a question about adenoids/tonsils please? ELIBEAN, any other experts?

[mad4myboys]

ds1 is going to see an ENT specialist for various problems, cutting it short gp says he may have floppy larynx and i queryed enlarged adenoids etc as he has the symptoms of it but gp says looking in his mouth there is no sign of theym being enlarged. Is it likely he will need adenoids etc out if the gp says they dont look big? One thing i have noticed is that his dangly thingy at the back of the throat is quite big but gp never mentioned that...

[mad4myboys]

bump

[FluffyBunnyGoneBad]

IIRC, you can't see the adenoids as they are up the nose. Symptoms are snoring so the child wakes tired, there really isn't any other symptoms to be honest. Tonsils are at the back of the throat on either side, they take them out for repeated infections, the dangly bit is a uvulva (sp?), it can sometimes be swollen but doesn't mean anything.

[mad4myboys]

so if thats the case with not being able to see them, why does the gp say 'they arent enlarged as i cant see them' if they are up the nose why are they looking in his mouth?!?!

[FluffyBunnyGoneBad]

He's looked at his tonsils as these are in the mouth. Even the ENT's can't see the adenoids very well. They really are up the nose.

[Elibean]

FluffyBunny is right, AFAIK, adenoids are right up at the back of the nose - he must have been talking tonsils?

When I was googling tonsil/adenoid stuff before dd2's op, I noticed several people talking about uvula reductions - I guess they had sleep apnoea and their large sized uvulas were contributing. Apparently they can be made smaller surgically. They were adults though, no idea if they do that for kids - imagine it would need to be fairly severe.

Its really good that ds is being referred to ENT though, mad4, because they are the ones who will know: tonsils, adenoids, uvulas, floppy larynxes....all their stamping ground, iyswim. When is the appointment, or have you not got one yet?

[mad4myboys]

very immature i know but cant help reading vulva!

still havent had appt. going to chase today. Hes still doing that waking gasping and asking for drink. I know know for def he sleeps with his mouth open as neen watching him, he is so tired. Half hour of waking he tells me hes tired

[mad4myboys]

do you think floppy larynx more likely than the adenoid thing?

[FluffyBunnyGoneBad]

I don't know. Adeniods is likely. Breathing through the mouth makes you thirsty, he'll only be mouth breathing if his adenoids are enlarged and he can't nose breathe.

[mad4myboys]

he def nose breathes at night. do they automatically do gromits?

[Elibean]

grommets are for ears, I think, as in glue ear etc.

Sounds more like adenoids than larynx,to me, but could be both I suppose - thing is, larynx usually gets better over time, whereas tonsils and adenoids do the opposite until a child is at least 6 or 7, when some 'grow into' their large adenoids/tonsils.

[FluffyBunnyGoneBad]

They don't do whatever isn't necessary. Like elibean say's, grommets are for glue ear (repeated ear infections, reduction in the amount of hearing due to the stuff in the ears not being able to drain away). There needs to be a clinical need for them to do everything.
Snoring and tiredness on waking are the signs they look for when deciding on whether to take out adenoids. It's not a nice operation as they really can't see them. There is a risk of bleeding afterwards, as well as infection so they will only do this if they really have to.

[mad4myboys]

today my gp said the ent guy may want to put camera down to check his vocal chords?! As i told her that he still gags very easily on certain foods even now at 3. Like when he coughs hard he gags too

[Elibean]

Its called a laryngoscope, its a very thin flexible tube with a teeny camera in/attached to it: dd had it done when she was 8 weeks old - its really really thin.

That said, I would imagine its harder to do with a 3 year old than a tiny baby in terms of upsetting them - so maybe they would do it under anaesthetic? I would think they probably do, or light sedation of some sort.

Its the standard diagnostic tool for floppy larynx (laryngomalacia) and can give them heaps of information.

Let us know what they say?

[mad4myboys]

will do. just cant belive im still going through it all 3 years later and with ds2 probs awell!

[FluffyBunnyGoneBad]

It's probably easier to do a barium swallow to look for the gaging reflex. It's far less incasive then a laryngoscope IMO.

[mad4myboys]

he had one as a baby for his bad reflux...wouldnt something have been mentioned then? can the gag reflex have anything to do with the larynx or adenoids?

[Elibean]

No, as I understand it, a laryngoscopy is the definitive test for floppy larynx. dd had no problem with her gag reflex, afaik, but she had/has a moderate laryngomalacia.

Just ask about sedation/anaesthesia, mad4, I'm sure a good hospital knows how to make thing as little invasive/traumatic for such a young child as possible. Its also quick, took less than a minute for an ENT specialist to see what he needed to see with dd, to make the diagnosis.

That said, another ENT doctor offered to do one on dd a year later 'to see how its going' and I refused: that wasn't a good enough reason to put a now much more aware child through the procedure, IMO. But original diagnosis was important. At 3yrs, I would certainly ask how they intend to manage it without overly upsetting the child though.

[mad4myboys]

really worried about it. ds2 was about 4 months when he had it and he was under GA but they were taking biopsys. Do you think they'd knock him out if i asked?

[Elibean]

I don't know, but definitely worth talking to them about it. Don't worry till you've done that, hopefully will be fine