Enlarged adenoids in a child 2 years of treatment. Symptoms, signs and treatment of adenoids in children. The reasons for such a difference in adenoid vegetation at the three-year turn of the development of the child's body

Adenoids (adenoid vegetations, adenoid growths) are pathological growths of the nasopharyngeal tonsil, which is located deep in the nasopharynx, they consist of lymphoid tissue. Normally, this amygdala is well developed in childhood, and after the age of twelve it begins to decrease, so adenoids are rare in adults.

Normally, the tonsils are a small accumulation of lymphoid tissue in the thickness of the mucous membrane around the openings that lead to the nasal cavity, mouth and pharynx. There are paired tonsils: two tubal, two palatine; and unpaired - three lingual and pharyngeal (nasopharyngeal) tonsils. The tonsils make up the so-called Pirogov-Waldeer lymphoepithelial ring, which is an integral part of the body's immunity - it protects it from external pathogenic influences. So, the main function of the tonsils is protective. They are a barrier to foreign bacteria and viruses inhaled with air, "catch" them and destroy them.

Adenoids are not the tonsils that you see on the sides of the throat when you look into a child's mouth. You will not be able to see adenoids at all without appropriate devices, since they are located above the pharynx, approximately opposite the nose, almost in the center of the skull.

Adenoids are a common disease among children. It is common between the ages of 1 and 15, but is more common in children 3 to 7 years of age.

Adenoids and adenoiditis are often confused. Adenoiditis is a disease inflammatory nature pathologically enlarged nasopharyngeal tonsil (adenoids). Occurs both in isolated form and in combination with inflammation corrupted palatine tonsils. Adenoiditis is accompanied by an increase in body temperature and a sharp violation of nasal breathing.

Some reasons for the formation of adenoids:

1. A variety of childhood infections (measles, scarlet fever), in which the mucous membrane of the nasal cavity and tonsils is affected;
2. Frequent inflammatory diseases of the upper respiratory tract;
3. Viral diseases;
4. Immunodeficiency;
5. Allergization of the child.

Symptoms by which adenoids can be suspected in a child:

Difficult nasal breathing and discharge from the nose;
Frequent runny nose;
Snoring in sleep;
Bad sleep;
The baby's mouth is often open;
The appearance of nasal and illegible speech.
Rapid fatigue, lethargy, apathy;
Headache;
Hearing loss. The child often asks again.

If you find several or even one of the symptoms in a child, then you should immediately visit an ENT doctor for a diagnosis and adequate treatment.

Complications that can lead to adenoids:

1. Violation of the normal functioning of the middle ear.
When the nasopharyngeal tonsil is enlarged, it closes the mouth of the auditory tube. This anatomical formation (Eustachian tube) serves to regulate the pressure difference between the internal (in the nasal cavity and nasopharynx) and external (atmospheric). Normally, air passes through the auditory tube from the nasal cavity to the middle ear. When the mouth is blocked, it is difficult for air to enter the middle ear. As a result, the eardrum becomes less mobile and this affects hearing. In advanced cases, such hearing loss (hearing loss) cannot be completely cured.

2. Inflammatory diseases of the middle ear. If the passage of air into the middle ear is difficult, then excellent conditions are created for the penetration and development of infection there (otitis media).

3. Deformities of the facial skeleton and chest, malocclusion. Such complications lead to constant mouth breathing.

4. Violation of lung ventilation and decreased performance. This leads to a decrease in blood oxygen saturation, as a result of which the brain does not get enough of it and this affects its normal functioning. Therefore, children who have adenoids often study poorly, are less efficient and attentive.

5. The constant presence of a focus of chronic infection in the body. Since the nasopharyngeal tonsil is constantly inflamed, it contains a lot of viruses and bacteria, which has a bad effect on the child's body as a whole.

6. Inflammatory diseases of the respiratory tract. The mucus that is constantly produced in the chronically inflamed tonsil sinks lower and causes pharyngitis (inflammation of the pharyngeal mucosa), laryngitis (inflammation of the larynx), tracheitis (inflammation of the trachea) and bronchitis (inflammation of the bronchi).

7. Violation of the activity of the gastrointestinal tract.

8. Violation of the composition of the blood.

9. Enuresis (bedwetting).

10. Spasm of the larynx.

11. Coughing fits.

First degree- adenoids cover the upper part of the vomer. In the first degree, the child may experience discomfort and difficulty breathing only when sleeping.

