are located in a person’s cheeks, between and above the eyes, and deep in the back of the nose. Fluid drains out of small openings, and if they become blocked, fluid builds up, allowing bacteria to thrive, resulting in infections.
Paediatric sinus surgery involves nasal endoscopy, in which Mr Annakan Navaratnam inserts a very thin, specially designed instrument into a child’s nose to remove blockages between the sinuses and the patients nasal passages.
The procedure is performed under a general anaesthetic, and no external incisions are required. Depending on whether nasal polyps need to be removed, the operation usually takes between 45 min to 1 hour.
Side effects include a minimal amount of pain and discomfort and a small amount of bleeding. The child may be prescribed brief courses of antibiotics or steroids and a saline wash used to flush out the nose and help heal the inflamed sinus.
PAEDIATRIC SURGERY
Tonsillectomy
Both the tonsils and adenoids are involved in fighting infection, and children can suffer from frequent bouts of infected or inflamed tonsils, which require removal in a procedure known as a tonsillectomy. An adenotonsillectomy removes both the adenoids and the tonsils.
A tonsillectomy is performed under general anaesthesia and usually takes 20 to 30 minutes. Specially designed instruments are used to remove the adenoids and/or tonsils. The surgeon stops any bleeding using diathermy. Mr Navaratnam usually use a technique called coblation which results in less pain after surgery.
Most children are treated as day cases, but you may need to stay overnight in the hospital. Specific complications of a tonsillectomy are uncommon but can include bleeding that starts soon after the operation. Your child will be observed closely after the procedure for signs of bleeding. If bleeding does occur, they may be taken back to the operating theatre for a further procedure to stop the bleeding.
PAEDIATRIC SURGERY
Inferior Turbinate Reduction
The nasal turbinates are structures in the nose that warm and humidify the air inhaled through the nose. The turbinates often become temporarily inflamed and swollen as a result of irritation, allergies or infection, but some people can develop swelling, which causes a persistent blocked nose or constant sensation of nasal congestion and stuffiness.
Turbinate reduction surgery removes excess tissue around your turbinate bones so you can breathe more easily. The inferior turbinate is the largest of the turbinate pairs and reduction surgery is recommended for children who have not responded to non-surgical treatments.
Mr Annakan Navaratnam will shrink or remove a portion of the turbinates using a specially designed tool. He adopts a conservative approach, preserving as much of the natural structures as possible.
The operation is performed through the child’s nose under a general anaesthetic and takes about 20 to 30 minutes.
Occasionally, bleeding can occur, which may require packing to be inserted into each nostril or a further operation to control it. Most children can return home the same day.
PAEDIATRIC SURGERY
Septal Surgery
Septal surgery, or a septoplasty, is a procedure to straighten and reposition the septum. This is the wall of cartilage and bone covered in mucous membrane that divides the nose into two sides.
A deviated septum is when the septum is not positioned in the middle or is misaligned. The problem can be congenital, which means the child is born with it, or it can occur later through trauma. A deviated septum can cause frequent sinus infections, pain in the face or headaches, noisy breathing or snoring while sleeping
Septal surgery is not commonly performed on young children because their cartilage is not fully developed and surgery to the nasal septum can affect the growth of the nose if certain structures such as growth plates are damaged during surgery. Mr Annakan Navaratnam is one of the few surgeons in the UK who perform paediatric septoplasty, and this option is usually only advised in a select few cases.
There are no external incisions, as the surgery is done entirely through the nostrils. The operation is performed under general anaesthetic and takes approximately an hour. Mr Navaratnam may cut, remove, or reshape part of the septum, which is then closed with dissolvable stitches. Potential risks include infection, nosebleeds, bruising, swelling, and, more rarely, complications such as a hole in the septum or change in the shape of the nose.