Adenoiditis is an inflammation of the pharyngeal tonsil (adenoids). The disease most often occurs in children under 12 years of age. It is very important to recognize the disease and promptly begin treatment, because the chronic form can cause complications and provoke the development of other diseases in the nasopharyngeal region and middle ear.
In this article we will figure out how to treat adenoiditis in a child.
Types of diseases and methods of their treatment
Like most diseases, adenoiditis can have acute and chronic forms. Acute manifests itself in the form of retronasal sore throat, chronic can be expressed by different symptoms. Manifestations depend on the body’s specific reactions to the inflammatory process, the state of the immune system and the degree of allergization. So, what are the symptoms of different forms of adenoid inflammation in children and what treatment is necessary in each case?
Symptoms and treatment of acute adenoiditis in children
Streptococcal and respiratory diseases provoke the development of acute forms. Typically, inflammation occurs palatine tonsils, but isolated inflammation is also possible.
- The first symptom of the acute form is an increase in temperature to 39 °C or higher.
- When swallowing, the patient feels a stinging pain in the depths of the nose.
- In most cases, a runny nose and nasal congestion appear; paroxysmal cough. Read about devices for treating runny nose.
- The patient often suffers from headaches that originate behind the soft palate.
- On the second or third day of illness, when examining the pharynx, you may notice swelling of the posterior arches and redness back wall.
- Purulent mucus begins to secrete from the nasopharynx.
- Possible hearing loss and ear pain.
U infants The acute form of odenoiditis is very difficult. The situation is aggravated by difficulties in making a diagnosis.
- You can recognize the disease by drowsiness; it is difficult for the baby to suck and it hurts to swallow.
- The child gets full faster, he may have a tummy ache and indigestion.
- Quite often the cervical and submandibular lymph nodes become enlarged, this can interfere with normal muscle function thoracic and provoke an unnatural head position.
To diagnose adenoiditis, doctors perform bacteriological examination swabs from the nasopharynx and palatine tonsils. Treatment of acute adenoiditis in infants is primarily aimed at resumption of nasal breathing. Depending on the patient’s condition, the presence of allergies and other contraindications, antibiotics are prescribed, which must be taken under the supervision of doctors.
Features of the chronic form of the disease
This form of the disease is a consequence of acute adenoiditis. Often the disease is combined with an enlarged pharyngeal tonsil.
The presence of chronic adenoiditis is manifested by difficulty in nasal breathing. The child has a constant catarrhal runny nose; purulent runny nose may occur less frequently. Outside periods of exacerbation, the child’s condition can be characterized as satisfactory. Parents should pay attention to indirect symptoms:
- Lethargy. The child constantly wants to sleep, but has difficulty falling asleep and waking up at night.
- Increased fatigue.
- Decreased appetite.
- Headache.
- Night cough.
- Speech impairment. The baby has difficulty pronouncing consonants.
- Attention disturbance, retardation in physical and mental development. For unknown reasons, a child may begin to study worse.
During periods of exacerbation, which occur frequently and are accompanied by an increase in temperature, the symptoms are similar to those of acute adenoiditis. After treatment, you feel better, but the disease remains.
Treatment of chronic adenoiditis in children consists of eliminating the source of bacteria in order to prevent the formation of an inflammatory process in the nasal cavity, nasopharynx, traeoronchial tree and middle ear. In children, therapy is carried out using medications and procedures that should be carried out with great caution due to the danger of opening the abscess. Vasoconstrictor nasal drops and sprays are prescribed, disinfectants for the nasopharynx (silver proteinate, 0.15 iodinol solution, 20% glucose solution, collargol). You should undergo a cycle 4 times a year complex therapy aimed at strengthening the immune system and eliminating allergic manifestations diseases.
Conservative treatment of enlarged adenoids in children
This type of treatment is recommended if the nasopharyngeal tonsil is slightly enlarged or if there are contraindications to surgery. Conservative treatment can be general or local.
- Local Treatment of adenoiditis in children involves the use of antimicrobial and anti-inflammatory drugs in the form of drops and sprays. Drops (1-2% solution of Galazolin, Ephedrine, Sanorin, 0.05% solution of Naphthyzin and others) are used for 5-7 days. In combination with instillation, it is recommended to rinse the nose (furatsilin solution, 1-2% Protargol, Albucid).
IN last years pharmaceutical laboratories have developed innovative drugs. It is increasingly recommended for the treatment of adenoids in children. Nasonex. The drug is part of a group of substances similar to natural hormones (steroids), which are produced by the body and help relieve swelling and reduce pain. Nasonex nasal spray does not penetrate the mucous membrane and does not enter the blood. This feature eliminates side effects due to which hormone therapy is prescribed only in exceptional cases. In addition to the obvious anti-inflammatory effect, the drug has the ability to reduce allergic reactions. - General Treatment consists of taking general restoratives. These include antihistamines (Suprastin, Fenkarol), immunostimulants, vitamins and microelements. In addition, physiotherapy is used therapeutic procedures: UV irradiation, electrophoresis with solutions of diphenhydramine or potassium iodide, helium-neon laser, UHF of the nose.
Surgical methods: surgery and laser
Surgery to remove adenoids is recommended to be performed as early as possible after the formation is detected and diagnosed. So far, this method of treatment is the most effective, because adenoids will not disappear anywhere and will pose a danger to the child’s health.
- Shown surgical intervention in the absence of success in conservative treatment, breathing problems and complications.
- Contraindications Some blood diseases may require surgery. Also, you will have to wait to remove the adenoids if the child is sick or has recently suffered acute infectious and skin diseases.
Due to growth characteristics child's body Operations are recommended to be performed before 3 years, from 5 to 6, from 9 to 10 and after 14 years. Before surgery, in order to avoid complications, it is necessary to cure the inflammation of the adenoid and sanitize the cavity. The operation lasts 15-20 minutes with local anesthesia.