Second degree- adenoids cover the upper two-thirds of the vomer. In the second degree, the child regularly snores at night, and often breathes through the mouth during the day, due to difficulty in nasal breathing.

Third degree- adenoids cover the entire or almost the entire vomer. In the third degree, the access of air through the nose is completely blocked by the adenoids, and the child can only breathe through the mouth.

Adenoids of the 1st degree, photo through the endoscope

Adenoids of the 3rd degree, photo through the endoscope

The clinical picture (the severity of pathological changes) does not always correspond to the degree of enlargement of the adenoids. It happens that adenoids of the first and second degree can cause severe difficulty in nasal breathing, a sharp decrease in hearing, and adenoids of the third degree do not cause visible disturbances. Therefore, only by size it is impossible to say unequivocally what needs to be done - to treat conservatively or radically (remove adenoids).

Diseases are diagnosed using basic (survey, examination) and additional research methods. The latter include:
- Pharyngoscopy - a method of visual examination of the oropharynx.
It is carried out under artificial lighting, using a spatula and a nasopharyngeal, laryngeal mirror. With pharyngoscopy, the state of the oropharynx is assessed (the color of the mucous membrane, the surface of the posterior pharyngeal wall), pathological formations of this part of the pharynx are revealed. You can see the adenoids, assess the degree of their increase.

Anterior rhinoscopy is a method for examining the nasal cavity. It is carried out with the help of a nasal dilator. At the same time, the anterior nasal passages are examined and evaluated (the presence of edema discharged from the nose), its septum. If you drip a vasoconstrictor, then you can consider the back wall of the nasal part of the pharynx, the adenoids.

Posterior rhinoscopy is a method for examining the posterior parts of the nose.
It can be carried out using a nasal mirror, fiberscope. With posterior rhinoscopy, one can examine the vomer, the posterior surface of the soft palate, the arch of the pharynx, the choanae, and the posterior sections of the nasal conchas. It is informative and harmless, but in childhood it is difficult to carry out.

X-ray examination. It allows you to diagnose adenoids in a child and establish their degree of growth.

Endoscopic examination of the nasopharynx. It consists in a detailed examination of the nasal cavity and nasopharynx, assessment of their functionality using special endoscopes. This is an informative and harmless method. It allows you to record the results of the study on photos and videos.

Treatment of adenoids.

There are two types of treatment - conservative and surgical.

1. Conservative treatment (without surgery) of adenoids in children

carried out with the help of medicinal and physiotherapeutic methods of treatment. Conservative methods are usually used with a small degree of enlargement of the nasopharyngeal tonsil or if there are contraindications to their removal.

Conservative treatment should be local and general. With local treatment, anti-inflammatory and antimicrobial drugs are used. For local exposure (instillation into the nose), vasoconstrictor drops are used. Drops are used from five to seven days. A 0.05% solution of naphthyzine or a 1-2% solution of ephedrine, galazolin, sanorin, etc. is instilled into the nose. After that, the nasal cavity is washed. It can be carried out with drugs (for example, protargol 1 - 2% or collargol 1 - 3% or rhinosept or albucid, furatsilin solution) or medicinal plants (infusion of horsetail, decoction of chamomile, eucalyptus, oak bark, etc.).

Along with local exposure, general treatment is also used. General remedies include general strengthening (vitamins with trace elements, immunostimulants (Echinacea tincture)), antihistamines (fenkarol, suprastin).

To improve the effectiveness of conservative treatment, physiotherapeutic methods are additionally used:

1. UFO. Can be used endonasally (inside the nose) for up to 10 procedures.
2. Helium - neon laser. Also endonasally up to 10 times.
3. Electrophoresis with solutions of potassium iodide, diphenhydramine - endonasally.
4. UHF on the nose area up to 10 procedures.

Climatotherapy often gives positive results on the condition of the child. The resorts of the Crimea and the Black Sea coast of the Caucasus are especially good for this.

The final decision on the choice of treatment method is made by the attending physician, based on the condition of the child.

2. Surgical treatment of adenoids (adenotomy).

This operation should be carried out as early as possible after the detection and diagnosis of adenoids, but only if indicated. This is the most effective treatment. After all, adenoids are an anatomical formation and it will not go anywhere, and no medicines can dissolve it.

