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252
Nose and Throat.
Table VII. summarises the findings; in all the groups 62;
boys and 576 girls had enlarged tonsils; 30 boys and 32 girls had
adenoids only; 292 boys and 291 girls had adenoids and enlarged
tonsils; 54 boys and 35 girls were mouth breathers; 356 boys and
327 girls exhibited enlarged glands in the neck.
Taking the cases of adenoids, enlarged tonsils with adenoids
and mouth breathers, as requiring operative measures, it is seen
that 8.6 per cent, of all school children examined in the three
groups were in need of surgical attention to the throat and nose.
In 1930, dealing with another group of children, the figure was
10.3 per cent.
Although the term enlarged tonsils and adenoids is always
used, the relative importance on the health of the child is the
other way round. Adenoids exert a much more pernicious influence,
inasmuch as they impede the proper performance of nasal
breathing. Children with enlarged tonsils or an unhealthy nasopharynx
are also more liable to develop complications if they contract
Scarlet Fever or Diphtheria, by far the most serious of which
is inflammation of the middle ear. The removal of healthy,
though enlarged tonsils, is inadvisable, and the medical officers
do not refer for treatment by operation, children whose tonsils
are healthy, even though they are enlarged, unless the enlargement
is so gross as to cause obstruction.
The operation of choice for enlarged septic tonsils is enucleation.
Resection does not get rid of all the infected tonsillar
tissue, and the remains may at a later date cause a renewal of the
trouble.
The importance of training in correct methods of breathing
after the removal of adenoids cannot be too stronglv emphasised.
All cases after operation are invited to attend the Rreathing Exercises
classes held at St. Andrew's Hall, but unfortunately only
some 296 of the parents appear to consider it necessarv. However,
the success or otherwise of the operative procedure depends on the
nose being used for its natural purpose. If the old, incorrect
habits are persisted in, the lymphoid tissue around the posterior
nares lacks the normal stimulus of the air currents passing over
it, and once more grows into the flabby hvpertrophied masses
which are known as adenoids.