Laser removal adenoids has a number of advantages over the traditional method:
- The recovery period after surgery is reduced.
- Minimal blood loss.
- The surgeon's actions are more precise.
- The area of the injured area is reduced.
- Complete sterility and reduced risk of complications.
Laser removal of adenoids in children can be used in two ways:
- Coagulation. A focused beam is used. Recommended for removing large formations.
- Valorization. The upper layers of the adenoids are burned with steam using a carbon dioxide laser. Recommended for early stages and small-sized lesions.
Doctors do not have a clear opinion regarding the advisability of treating adenoids in children with laser. Some doctors consider it ineffective.
Folk remedies: simple natural recipes
One of the most effective means traditional treatment of adenoids in children is recognized propolis. You can use different recipes:
- Mix propolis with creamy or vegetable oil(1/10) and cook the mixture in a water bath, the medicine should boil for about 25 minutes. You can smear the mixture on your nose, wet cotton or bandage swabs, which are held in the nasal passages for about half an hour.
- For alcohol tincture 200 ml of boiled, cooled water should be mixed with 1/4 teaspoon baking soda. Add 20 drops of propolis alcohol tincture to the resulting mixture. The product is used to rinse the nose (3 times a day).
Traditional healers believe that regular use fish oil helps stop the growth of adenoids.
The most affordable juices are very effective:
- Aloe or Kalanchoe. Freshly squeezed juice is mixed in equal proportions with warm boiled water. The mixture can be instilled into the nose (every 3 hours) and used for gargling. Read about the treatment of Kalanchoe runny nose.
- Nasal instillations give excellent results freshly squeezed juice beets(3 times a day).
- It is recommended to drink the juice mixture on an empty stomach carrots and spinach(carrots – 10 tbsp., spinach – 6 tbsp.).
Will help cure adenoiditis and strengthen the body inhalations with pine buds. 20 g of kidneys are crushed and poured into a glass of boiling water. The mixture is prepared in a water bath for 20 minutes, after which it is infused for about half an hour.
Effective homeopathic medicines
Treatment of adenoids with homeopathy in children is most often intended to eliminate the infection, improve metabolic processes and restore the child’s immunity.
- Barberry Comp Job Baby– a complex drug. There have been cases of resorption of even neglected adenoids.
- Complex aerosol Euphorbium compositum Nazentropen S prevents exacerbation of adenoiditis and relieves inflammation, improves metabolic processes.
- It is recommended to use it as a monotherapy Thuja oil.
Dr. Komarovsky will talk about the treatment of adenoiditis in children in the video below.
There are a lot of ways to treat adenoiditis; depending on the form of the disease, indications and general health of the child, an experienced doctor will choose the best therapy. The task of parents is to notice the disease in time and follow the doctor’s recommendations. This will help avoid complications.
Inflammation of the nasopharyngeal tonsil is a fairly common ENT pathology in childhood. Besides unpleasant symptoms causing discomfort to the child, sluggish inflammation of the adenoids provokes the emergence of infectious foci, which threatens serious complications. What is the danger of chronic adenoiditis for children, how to recognize it and what therapeutic measures will help restore normal breathing to the baby?
What is chronic adenoiditis
In the first years of life, the nasopharyngeal tonsil, which is located in the upper part of the pharynx, performs the most important immune function, playing the role of a kind of protective barrier that prevents pathogens from entering the body.
In preschool institutions, viruses and bacteria literally attack the child, loading the pharyngeal tonsil with work, as a result of the growth of which adenoids are formed. Due to infections of the upper respiratory tract(ARVI, influenza) the adenoids become inflamed, which causes the development of adenoiditis.
Adenoiditis is an inflammation of the hypertrophied (enlarged) nasopharyngeal tonsil
Chronic adenoiditis is characterized by prolonged development (at least a month). Not only the nasopharyngeal tonsil is affected by inflammation, but also nearby organs, so that in addition to the unpleasant signs of adenoiditis itself, symptoms of ENT diseases and respiratory tract diseases are added: runny nose and otitis media.
Most often, pathology is diagnosed in children aged 3 to 7 years and in primary schoolchildren.
According to medical statistics, chronic adenoiditis is observed in 20% of preschool children. Closer to adolescence, the nasopharyngeal tonsil shrinks significantly, and by the age of 20 it completely atrophies.
Causes
Highlight the root cause chronic inflammation The nasopharyngeal tonsil is very difficult. This disease differs from acute adenoiditis, which is usually a consequence of a viral infection.
Experts note that the likelihood of adenoiditis becoming chronic increases significantly with a weak immune system and allergic diseases (diathesis, atopic dermatitis). In addition, risk factors include:
- refusal breastfeeding;
- unbalanced diet, in which carbohydrates predominate;
- vitamin D deficiency, including rickets;
- chronic infectious diseases (for example, tonsillitis);
- frequent hypothermia;
- chronic and others inflammatory diseases upper respiratory tract;
- unfavorable environmental conditions (polluted air, poor room ventilation);
- passive smoking, since a child’s inhalation of cigarette smoke and tar reduces local immunity.
Exacerbation of chronic inflammation of the pharyngeal tonsil often occurs against the background of acute respiratory viral infections and other viral infections, when pathogenic microorganisms actively multiply in the overgrown lymphoid tissue.
Constant interaction with the allergen causes further growth of the adenoids, the appearance of purulent foci and chronic swelling of the tonsil.
Doctor Komarovsky about the causes of adenoids in children - video
Symptoms and signs
- chronic runny nose with purulent or mucous discharge from the nasal cavity;
- constantly slightly open mouth;
- low-grade body temperature (37.1–38°C);
- sleep disturbance at night, drowsiness during the day;
- nasal congestion, manifested by snoring, wheezing, and nasal sounds;
- decreased appetite;
- retardation in physical and mental development;
- headache;
- cough at night due to purulent discharge down the throat;
- increased fatigue;
- decreased hearing due to concomitant diseases ears.