The operation is shown when:

Failure of conservative treatment of adenoids;
- persistent difficulty breathing through the nose, which leads to constant colds and infectious diseases of the child (tonsillitis, pneumonia, chronic tonsillitis);
- frequent otitis;
- the appearance of complications from the paranasal sinuses (sinusitis);
- snoring and holding your breath during sleep.

Some contraindications for surgery:

1. Blood diseases
2. Acute period of infectious and skin diseases or with recent diseases.

Most often, an edentomy operation is performed at the age of up to three years, from five to six years, from 9 to 10 years and after 14 years. The choice of this age for the operation is associated with periods of growth of the child's body.

Before the operation, it is necessary to sanitize the oral cavity and cure the inflamed adenoids. If this is not done, then the surgeon may not be able to remove the entire focus of infection, and various complications are possible after the operation.

Surgical removal of the adenoid (adenotomy) can be performed on an outpatient basis (in a clinic) or in a hospital under local anesthesia or under general anesthesia. There are conventional methods of removal and using modern medical equipment (endoscopes). Under local anesthesia, the operation is performed quickly and painlessly. Under general anesthesia, the operation is performed with increased excitability of the child or when the adenoids are close to the mouths of the auditory tubes in the nasopharynx.

The operation is short in time, lasts 15–20 minutes, “cutting off” the overgrown tissue takes only 2–3 minutes. The Beckmann adenoid (a ring-shaped knife) captures the adenoid tissue and cuts it off in one motion (conventional technique).

During the operation, the child sits with his head slightly thrown back. The nostrils of the nose are closed with cotton. The head is held by an assistant (nurse), slightly pressing from above so that it is impossible to rise.

Stages of the operation:

1. Conducting anesthesia. First, the nasal cavity is anesthetized, special attention is paid to the posterior end of the vomer, and then to the posterior wall of the nasopharynx and the nasopharyngeal surface of the soft palate. Sometimes you can do without anesthesia.
2. The tongue is pressed out with a spatula for a better view.
3. The adenome is held with the right hand like a stick and inserted into the pharynx behind the soft palate.
4. The annular knife is pulled forward until it contacts the coulter and moves up until it stops.
5. With a sharp movement of the adenoid posteriorly and simultaneous downward rotation, the adenoid tissue is cut off, after which the knife is brought out.

Stages of adenotomy

After removal of the adenoids, cotton wool is taken out of the nose. The patient must blow his nose, and then breathe through his nose, while closing his mouth. There is usually bleeding that stops quickly. Several re-examinations are carried out within a couple of hours. If there are no complications, the bleeding has stopped, then they are usually allowed to go home (this is if the operation was performed under local anesthesia).

On the first day after the operation at home, the child is shown strict bed rest. It is necessary to exclude physical activity (for at least two weeks), hot and rough food. It is necessary to limit exposure to the sun, you should not wash in hot water and steam. It is useful to carry out breathing exercises, which should be advised by an ENT doctor. Further gradual transition to a normal way of life.

In addition to the usual method of removing adenoids, there is a more modern operation - endoscopic adenoidectomy. This operation is performed using a special technique (endoscope). With its help, penetration into the nasopharynx occurs, where you can not only have a good look at the size and condition of the adenoid tissue in a child, take a photo of this tissue and remove it.

The effect of the operation is usually good: in most cases, nasal breathing is restored immediately after the operation, the child becomes mobile, begins to develop better. Unfortunately, relapses are possible, adenoids can grow back. In such cases, a second operation is needed.

Relapses can be caused by:

1. Incomplete removal of adenoids (even if a millimeter of tissue is left, it can grow again). This usually does not happen when using an endoscope.;
2. Early age of the operation (up to three years). But if there are absolute indications for surgery, then it is performed at any age;
3. The child's tendency to allergies;
4. Individual features of the rapid growth of adenoid tissue in a child.

There is no need to be afraid of a repeated operation, since its implementation will take about five minutes, and will bring relief to the child. If a second operation is needed, but it is not performed, then the child will have complications that were described above.

Adenoids are pathological hypertrophy (enlargement) of the pharyngeal tonsil, which is located in the nasopharynx. The pharyngeal (nasopharyngeal) tonsil is developed only in childhood, somewhere from the age of 12 it begins to decrease in size, and by the age of 20 only small remnants of lymphadenoid tissue usually remain.

