Mist: for teng's case, the ENT specialist dun recommend us to wait for him to outgrow.. coz of his slurred speech. Teng's speech is not that bad because u can hear him clearly but u know that he sounds different as if he is speaking with a blocked nose. plus his snoring at night which results in sleep deprivation which gives him his dark eye circles despite having enough hours of sleep..the ENT said he can sleep deeply but it is poor quality sleep because of congested breathing..(in future might affect school performance.. which can linked to hyperactivity or attention deficit because when the ENT channel is all blocked up, the child cannot hear clearly...though this, with my limited knowledge of special needs for ADHD, i will disagree because ADHD is a neurological disorder.. something to do with the brain.. and not somthing which happen because the ears are blocked. and definitly not teng because all those who seen him will know he focuses v well).. and slows his growth.. i am not sure if this is why teng has lost some weight because of this or because of increased metabolism.. but he is still happy and well.. such things hard ot pin pt..
another impt reason why the ENT recommended surgey is because teng dun respond to the night antihistamine and nasonex spray.. the spray is prescribed with the intention to shink the adenoids in the nose, but his is still enlarged..and the speech still slightly slurred.. so sensitive nose tend to be because of the enlarged adneoids which wun shrink back to normal size...
a video on Adenoids, snoring and blocked nose in children done up this by ENT specialist
http://www.youtube.com/watch?v=G2l_-YUwOuY
some information on adenoids, the tonsils and the turbinate:
for his enlarged tonsils:
http://kidshealth.org/parent/medical/ears/tonsil.html?tracking=P_RelatedArticle#
for his enlarged adenoids:
http://kidshealth.org/kid/ill_injure/sick/adenoids.html
for the slightly swollen turbinates:
http://findarticles.com/p/articles/mi_hb4384/is_6_41/ai_n29357267/
star: adenoids is far back of the nose, turbinate in the nose and tonsils in the throat. his speech is a 'by-product'. My current understanding is the speech can be because the adenoids, the turbinates or both.. ent says treats the immediately obvious first and monitor the speech and if need be speech theraphy.
teng's vocal cords are ok.. so i think it might be a resonance issue coz of the blocked up nose. I am concerned because speech is determined quite early so his nose needs to be settled else he falls into a permenent 大舌头 when he grows up.
'■Resonance Disorders: These are caused by an imbalance in sound energy as the voice passes through the spaces of the throat, nose, or mouth. When parents report that their child’s voice sounds “nasal” they are usually hearing one of two different types of resonance disorder:
■Hyponasality (or Denasality): This is when not enough voice energy comes through the nose, making the child sound “stopped up.” This might be caused by some blockage in the nose, or by allergies.
■Hypernasality: This happens when the movable, soft part of the palate (the velum) does not completely close off the nose from the back of the throat during speech. Because of this, too much sound energy escapes through the nose. This can be due to a history of cleft palate, a submucous cleft, a short palate, a wide nasopharynx, the removal of too much tissue during an adenoidectomy, or poor movement of the soft palate.
Reasons for Concern:
■If the voice is hoarse, harsh, breathy, or of poor quality
■If the voice is always too loud or too soft
■If the voice is too high or too low for the child's age or sex
■If the voice often breaks or suddenly changes pitch
■If the voice sounds hyponasal or hypernasal
'
SQ/Ash: I dunno. I know def the tonsils need to go. coz currently, there is no conclusive evidence that tonsils helps in the immune systems to prevent throat infection (the topic we were discussing on some days back). So the tonsils can go just the way as the appendix.
I am in second mind over the adenoids and the turbinates. Adenoids swell rapidly from 3 - 6 years old and reduced and goes away by age of 12. the ENT dun recommend waiting for it to go away coz it is causing teng some problem with sleep depreviation and of course the speech. but adenoids can help in the immune system till 5... and enlarged adenoids is common in young children..
same goes for turbinates and maybe even more.. coz for the turbinate, cannot remove the whole thing coz it is impt.. my only concern is how much to remove.. coz if too much , it upsets the nasal equilibrium in the nose.. might lead to a sydronme called Empty Nose Syndrome
http://www.emptynosesyndrome.org/what_is_ens.php
though i doubt it will happen in the case of teng's.. but still it is a matter of how much to trim for his turbinates.. i am thinking if we can dun trim. but swollen turbinates can be a cause of blocked nose which leads to the snoring..
I am not sure. i know there must be an operation for the tonsils.. all three can be done at one sitting.. one hour day op.. and dischrage in the same day.. discomfort is minimal.. most children dun report any.. but tonsils might caused throat to be sore and needs a recovery period of a week or so...
i can't make a decision because it seems all linked together and required a multi prongs approach.. i would be arranging another opinion.. but i will just bring the cd of the scope done on teng(the ent said to me, 'mummy, be brave' as he inserted the scope into teng's nosestrils.. while it is not painful.. it is irritating.. they wrap teng up so that he cannot resist.. but still he was tossing his head around coz he hates to be restrained.. ' i dun want to do another uncessary scope on him.. miser said dun need to .. just bring the cd..
also miser says he doesn't like the ent coz he feels he is a saleman.. miser wasn't there.. but conclude based on the ent's website and his video...that makes me even more sian coz i got to 'lug' miser around for him to 'sense' if the doctor is genuine or not.. but his time is so tight.. and not like i have the time of my world now that i need to do some coordination work for next sem which needs ot happen now.. so i feel vexed..
Mejo: possible complication is the empty nose syndrome but that one i think not that much unless major reduction of the turbinate. or the common post operative bleeding..but dun be too much if they perform intracapular tonsillectomy.
(in the link for the tonsils) and also coblation on the turbinates. (good so that he doesn't have to be on long term steriod nasal spray and antihistamine...)
I wasn't assured on the risks and must have, unknowingly, given a very worried look for the ent to tell me quite specifically, ' it is much safer that you giving birth to him...'
i do want to take time to deliberate on it.. but while it is not time critical.. it does affect teng's sleep and speech if too much time is taken to consider if the op goes ahead..
thanks ladies for showing interest in teng's case. I think i feel much better posting all these here coz it helps me to streamline my thoughts.. sorry for those who feels i am spamming the forum on this.. coz it is afterall nothing really major.. considering it is a day op kind of things..
pink: kudos to u for being strong for leia when she has to haveher eyes scrapped while awake.. it was nothing comparable, i feel, for teng's scope.. but i feel sian if he has be subjected to it a second time...