If inflammatory processes are accompanied by a significant proliferation of lymphoid tissue, then the child develops an “adenoid face”, characterized by sagging of the lower jaw, increased salivation, malocclusion and swelling of the face.
Diagnostics
First of all, the otolaryngologist analyzes the complaints and examines the baby. During inflammatory processes in the pharyngeal tonsil, its redness, swelling, and suppuration are detected. There is a presence of mucous discharge flowing down the back wall of the pharynx.
In the absence of an endoscope or to clarify the degree of growth of the adenoids, doctors use a digital examination of the nasopharynx by palpating the nasopharyngeal tonsil with a bent finger placed behind the soft palate.
To establish an accurate diagnosis, the doctor may use the following methods:
In addition, it is important differential diagnosis, in which adenoiditis is distinguished from chronic runny nose, sinusitis, and sinusitis. Usually differentiation is not particularly difficult due to the inflamed, hypertrophied tonsil.
In adolescence, the disease must be distinguished from juvenile angiofibroma, a benign tumor in the nasal cavity.
Treatment
The main task of treating chronic adenoiditis is restoration normal operation nasopharynx due to the elimination of the inflammatory focus. Treatment for the disease usually takes place in outpatient setting, that is, at home (with regular visits to the clinic). Hospitalization is prescribed only in case of surgery.
Drug therapy
When treating chronic inflammation of the pharyngeal tonsil, there are no strict standards; the choice of medications remains with the doctor. Therapy is usually complex, it includes the use of both antihistamines and antibiotics local action.
Means for the treatment of chronic adenoiditis - table
| Group of drugs | Name | Destination purpose |
| Vasoconstrictor drops |
| Reducing nasal congestion and swelling. |
| Antihistamines |
|
|
| Antipyretic drugs |
|
|
| Antibiotics and antiseptics local application |
| Suppressing the activity of pathogenic microorganisms that cause the development of infection in the nasopharynx. |
| Systemic antibiotics |
| They are prescribed extremely rarely and only if adenoiditis is accompanied by:
|
| Homeopathic remedies |
|
|
| Antiviral drugs |
| Prescribed for exacerbation of chronic adenoiditis caused by a viral infection. |
| Vitamin complexes |
|
|
Drugs for the treatment of chronic inflammation of the pharyngeal tonsil - gallery
Sumamed is a drug from the group of antibiotics latest generation 
Sinupret is a combination drug of herbal origin 
Panadol - medicine, which has analgesic and antipyretic effects 
Nazol Baby - vasoconstrictor drug for topical use 
Multi-tabs Baby is a vitamin complex product 
Isofra is antibacterial drug, which is intended for the treatment of local inflammatory processes of the nasal cavity 
Zyrtec - antiallergic drug 
Viferon - medical drug, which has an immunostimulating and antiviral effect
Washing
According to experts, the beginning of treatment and prevention of chronic adenoiditis in children is daily hygiene of the nasopharyngeal cavity, which is based on rinsing the nose with special solutions.
Irrigation therapeutic measures help remove a significant portion of viral, bacterial and allergic agents from the surface of the mucous membranes of the nasopharyngeal cavity, significantly reducing the degree of inflammation.
Usually, washing is carried out 2-3 times a day with mandatory nose blowing. In case of exacerbation of chronic inflammation, the frequency of hygiene procedures increases to 5–6 times a day. The doctor will determine a detailed treatment regimen!
The nasopharynx is rinsed using:
- a syringe or a special aspirator (suitable for young children who do not yet know how to blow their nose);
- Esmarch's mugs;
- a small teapot;
- syringe without a needle;
- special devices sold in pharmacy chains along with rinsing preparations.
Rinsing the nasopharynx for chronic adenoiditis is carried out several times a day Irrigation procedures are carried out using mineral water, isotonic saline solutions (sodium chloride concentration 0.9%), preparations based on sea water.
Important! Rinsing the nasopharynx is carried out only when the nasal passages are free. If a child has difficulty breathing due to a stuffy nose, it is necessary to first (10 minutes before) apply vasoconstrictor nasal drops, approved for children.
Physiotherapy
The choice of physiotherapeutic procedure is made by an otolaryngologist based on the severity of the disease, the degree of inflammation of the tonsil, and the size of the enlarged adenoids. Today, one of the most common methods is laser therapy: inflamed adenoids are heated with a medical laser, which, acting locally, helps:
- reduce swelling;
- relieve inflammation;
- destroy pathogenic microorganisms.
When treating chronic adenoiditis, a helium-neon laser is usually used. Therapy consists of two main stages:
- First, the inflammatory process is relieved, while at the same time the cells of the immune system are restored.
- Subsequent procedures are prescribed to prevent possible inflammatory processes in the nasopharynx.
To increase the effectiveness of treatment, before each session, a small patient needs to rinse the sock with a saline solution to clear the nasopharynx of mucous and purulent secretions.
Ozone therapy is another one effective method treatment of adenoiditis in children, involving the use of ozone gas. Ozone is a modification of oxygen that helps:
- suppress the reproduction and growth of pathogenic bacteria, viruses and fungi;
- restore local immunity;
- protect cells of the nasopharynx mucosa from damage and accelerate their regeneration.
Ozone can be easily dissolved in water, so for adenoiditis, a composition saturated with this substance is used to rinse the nasal cavity and pharynx.
Folk recipes
For mild cases of the disease, along with traditional methods, folk recipes are also used, which enhance the effectiveness. drug therapy.
Important! Traditional medicine recipes are just an auxiliary method of therapy light form chronic inflammatory processes in the nasopharynx in children. They should be used only with the permission of the treating doctor.