And in adults, its complete atrophy usually occurs. From this it follows that adenoids are a childhood disease. Most often, adenoids in children are observed between the ages of 3 and 10 years.

Causes leading to the appearance of adenoids in children

The most common cause is childhood infectious diseases such as measles, scarlet fever, whooping cough, diphtheria, influenza and others. That is, infections that cause an inflammatory reaction of the nasal mucosa.

Risk factors include: unfavorable living conditions, damp, poorly ventilated rooms, unbalanced diet, frequent and irrational use of vasoconstrictor drops.

Clinical symptoms of adenoids

Symptoms vary from severe to mild, depending on the extent of the tonsil enlargement. We list the main symptoms of adenoids.

Intermittent or persistent stuffy nose with copious discharge.

Chronic runny nose that causes children to breathe through their mouths. As a result of difficult nasal breathing, children sleep with their mouths open, their sleep is accompanied by snoring, and in severe cases, even asthma attacks due to the retraction of the root of the tongue. Sleep is usually restless, in the morning children are lethargic, lethargic, headaches may occur.

With a strong growth of the pharyngeal tonsil, due to swelling of the mucous membrane of the nasal cavity, phonation disturbances begin to be noted, the voice takes on a dull tone, loses its sonority, and becomes nasal.

In cases where the adenoids close the openings of the auditory tubes, hearing loss occurs.

Adenoids and prolonged breathing through the mouth can lead to various anomalies of the facial skeleton, changes in bite, deformities of the chest, and spine. A change in the shape of the face and upper jaw, a constantly open mouth, in combination with an indifferent expression, is called the adenoid face.

Adenoids in infants

Infants endure difficulty breathing harder. The act of sucking is disturbed, sleep becomes restless, there is a nocturnal cough. All this leads to underfeeding, children become restless, capricious.

Why are adenoids dangerous?

When breathing through the mouth, incoming cold, unmoistened air leads to frequent colds (runny nose, tonsillitis, laryngitis, bronchitis)

Acute adenoiditis is often the cause of acute otitis media, and an enlarged nasopharyngeal tonsil blocks the mouth of the auditory tube, which in turn leads to hearing loss. If this is noted in very young children, then this can cause speech disorders, such children cannot learn to speak for a long time.

Severely hypertrophied tonsils can cause poor appetite, as the child has trouble swallowing food.

Adenoids lead to sleep disturbance. Children often wake up, sleep poorly, some have a fear that they will suffocate.

Occasionally observed nocturnal urinary incontinence, choree-like movements of the muscles of the face (grimaces), asthmatic attacks with adenoids are reflex in nature.

Difficulty breathing leads to an insufficient supply of oxygen, and above all to the brain. This leads to a decrease in academic performance and lagging behind other children.

Diagnostics

The diagnosis is made on the basis of a characteristic clinical picture and examination.

Finger examination - palpation of the nasopharynx with a finger.

Posterior rhinoscopy - examination with a special mirror.

These two methods are very unpleasant for patients and are not always reliable.

Most often, an X-ray of the nasopharynx, computed tomography, and endoscopic examination are used to confirm the diagnosis.

Treatment depends on the degree of enlargement of the adenoids.

There are three degrees of growth of the pharyngeal tonsils: I - adenoids cover the upper part of the vomer; II - the upper two thirds of the coulter; III - large adenoids, covering completely or almost completely the vomer.

At I degree, without pronounced respiratory disorders, conservative treatment is possible - instillation of a 2% solution of protargol into the nose, taking vitamins, calcium preparations.

At II-III degree, with the development of serious complications (hearing impairment, nasal breathing disorder, speech disorder, etc.), surgical treatment is indicated. However, the operation should not be rushed. If there is no urgent indication for surgical treatment, then first, non-surgical methods of treatment should be tried. Since over the years, as mentioned above, the palatine tonsil decreases in size.

From the main, non-surgical methods, attention should be paid to: strengthening the immune system, preventing diseases of the upper respiratory tract, spa therapy, herbal medicine and homeopathy. It should be noted that the treatment should be carried out by appropriate specialists with mandatory monitoring of the child's condition.

How to help a child?

If surgical treatment is not yet required, but the child is concerned about clinical manifestations, his condition can be alleviated by the following methods.

Washing the nose and nasopharynx - not all children like this procedure, but it is very useful for adenoids. You can rinse with plain water, decoctions of herbs, sea water.

