Mucocele – Swelling On Inner Side Of The Lip

Mucocele is a fairly common condition seen in children.

How does it form?

The minor salivary glands, and, there are over 600 of them, are small glands that produce saliva. They are too small to be seen by the naked eye and consist of a small globular gland. The saliva that forms in the gland drains out through a narrow tube (the duct) into the mouth. This saliva helps us chew our food and also starts the process of digesting food.

Continue reading “Mucocele – Swelling On Inner Side Of The Lip”

Doctor, my child’s testis cannot be felt! Should we do an ultrasound examination?

Is an ultrasound necessary in a child who has an undescended testis?

Almost every patient that comes to me for consultation for undescended testis, comes armed with an ultrasound (USG) report, that the parent will promptly proceed to show me after the initial formalities, even before I have had a chance to ask as to why they are consulting me.
The sad part is that ultrasound is not only unnecessary but actually misleading in children with undescended testes [1].

USG is accurate in predicting examination findings in only 54% of children. Additionally it delays required surgery in infants by as many as 3 months.
The algorithm for managing undescended testis only requires whether an experienced pediatric surgeon can palpate the testis or not. So please do not get unnecessary tests done.
1. Ultrasound Overused to Diagnose Undescended Testicle

Tongue Tied? Could be literally true!

Tight Frenulum causing tongue tie
Note the tight cord anchoring tongue to the floor of the mouth

While most of us get tongue tied when we are overawed by a famous personality or when asked to speak in public, or too overcome by emotions, in the case of your infant, it could be due to the fact that the cord of tissue (called the frenulum) that holds the tongue in place against the floor of the mouth is too tight / thick / rigid.

Continue reading “Tongue Tied? Could be literally true!”

Can I avoid circumcision on my child?

The good news is that most of the time one can avoid circumcision in children with tight foreskins. As I have explained here, almost all male newborns are born with tight foreskins. If the child does not have any problems, it is best to wait it out for natural separation to occur in almost 95% of all children by 5 years of age. They just require the usual care of the foreskin in uncircumcised boys.

Continue reading “Can I avoid circumcision on my child?”

Is the surgery normal, Doctor?

Crossing a busy street

This is probably one of the most common questions that I encounter. By the time this question comes up, I have already discussed about the near negligible risks (but not zero) of surgery and anesthesia in children at least twice. The actual risk of death for healthy children undergoing anesthesia is of the order of 1:100000 children undergoing anesthesia. To define this in easily understood terms, the risk is less than half the risk of crossing a busy street. We merrily (or should I say with gay abandon!) cross streets 15-20 times a day at the very least, paying nary a thought to the very real possibility of an accident.

Continue reading “Is the surgery normal, Doctor?”