For irrigation procedures, experts suggest using beneficial properties medicinal plants. To do this, pour a tablespoon of the mixture into a quarter cup hot water and simmer over low heat for 10–15 minutes. The resulting infusion must be infused for several hours in a warm place, then strained and dripped into the nose or rinsed into the nasopharynx.
Herbal mixtures for the treatment of chronic adenoiditis - table
In addition to medicinal herbal collections, there are other popular folk remedies:
- Juice from Kalanchoe leaves. Rinse well and grind the raw materials in a blender, squeeze out the juice. Place a few drops into your nose 3 times a day.
- Red beet juice. Suitable for treatment only fresh product, which should be instilled three times a day into each nostril, a few drops.
Until recently, to relieve inflammation of the nasopharyngeal tonsil, the so-called eggnog was used, consisting of 0.5 liters of boiled milk, a teaspoon of honey, raw chicken egg and a piece butter. Now many doctors consider the effectiveness of this cocktail unproven and recommend using it only as a nutrient during an exacerbation of chronic adenoiditis (drink the mixture warm during the day in small sips).
Folk remedies for the treatment of chronic adenoiditis - gallery
Horsetail herb is a common ingredient in preparations for rinsing the nasopharynx for chronic adenoiditis. 
Beetroot juice is used for nasal drops 
Kalanchoe juice is used as nasal drops 
Gogol-mogol will help your child regain strength
Breathing exercises
Another auxiliary method of conservative treatment of the disease is breathing exercises. the main objective- teach the child proper breathing through the nose, and do this during the game, so that the child can subsequently perform this gymnastics independently.
Today you can find the most different techniques and directions breathing exercises. The original methods of Strelnikova and Buteyko are popular in pediatric practice. They must be used under the guidance of specialists.
Doctors offer a simple course of exercises that will help ease breathing during chronic adenoiditis and improve the well-being of a small child:
- Breathing through one nostril. Plug one nostril with your finger and take 5-6 deep breaths through the other. Then close the second nostril. Repeat the exercise 2-3 times.
- "Hedgehog". commit deep breaths, turning your head from side to side. To turn the exercise into a game, invite your child to imagine himself as a hedgehog who went into the forest in search of an apple and sniffs in search of prey.
- "Crane" Place your palms on your collarbones, take a deep breath through your nose and raise your arms up. Then exhale slowly and lower your arms.
- "Pump". Extend your arms straight in front of you and slowly bend forward on the count of three. In this position, deep breaths occur, and when bending, noisy exhalations occur. Repeat the exercise 5-6 times.
- "Ball". Ask your child to imagine that there is a balloon in his tummy. While inhaling smoothly, inflate your stomach, and then just as slowly “deflate the balloon,” exhaling all the air.
Doctors recommend doing gymnastics in the morning, after thoroughly cleaning the sinuses or putting vasodilating drops into the nose. To prevent the baby from getting bored, parents should join him, showing him how to properly perform this or that exercise.
Breathing exercises by Strelnikova for schoolchildren and teenagers - video
Surgical method
Surgical treatment of chronic inflammation of the nasopharyngeal tonsil is carried out quite often. An absolute indication for surgical intervention is obstructive apnea syndrome (stopping breathing at night).
TO relative indications doctors include:
- failure of other methods of treating chronic adenoiditis for six months;
- recurrent otitis of the middle ear;
- chronic sinusitis;
- hearing loss.
Adenotomy (an operation to remove a hypertrophied tonsil) is performed in a hospital setting. Depending on the severity of the disease and the characteristics of the little patient, the doctor may suggest the following types surgical intervention:
- Classic surgery under local anesthesia. To remove adenoids, Beckmann's adenoid is used - a special knife shaped like a loop. Before the procedure, the doctor thoroughly rinses the tonsil and numbs the nasopharyngeal mucosa with a spray.
- Endoscopic surgery under general anesthesia. To remove an inflamed tonsil, use a special endoscopic equipment, with which the doctor examines the adenoids, takes photographs of them, and visually monitors the progress of the operation.
- Laser adenotomy. In this case, a narrowly directed beam of laser radiation acts as a “scalpel”. There are three types of such surgical intervention:
- Laser adenotomy is considered the most modern method of removing adenoids
- attacks of suffocation at night, which are associated with insufficient oxygen supply due to inflammation of the excessively enlarged nasopharyngeal tonsil;
- transition of the inflammatory process and infection to nearby organs:
- otitis media is a frequently diagnosed complication of the disease, since the hypertrophied tonsil blocks the auditory tubes connecting the middle ear to the nasopharynx;
- decreased hearing acuity due to the development of a chronic inflammatory process;
- constant separation of mucous secretion and pus leads to the occurrence of chronic forms of tracheitis and laryngitis;
- inflammation paranasal sinuses nose, among which the most common are sinusitis and sinusitis;
- chronic tonsillitis.
- promptly consult a doctor at the first signs of tonsil enlargement (the child snores in his sleep, sleeps with his mouth open, his nose is constantly stuffy);
- treat colds, infectious inflammatory processes in the ENT organs;
- do physical exercise, exercise, take vitamin complexes, especially in the autumn-winter period, balance the diet (increase the consumption of vegetables and fruits, reduce the amount of carbohydrates, and also eliminate fried and spicy foods;
- isolate the child from communication with patients with acute respiratory infections;
- accustom the baby to regular hygiene procedures (rinse the nose with saline solution, brush teeth, gargle after eating).
The choice of the type of surgical intervention is made by an otolaryngologist based on the degree of growth of the adenoids, the child’s well-being, his age, and the presence of infectious diseases and associated complications.
In the postoperative period, the small patient must follow certain rules. For example, sour and hot foods are prohibited; it is recommended to limit physical activity and refuse to visit the pool.
Possible complications
Chronic inflammation of the nasopharyngeal tonsil is far from a harmless disease. In the absence of proper treatment, undesirable consequences may occur and severe complications. For example, in a child with an advanced pathological process, the structure of the face sometimes changes, and there is a lag in physical and mental development.