Some children are helped by instillation into the nose of a 2% solution of protargol. The effect is better if you wash the child's nose beforehand.

Prevention

Prevention follows from the causes of the disease. Adenoids are caused by infection. Therefore, prevention consists in adequate and unhurried treatment of childhood colds and strengthening the immune system.

Other related information

Exudative diathesis in children - causes, symptoms, treatment
Infections in the oral cavity in children: herpes, scarlet fever, measles, etc.

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Adenoids are immune tissue that produces immunoglobulins that are directly involved in the normal development of the child's body.

Negative effects: colds, infections, allergies provoke the growth of adenoids and the inflammatory process. Such factors indicate that the body is exposed to allergens and there are malfunctions in the immune system.

Performing a protective function, adenoids neutralize the negative impact of the external environment on the child's body. As a result, mucous secretions occur, swelling of the adenoids occurs, which prevents nasal breathing.

Adenoids can have varying degrees of growth.

I degree: in the daytime, the child's breathing is nasal, free and light. At night, when the adenoids increase somewhat in volume, breathing becomes difficult, sneeze appears.
ІІ and ІІІ degrees: the child breathes through the mouth during the day. At night, snoring appears due to an increase in adenoids in volume and overlapping of the posterior parts of the nose.

Symptoms of adenoids in a child 1-3 years old

The disease proceeds sluggishly, without sharp and obvious symptoms, this can somewhat relax the vigilance of the parents and even give the impression that the child is healthy. However, one should not be superficial about adenoids and their manifestation.

The first signal of danger are frequent colds.
The child complains of frequent runny nose, which over time can transform into chronic rhinitis.
The child has restless sleep, accompanied by snoring and even asthma attacks. As a result of poor sleep, the child does not restore strength and is lethargic and inactive during the day.
Due to the limited mobility of the soft palate, the sound is formed incorrectly, and the child's speech turns into an unintelligible set of sounds.
If the disease has become chronic, a change in the facial skeleton may be observed, since the jaw is in a constantly drooping position. As a result, the lower jaw acquires a narrow and elongated shape, the bite is also formed in the wrong way, and the hard palate in the upper jaw becomes high, in medicine this phenomenon is called the "Gothic" palate.
The chest is formed incorrectly, as the child breathes through the mouth and not through the nose for a long time.
The child develops a morning cough and hearing deteriorates.

Removal of adenoids - pros and cons

Nasopharyngeal tonsils are actively involved in immune reactions and the formation of the body's defense against viruses, so most doctors practice the use of conservative methods of treatment.

In addition, the adenoids of a small child are difficult to remove completely. And given the ability of the adenoids to recover, after surgery, after some time, the situation may repeat itself. There are cases when a child had to undergo a second operation three or even four times.

Nevertheless, one cannot do without a surgical method for the treatment of adenoids in the case when conservative treatment has exhausted itself and did not lead to the desired result - recovery.

It is important to remember that the period of functioning of the adenoids falls on the age of 11-14 years. Subsequently, having completed the amount of work appropriate for them, the nasopharyngeal tonsils disappear.

In any case, you should not agree to the removal of adenoids. It is necessary to consult additionally with several doctors. If the diagnosis is confirmed, you should undergo several courses of conservative treatment, and if the symptoms of enlarged adenoids do not disappear, use the last method - surgery.

How to treat adenoids in children up to a year, 2 or 3 years

Treatment of adenoids is carried out in several stages. Before prescribing the necessary course of treatment, you should consult an otolaryngologist who can correctly assess the situation.

Modern medicine offers several possible options for the treatment of adenoids, however, each of them involves eliminating the source of infection, stopping inflammation and stopping the focus of bacteria that cause the disease.

As for treatments:

Drug therapy. Salt solutions are used to rinse the nose and remove mucus. Antiseptic preparations are used and dry the nasal mucosa. In addition, drugs that eliminate swelling and inflammation are needed.
Laser therapy. This method is aimed at eliminating edema and inflammation of the adenoid tissue. The mucous membrane of the nose dries up and the number of pathogenic microbes decreases. For a full course of treatment, 10 procedures are required.
Homeopathy. This method is based on exclusively natural preparations, however, its disadvantage can be called the duration of the course of treatment - several months.
Nasal lavage

Alternative treatment of adenoids in children

1. Washing the nose

Before proceeding with the procedure, the nose should be cleared of mucus. It is necessary to release the nose in stages, each half separately. Washing the nose will help eliminate the secret that has accumulated on the adenoids.

Procedure scheme:

put the child on the tummy, while the head should be slightly tilted forward;
the syringe must be inserted into one half of the nose perpendicular to the face to a depth of no more than 1 cm;
the solution should be administered in small portions, gradually increasing the pressure of the jet.

To reduce adenoids and eliminate the inflammatory process, you can use:

infusion of horsetail. Pour 1 teaspoon of herbs with a glass of boiling water and leave for no more than five minutes. Cool and rinse your nose.
decoction of herbal collection: oak bark, eucalyptus, St. John's wort. Proportion: for 200 ml of water 5-6 g of the collection. Boil for five minutes, cool and apply.
sea salt solution. Proportion: for 1 glass of water 0.5 teaspoon of sea salt.
Decoction of chamomile with honey. Proportion: for 1 glass of water 5-6 grams of chamomile, 0.5 teaspoon of honey. Add honey to the finished and non-hot broth.
green tea. Proportion: for 1 glass of hot water 1 teaspoon of tea. Leave for 15-20 minutes, rinse your nose.

2. Drops in the nose

fresh beetroot juice. The number of drops depends on the age of the child: from 4 to 8 drops. Instill after washing the nose.
decoction of small duckweed. Proportion: for 0.5 cup of water 2 tablespoons of herbs, boil for five minutes, strain, instill nose after washing.
infusion of green walnut skin. Proportion: for 1 glass of water, 2 tablespoons of chopped walnut peel. Pour in water, bring to a boil and leave for an hour. Strain, instill 3-4 drops no more than 4 times a day.

You can also use a plastic inhaler and breathe in vapors of eucalyptus, calendula and soda. The ingredients can be mixed or used individually. One inhalation requires 0.5 teaspoon of the mixture. The duration of the procedure is from 5 to 10 minutes, the frequency is 1-2 times a day.

Before alternative methods of treatment, it is important to check if the child is allergic to the components, and also consult a doctor.

Cost of adenoidectomy surgery in children

If there is a need for surgery, it is important to remember that there are certain favorable periods for the removal of adenoids. It is better not to perform the operation during the growth period of the child, when the growth and formation of the nasopharynx occurs. The optimal period for adenotomy is the period of slowing down the growth of the child, namely from 5 to 6 years, from 9 to 10 years and after 13-14 years.

Many people have fresh memories of how they had their adenoids removed without anesthesia. However, modern medicine, which uses endoscopic equipment, offers a completely painless method of performing an operation under general anesthesia.

The cost of such an operation will be slightly higher than adenotomy under local anesthesia. This is due to the fact that not only the surgeon takes part in the operation, but the operating sister and the anesthesiologist. Also, the operation requires the use of modern equipment.

The cost of the operation in Moscow, in Kyiv

The cost of adenotomy in Moscow clinics ranges from 15 thousand to 30 thousand rubles. The price depends on the chosen anesthesia, the clinic in which the child is observed.

As for the cost of surgery in Kyiv clinics, it ranges from 1000 to 3000 UAH.

We also offer you to watch an informative video on the topic of symptoms, treatment and removal of adenoids in a child:

Adenoids are one of the most common pathologies in childhood, which can lead to a delay in the physical and mental development of the child.

What are adenoids?

Most infectious agents (bacteria and viruses) transmitted by airborne droplets enter the child's body through the oral cavity. To protect the body in the nasopharynx and oropharynx, there is a Pirogov protective ring, consisting of two tubal and two palatine, lingual and pharyngeal tonsils.

Lymphocytes located in the tonsil tissue are the first to react to the appearance of a foreign agent and prevent its penetration into the lower respiratory tract. For a number of reasons, proliferation of lymphoid tissue in the tonsils can occur. Adenoids - a pathological increase in the volume of the lymphoid tissue of the pharyngeal tonsil.

The pharyngeal tonsil is located on the back wall of the nasopharynx. Normally, it does not come into contact with the internal openings of the nasal passages and does not block them. In the presence of adenoids, the tissue of the pharyngeal tonsil may partially or completely block the nasal passages.

With the development of adenoids, the pharyngeal tonsil ceases to fulfill its protective function. Adenoids become a source of infection, especially when they become inflamed - adenoiditis.