The number of complications that can result from incorrectly chosen treatment tactics or late treatment medical care, relate:
Prevention
Chronic adenoiditis in a child is considered quite serious illness and is accompanied by unpleasant and sometimes dangerous symptoms. If left untreated, a low-grade inflammatory process can cause various complications and disrupt normal development baby. At the first signs of an enlarged nasopharyngeal tonsil, parents should seek medical help.
Adenoids are an extremely common occurrence in children aged 3 to 12 years. The disease causes considerable discomfort to children and worries their parents, and its chronic form has a negative impact not only on the breathing process, but also on the behavior and physical development of the child.
Adenoids first appear in children in early preschool age and in most cases retain symptoms for several years. During middle school they tend to decrease in size and atrophy over time.
Adenoids are not typical for adults - this disease occurs only in children. Even if in early childhood you were diagnosed with adenoids; they will not return in adulthood.
Reasons for the development of adenoids in children
What are adenoids in the nose in children? Adenoids are the pathological growth and enlargement of the tissue of the nasopharyngeal tonsil; normally, this anatomical formation is part of the immune system - the nasopharyngeal tonsil protects a person from microorganisms that enter the body along with the inhaled air.
During illnesses (ARVI, colds, flu, allergies), the tonsil tissues increase in order to generate a protective barrier, and after the inflammation passes, they return to their normal state. If we are talking about frequent illnesses, and the interval between illnesses is too short (1 week or less), the overgrown tonsil tissue does not have time to shrink. In this case, they are in a state of constant inflammation, due to which the lymphoid tissue grows even more and can block the entire nasopharynx.
This pathology is most common in childhood, namely in children aged 3–7 years. In some cases, adenoids are diagnosed in children under 1 year of age. In adolescence and adulthood, adenoid vegetations are extremely rare, since the inflamed tissues of the tonsil tend to develop inversely - towards reduction. However, this should not be a reason to ignore the pathology, since enlarged adenoids in a child are a constant source of infection in the body.
Most common reasons the development of adenoids in children is acute and chronic diseases of the upper respiratory tract: laryngitis, pharyngitis, tonsillitis, rhinitis or sinusitis. The impetus for the growth of adenoids in children of preschool and primary school age is often infections - ARVI, influenza, rubella, measles, diphtheria, scarlet fever, whooping cough, etc. If a child is diagnosed with tuberculosis or a congenital syphilitic infection, this will also play a role in pathological growth tonsil tissue. Adenoids in children are rarely an isolated pathology; cases of a combination of adenoid proliferation and tonsillitis of various etiologies are more common.
The fact that the mother suffered a viral disease in the 1st trimester of pregnancy can also provoke excessive growth of adenoids in children, but in fact, this reason in each specific case is not the only one - as a rule, there are other provoking factors.
Other common reasons for enlarged adenoids in a child are frequent allergic conditions of the nasopharynx, fungal infections in the pharynx, hypovitaminosis, or difficult social and living conditions. Among these reasons, allergies are distinguished, since permanent exposure to allergic factors without symptomatic therapy often leads to the proliferation of adenoid tissue.
At the moment, determining the root cause of allergies in children from 3 to 7 years old is a rather troublesome and expensive task, which is why some allergists often take the simplest route and suggest getting rid of pets, plants and soft toys first.
In practice, this can only lead to temporary relief of symptoms - if the child has been raised in close proximity and contact with animals since birth, the sudden appearance of an allergy to them is excluded. In addition, according to the observation of child psychologists, this leads to delayed psychological trauma in children attached to their pets.
According to the results laboratory diagnostics in 70% of cases an allergic reaction to components of house dust is detected, food products or household chemicals and construction/finishing materials that have recently appeared in the house.
In addition, there have been cases where the cause of the growth of adenoids was dry air in the house (especially during the heating season) or an excessively dry climate.
Symptoms of adenoids in the nose in a child
Adenoids in a normal - not hypertrophied state - do not cause any unusual symptoms in children. However, with the frequent incidence of ARVI and colds tonsil tissue begins to grow to effectively perform its main function - containing and destroying germs and viruses. Accordingly, in order to understand what it is - adenoids in children - we must take into account the fact of the proliferation of tonsil tissue due to a hyperreaction of the immune system to the constant presence of dangerous pathogens in the nasopharynx.
Quite often, the growth of adenoids occurs when the child begins to attend kindergarten. The fact is that the first year in a children's team is a strong test for immunity. On the one hand, the body’s immune defense “gets acquainted” with new viruses and bacteria, as a result of which the immune system becomes stronger, and the child himself is less susceptible to infections in the future. On the other hand, against the background of frequent acute respiratory viral infections and bacterial diseases, the tissues of the tonsils enlarged during the illness do not have time to return to their normal state.
How to determine adenoids in a child - and which specialist should I contact? Only an ENT doctor can make this diagnosis based on the results of a special examination. A pediatrician does not see signs of pathology during a routine examination of the throat, but an experienced one pediatrician Based on the signs listed by the parents and frequent ARVI diseases, it can be assumed that this picture is caused by the growth of the child’s adenoids. In this case, the pediatrician sends the baby for additional examination to an ENT doctor, where an examination is carried out using medical mirrors.
At the moment, examination using mirrors is the most recommended for use, since the previously widely used digital examination can cause vomiting in children, and x-rays in diagnosing adenoids have been found to be ineffective due to the frequent distortion of results.