Reasons for the development of adenoids

Adenoids occupy a leading place among respiratory diseases in children. Most often, the disease occurs between the ages of three and nine years. A rare incidence of children under two years of age is associated with a limited circle of persons in contact with the child. The immune system does not receive excessive stimulation, and the lymphoid tissue does not increase in volume. In addition, breastfed babies receive protective antibodies in their mother's milk. Immunity in infants is also not overloaded.

From the age of 2.5-3 years, children in most cases begin to attend preschool institutions. The baby's immune system is not yet perfect, but is already exposed to massive exposure to pathogenic microorganisms. Lymphoid tissue responds to such exposure with hypertrophy (growth). In adolescence, the pharyngeal tonsil decreases and gradually atrophies.

The causes of the appearance of adenoids can be:

Lymphatic-hypoplastic diathesis. This is an anomaly of the child's constitution, a hereditary predisposition to an increase in lymphatic tissue even in the absence of infection in the body. Diathesis is accompanied by a malfunction of the thyroid gland (hypofunction) and severe allergic reactions.
Frequent bacterial and viral infections, including chronic ones. Adenoids develop with prolonged acute respiratory diseases, tonsillitis, pharyngitis. Often adenoids appear after childhood infections - measles, rubella, diphtheria, mumps, whooping cough. The development of pathology is also possible in chronic diseases, such as tuberculosis or syphilis (congenital).
The impact of adverse factors on the mother's body during pregnancy. Alcohol, harmful chemicals, infections, some physical factors, affecting the body of a pregnant woman, can cause a disruption in the functioning of the fetal immune system.
Allergy. Children predisposed to the development of allergic reactions (allergic conjunctivitis, rhinitis, atopic dermatitis, bronchial asthma) are more likely to suffer from adenoids.

Degrees of adenoids

Adenoids, according to the area of \u200b\u200bgrowth of lymphoid tissue and the severity of symptoms in a child, are divided into three degrees:

Adenoids cover less than ⅓ of the area of the internal openings of the nasal passages, the symptoms in a child appear only during a night's sleep.
Adenoids cover half the area of the openings, symptoms in children appear in the daytime, but they are mild.
Lymphoid tissue grows, almost completely blocking the internal openings of the nasal passages. Symptoms of respiratory failure are very pronounced.

The degree of adenoids is set by an otorhinolaryngologist after the examination.

Symptoms of the disease

Symptoms of the development of adenoids appear due to the overlap of the nasal passages with lymphoid tissue. As a result, the child's nasal breathing is disturbed. Parents may notice the following pathological signs:

The child began to breathe through the nose with difficulty. First, normal nasal breathing is disturbed during sleep. Parents may notice that the baby breathes through the mouth in a dream, sometimes snoring occurs, which is associated with the rapid passage of the air flow through the narrowed nasal passages. If the child began to breathe through the mouth during the daytime, this indicates an increase in the severity of the disease.
Children become lethargic. During the day, the child wants to sleep, reacts poorly to stimuli, does not participate in games with other children, does not study well at school, and cannot concentrate. This is due to the fact that when breathing through the mouth, the blood is poorly saturated with oxygen, anemia of varying severity occurs, and the brain does not receive the nutrients it needs.
The child's face changes. A constantly open mouth changes the baby's bite over time, the lower jaw narrows and sags. Physiological folds on the face of the baby are smoothed out. In some cases, exophthalmos ("protrusion" of the eyeballs) occurs.
Runny nose develops. Lymphoid tissue, growing, exerts a pronounced pressure on the small capillaries of the nasal mucosa, causing swelling of the mucosa and the appearance of a slight serous discharge.
The child is hearing impaired. The pharyngeal tonsil is located close to the internal openings of the auditory tubes. With the growth of the pharyngeal tonsil, these holes overlap, thereby causing hearing loss in the child.
The voice changes. Normally, the air flow during a conversation passes through the nasopharynx and enters the sinuses, which act as resonators. Adenoids close the entrance to the sinuses. The child's voice becomes quiet, nasal, he says "in the nose."
Swallowing is disturbed. Adenoids can block the oropharynx, causing a violation of the act of swallowing. The child often chokes while eating, he regularly has a paroxysmal cough.

Diagnosis of pathology

In the presence of the above symptoms, parents should contact a pediatric otorhinolaryngologist. He will conduct a general examination of the child, an additional examination, and after making an accurate diagnosis, he will tell you how to treat adenoids.

As additional methods of research, pharyngoscopy, anterior and posterior rhinoscopy, radiography of the pharynx and endoscopy are used.

Pharyngoscopy - examination of the oral cavity and oropharynx. The doctor evaluates the nature of the oral mucosa, the presence of proliferation of palatine tonsils.

With an anterior rhinoscopy, the otorhinolaryngologist examines the nasal passages. With adenoids of the second or third degree, they can be clearly seen through the internal openings of the nasal passages.

The main research method for adenoids is posterior rhinoscopy. The doctor installs a special mirror in the oropharynx, turning it up. In the mirror, growths of the pharyngeal tonsil are determined. With posterior rhinoscopy, the degree of adenoids is established. The disadvantage of the method is the impossibility of conducting such a survey in young children.

Radiography with adenoids - a picture of the oropharynx in a lateral projection. On radiographs, the degree of adenoids can also be determined. During endoscopy of the oropharynx with the help of a special device (endoscope) with an optical part, adenoids are visualized in more detail.

Treatment of adenoids

With the first degree of the disease, you can do without surgery, with the second and third degrees, the removal of adenoids in children is most often performed.

Medical therapy

Drug treatment includes the use of vasoconstrictor drops, nasal lavage with special saline solutions. Drug therapy can reduce the symptoms of adenoids for some time. In some cases, this time is enough for the gradual development of atrophy of the pharyngeal tonsil. To strengthen the immune system, multivitamin complexes and immunostimulating drugs are used.

With inflammation of the adenoids, the development of adenoiditis, broad-spectrum antibacterial agents, antihistamines are used.

Treatment with folk remedies

For the treatment of adenoids, there are many homeopathic preparations and collections of medicinal herbs. Such treatment is aimed primarily at reducing the symptoms of the disease.

Horsetail leaves, arborvitae and tea tree oil restore nasal breathing by constricting blood vessels and preventing swelling of the nasal mucosa. In addition, they have weak antibacterial and antioxidant effects.

Physiotherapy treatment

In the treatment of adenoids of the first degree are effective:

halotherapy (salt cave);
magnetotherapy;
electrophoresis;
UHF (exposure to high-frequency electromagnetic field);
UFO-therapy (ultraviolet radiation).

Surgery

Surgical treatment of adenoids is carried out from the second degree of the disease, as well as with the ineffectiveness of conservative therapy. With frequent colds, respiratory failure, the doctor may also recommend surgery.

Open operation

Open surgery for adenoids is called adenotomy or adenoidectomy. Surgery is performed under local (in older children) or general (in infants) anesthesia. Removal occurs through the mouth. With adenotomy, only the overgrown lymphoid tissue is removed, with adenoidectomy, the entire pharyngeal tonsil is removed. The disadvantage of the operation is its high trauma and frequent relapses of the disease.

laser removal

Laser removal is possible with the second degree of adenoids. The laser vaporizes the lymphoid tissue of the tonsil.

Cryodestruction

This type of surgery begins with a classic adenoidectomy performed with a special arcuate knife. After removal of the tonsil, cauterization of the wound surface with ultra-low temperature nitrogen is carried out. This procedure helps prevent the recurrence of the disease.

Endoscopic removal

Endoscopic adenoidectomy is performed with an endoscope through the nose. At the end of the endoscope there is an optical instrument. Through an endoscope inserted into the nasal passage, the surgeon sees the pharyngeal tonsil and removes it. The operation is less traumatic compared to open surgery.

Complications of the disease

If the diagnosis of adenoids is made in the early stages, there are practically no complications. With adenoids of the second and third degree, in combination with a high risk of developing an allergic reaction in a child, inflammation of the adenoids - adenoiditis may occur. The disease is manifested by high fever, general intoxication. In these children, the risk of recurrence after surgery is increased.

Prevention

Prevention of adenoids consists of increasing the immunity of the child. From early childhood, it is necessary to perform hardening procedures, the baby needs to walk more in the fresh air, eat fresh fruits.

In autumn and spring, you can take multivitamins. During the cold season, it is necessary to limit visits to places with a large crowd of people, to follow the rules of hygiene.

Vaccination is of great importance in the prevention of adenoids.

When the first signs of adenoid development appear, parents need to consult a doctor who will make the correct diagnosis and prescribe the necessary treatment.