What symptoms of adenoids in children should parents pay attention to? ENT specialists highlight following signs enlarged adenoids:
- frequent prolonged runny nose, which is difficult to treat;
- difficulty breathing through the nose and a constant feeling of nasal congestion even in the apparent absence of a runny nose;
- persistent mucous discharge from the nose, leading to irritation of the skin around the nostrils and on the upper lip;
- the child tries to breathe with his mouth open;
- morning dry cough and heavy coughing - sometimes to the point of vomiting;
- disturbing restless sleep - the child often wakes up;
- snoring, snoring and coughing during sleep, sometimes holding your breath;
- lethargy, drowsiness, apathy - or, on the contrary, irritability;
- decreased concentration and attention;
- with grade 2-3 adenoids, attacks of night suffocation may occur when the child does not have enough air;
- general nervousness of motor skills: blinking, tics, nervous finger movements;
- voice disorders – the child’s voice becomes hoarse;
- headaches due to insufficient oxygen supply to the brain;
- Due to pressure on the auditory tube and infection, hearing may decrease.
Otorhinolaryngologists also introduced a special term - adenoid face or adenoid type face. If a child suffers from overgrowth of adenoids for a long time, this is accompanied by the following symptoms:
- constantly slightly open mouth;
- malocclusion;
- wedge-shaped modification of the lower jaw;
- narrowing upper jaw and shortening of the upper lip;
- puffiness of the facial oval;
- emotionless facial expression;
Such changes, despite the advanced state of the adenoids and the severity of the symptoms, can also be treated conservatively if the formation of the facial bones has not yet completed. In severe cases, surgical removal of the adenoids and subsequent monitoring for changes in bite and facial structure may be suggested.
Degrees of adenoid hypertrophy in children
Modern otorhinolaryngology distinguishes 3 degrees of adenoid proliferation:
- 1st degree: the child’s adenoids are slightly enlarged. Symptoms of adenoids are also insignificant - this means that in daytime the child can breathe freely, but in a horizontal position, during sleep, nasal congestion is heard and difficulty breathing is felt. Children with grade 1 adenoids often sleep with their mouths open.
- 2nd degree: the child’s adenoids are noticeably hypertrophied. A child with grade 2 adenoids tries to breathe through his mouth even during the daytime, and often snores at night.
- 3rd degree: the child’s adenoids practically block the nasopharynx. It is difficult for a child with grade 3 adenoids to sleep at night. Due to lack of sleep and poor access to oxygen, children with this diagnosis quickly get tired and suffer from lack of attention. They find it difficult to concentrate. Headaches may occur. The child constantly keeps his mouth slightly open, which is why, over time, an adenoid type of face may begin to form. Due to the lack of normal ventilation of the nasal cavity, the runny nose becomes chronic, and the voice becomes nasal. Speech may become difficult to understand and slurred.
Unfortunately, parents and pediatricians often see symptoms of adenoids in children only at stages 2-3, when difficulty breathing through the nose becomes clearly visible and treatment becomes somewhat more difficult.
Adenoids in children: photo
We offer detailed photos for viewing of what adenoids look like in children.
Treatment of adenoids in children: general information
If enlarged adenoids are discovered in a child, parents are faced with the acute question of choosing treatment methods. Practicing otorhinolaryngologists usually give a choice between surgical and conservative treatment. Naturally, if it is possible to take a conservative route - without removing the adenoids - this will be the preferable solution. If conservative therapy does not help - or nasal breathing is completely impaired, which interferes with the normal life of a small patient, the question of adenotomy (surgical removal of the adenoids) is raised.
Conservative treatment of adenoids in children is always preferable to surgical intervention. In addition to the stress that the child receives from the very fact of the operation, adenotomy significantly reduces immunity and is accompanied by a long recovery period.
Adenotomy is usually elective surgery, so don’t rush and carry it out immediately. If your treating otolaryngologist recommends adenoid removal, take a break and additional diagnostics, try all the prescribed procedures and conservative treatment methods, consult with other practicing ENT doctors and surgeons who themselves perform adenotomy. Conservative measures often help to avoid surgery and wait for the natural physiological reduction of the adenoids to normal size. If you improve the condition of inflamed tonsils traditional treatment If it doesn’t work, and the chronic inflammatory process in the nasopharynx interferes with normal life, consult additionally with operating doctors - they can give valuable practical recommendations and professionally assess the condition of the adenoids.
Grade 3 adenoids in children - to remove or not?
There is an opinion that the choice is adenotomy or conservative treatment– is based only on the degree of growth of the adenoids: grade 1-2 adenoids can be treated in the traditional way, and grade 3 tonsil hypertrophy is subject to mandatory surgical intervention. This point of view is not entirely correct.
The fact is that even a good otolaryngologist can make a mistake – not in assessing the degree of adenoids, but in prognosis of the clinical situation. Such false diagnosis occurs, as a rule, after a child has recently suffered an illness or against the background of an ongoing respiratory disease - when the inflamed tissue of the tonsils has not yet had time to recover. In this case, the doctor may diagnose “grade 3 adenoids” and recommend immediate adenotomy.
In such a situation, within a month the diagnosis can be removed, when the adenoids return to normal size due to the cessation of the inflammatory process - the child breathes normally, gets sick no more often than his peers and sleeps normally at night.
At the same time, the opposite situation may occur - in some children, due to physiological characteristics adenoids of 1-2 degrees can lead to constant ARVI, chronic otitis and even sleep apnea syndrome. In this case, doctors actually recommend surgical treatment of adenoids.
Also, the famous pediatrician Evgeniy Olegovich Komarovsky will tell you about the situation when adenoids need to be removed, and when it is not recommended:
Conservative therapy and treatment of tonsil hypertrophy in a child
Conservative therapy for adenoids is always complex - the child is prescribed oral and local medications, physiotherapy and, provided the patient has a sufficient level of consciousness and age, breathing exercises.
As a rule, the following drugs are prescribed for the drug treatment of adenoids in children:
- Antihistamines (anti-allergic) - to reduce swelling of the nasopharynx, pain and reduce nasal discharge (orally - Zirtec, Zodak, Suprastin, Tavegil, Erius, Claritin);
- Vasoconstrictor drops and nasal sprays - for the same purpose, to ease breathing and reduce the amount of mucus discharge (Nasonex, Vibrocil, Avamis, Otrivin, etc.);
- Local antiseptics - to cleanse the local microflora from pathogenic bacteria (Aquamaris, Aqualor, Collargol, Protargol);
- Homeopathic remedies are the most gentle drugs with selective effectiveness. They help some patients, but have no effect on others. One of the most effective means– purified thuja oil for instillation into the nose.
- Children's multivitamins to support immunity (“Alphabet”, etc.).
Attention! Topical vasoconstrictor drugs can be used in courses of no more than 5 days. The drug "Nasonex" can be used more prolonged, but it must be taken into account that due to the content of glucocorticosteroids there is a risk of triggering the growth of fungal microflora (Candida).
In addition, when choosing methods for treating adenoids in a child, doctors often tend to carry out procedures in courses of 10 to 15 sessions. This technique shows high effectiveness in combination with medications and in many cases helps prevent adenotomy:
- Washing is a procedure for washing out purulent discharge from the surface of the adenoids. Recommended for use in a medical facility and only by an experienced doctor (at home there is a high risk of driving purulent discharge deeper into the nasopharynx). It is performed using a nasopharyngeal shower or the “cuckoo” method (the solution is injected through one nostril and vacuum is sucked out of the other). The procedure is considered effective, but quite unpleasant for children - it can cause vomiting.
- Laser therapy - in this procedure, a light guide is inserted through the nose into the nasopharynx and laser irradiation is performed to reduce adenoids and improve local immunity.
- Quartzization of the nose and oral cavity, electrophoresis, heating, ultrasound and ultraviolet.
In addition, courses of 5 to 10 dry or wet inhalation procedures are recommended to facilitate nasal breathing and help with coughing. Inhalations, depending on the drug used, relieve swelling, moisturize the mucous membrane, eliminate nasal congestion and have an anti-inflammatory and antiseptic effect.
To generally improve the condition of a child with enlarged adenoids, ENT doctors advise spending more time with children in the fresh air, humidifying the room, and if possible, doing climatotherapy (sea or mountain air, walks in the forest).
Removal of adenoids in children
Adenotomy is surgical or laser removal of inflamed pharyngeal tonsils. As a rule, such an operation lasts no more than 15 minutes. Applicable for children over 7 years old local anesthesia, and surgeons prefer to give general anesthesia to younger patients to minimize the shock and stress of surgery.
Adenotomy is resorted to in extreme cases– even if the doctor recommends scheduling an operation at the first appointment, there is no need to rush without strict indications. Conservative treatment with the help of procedures and medications is more gentle, and surgery, especially under general anesthesia, is a great stress for the body. There are 2 more reasons why today they are trying to replace adenotomy with non-surgical treatment:
- During the period of rapid growth of the child, fragments of the tonsils left during the operation (even a few millimeters) can become inflamed and grow again, which will become an indication for re-treatment or repeated adenotomy.
- The tonsils located in the pharynx are a barrier to deeper penetration of viruses, bacteria and other pathogens, so removal of the adenoids always damages the body's immune defense.
If surgical intervention is unavoidable, they try to plan it for the age of 5-6 years, since before that the child’s active growth phase occurs. The next stage at which adenotomy is recommended is 13-14 years.
At 8-9 years of age, as a rule, hypertrophied adenoids begin to shrink, and often by the end puberty the disease goes away on its own.
Strict indications for adenotomy include:
- relapses of adenoid inflammation more than 4 times a year;
- failure conservative methods treatment;
- manifestations of apnea (stopping breathing during sleep);
- complications due to adenoids in children (rheumatism, arthritis, vasculitis or glomerulonephritis);
- severe nasal breathing disorders;
- regular relapses of otitis media;
- frequent acute respiratory viral infections (the interval between diseases is about 1 week).
In any case, it is worth knowing that adenotomy undermines immune protection body. Therefore, while the role of the protective barrier, which the tonsils performed before the operation, is compensated by the immune system, the child will have to for a long time carefully protect from possible sources of infection. Kindergarten, school and public places It is recommended not to visit for 2-4 months (depending on the patient’s condition), and to avoid hypothermia and prolonged exposure to the sun for at least 1 month after surgery.
In addition, the postoperative period is accompanied by drug therapy to accelerate healing and reduce the risk of inflammatory processes:
— use of antibiotics (“Flemoxin Solutab”, “Ampicillin”, “Augmentin”) + means to maintain intestinal microflora;
- vasoconstrictor drugs - topically, in the form of drops or nasal spray (“Sanorin”, “Naphthyzin”, “Nazol” for 5 days);
- taking anti-inflammatory drugs (based on ibuprofen);
- use of antihistamines (antiallergic drugs) according to age recommendations.
Strict contraindications to adenoid removal are blood diseases and acute period infectious diseases.
Surgical removal of adenoids is not the most pleasant procedure, so it is resorted to in case of emergency. For children under 7 years of age, the operation is performed under general anesthesia to avoid stress and additional damage if the child begins to twitch during surgery. At the same time, many doctors do not recommend performing adenotomy at all before 5-6 years of age, if the patient does not have apnea syndrome ( sudden stop breathing during sleep) or deformation of the facial part of the skull according to the adenoid type (“adenoid face”).
In modern medical practice, it is possible to perform adenotomy using a laser device. The advantages include minimal blood loss and less pain.
A situation where several experienced otorhinolaryngologists give different recommendations The question of whether to remove the adenoids or wait is encountered everywhere in practice. Therefore, it is important to consult with several specialists, undergo all prescribed therapeutic procedures, including laser treatment and lavage, show the child to a practicing adenotomy surgeon - and only then make a decision about surgical intervention.
Adenoids in the nose - treatment: general principles
Having heard a diagnosis of “adenoids” from an otolaryngologist, parents are primarily interested in what it is and how to treat them in their child. Adenoids are a collection of lymphoid tissue that forms the basis of the nasopharyngeal tonsil. They perform the function of protecting the child’s body from microbes, viruses, bacteria and other pathogens - that is, from infections. In case of ARVI, colds or exacerbation of allergies, the volume of lymphoid tissue increases - as a protective measure. After the end of the disease, the adenoids gradually return to normal - this process can take up to several weeks. Therefore, in order to avoid false diagnosis, the otolaryngologist should diagnose “adenoids” only in a healthy child, after full recovery from infection and completion of the rehabilitation period.
Due to the fact that adenoids are purely age phenomenon, which first appears at 3-7 years of age and fades away by late adolescence, doctors prefer the term “adenoid vegetations.” Cases of overgrowth of adenoids in adults practically do not occur.
Treatment of adenoid vegetations comes down to 2 main methods: removal of adenoids or conservative therapy. Even with the growth of adenoids to degree 3, conservative treatment is preferable, since surgical intervention (adenotomy):
- is a great stress for the body and weakens the immune barrier;
- for children under 7 years old at this stage it is carried out under general anesthesia;
- does not exclude the need for repeated adenotomy in case of new growth of lymphoid tissue of the tonsils;
- like any surgical intervention, it has a negative impact on psychological state child.
Symptoms of adenoid vegetations
Symptoms of adenoid vegetations can be general (the disease affects the condition of the entire child’s body) and local.
Parents often mistake the general symptoms of adenoids in the nose in children for individual behavioral characteristics and age-related changes, not requiring special treatment. A child suffering from enlarged adenoids may become lethargic, uninitiative, whiny, unable to concentrate - or, on the contrary, irritable and aggressive. Such children have a hard time studying and developing activities, they get tired quickly and may lag behind their peers in terms of performance. physical development. All of these symptoms are a consequence of a constant lack of oxygen and bad sleep which arise due to adenoid vegetations.
Local symptoms of adenoid vegetations, as a rule, attract more attention from doctors and parents:
- complicated nasal breathing and, as a result, the habit of breathing through the mouth;
- mouth slightly open during sleep outside the period of ARVI;
- snoring and snoring during sleep;
- nasal congestion and constant runny nose;
- hearing impairment;
- frequent otitis media;
- change in voice timbre (nasality);
- nocturnal paroxysmal cough;
- formation of an adenoid type of face with long-term illness and lack of therapy.
Depending on how enlarged the tonsils are, there are 3 degrees of adenoid vegetations:
- at grade 1, the lumen of the choanae (the opening for oxygen supply) is blocked by one third (1/3);
- at grade 2, the lumen of the choanae decreases by two thirds (2/3);
- at grade 3, the lumen of the choanae is almost completely closed, which is why the child is unable to breathe through the nose.
A typical sign of the growth of adenoids to degrees 1 and 2 is a prolonged runny nose after the end of an acute respiratory viral infection or other infection. This kind of runny nose is usually difficult to treat. With an increase in adenoids to degree 3, all of the above symptoms appear more clearly.
Treatment of adenoid vegetations
The question of how to treat adenoids is decided by the otolaryngologist individually - depending not only on the degree of adenoid vegetations, but also the general condition and age of the patient, existing complications (otitis, arthritis, rheumatism, etc.) and the presence of apnea syndrome.
Apnea is a sudden stop in breathing during sleep. The phenomenon is very dangerous and can be fatal, therefore, in the presence of this syndrome, many experts recommend adenotomy - removal of the adenoids.
With absence dangerous complications or apnea syndrome, most specialists prefer conservative treatment - a combination of drug therapy, physiotherapy, nasal lavage, laser treatment and homeopathy. For grade 1 and 2 adenoids, conservative treatment almost always helps, but this does not mean that grade 3 adenoids must be removed.
Firstly, the condition of a small patient with grade 3 adenoid vegetations can be significantly alleviated until the period when the mechanism of independent reduction in the volume of the tonsils works - usually this happens before the end of puberty or during middle school age. Secondly, grade 3 adenoids are also amenable to conservative therapy - it’s just that the set of procedures for this diagnosis is larger, and courses of treatment are repeated more often.
If conservative treatment does not help for a long time, and the child’s general condition continues to deteriorate, the ENT doctor will suggest considering the option of adenotomy.
Complication of adenoiditis
Hypertrophied tonsils not only affect general condition child and interfere with normal breathing and sleep. Otolaryngologists indicate what complications enlarged adenoids can cause in the absence of therapy:
- increase in frequency respiratory diseases up to 10-12 times a year and their course is more severe;
- chronic form of adenoiditis;
- problems with speech (slurriness, nasality);
- frequent otitis media and the likelihood of hearing impairment;
- development of sinusitis at school age;
- the occurrence of anemia due to oxygen starvation;
- deterioration in school performance;
- constant irritability and worsening behavior;
- formation of an inert style of behavior;
- deformation of the facial bones of the skull (“adenoid face”).
Prevention of adenoids
The proliferation of adenoid tissue often occurs during periods of:
- active growth of the child;
- frequent diseases with viral and bacterial infections;
- when in unfavorable climatic or social conditions.
To date, the following measures for the prevention of adenoids have been recognized as effective:
- strengthening the immune system and hardening: walks in the fresh air, physical activity according to age, inclusion of fruits, berries and vegetables in the diet or, in their absence, multivitamin complexes;
- complete treatment (and “follow-up treatment”) of bacterial and viral infections, colds, etc.;
- oral care and treatment of caries even in baby teeth.
Adenoids are serious pathology, which requires timely treatment. Don't ignore your child's nasal congestion. With proper therapy, adenoids can be easily managed. But if you have a third degree of enlarged adenoids, do not be afraid of surgery, this will help the child live again normal life. The most important thing is to find good doctor, to whom you can entrust the most important thing – the health of your baby.
Adenoiditis is an inflammatory process in the nasopharyngeal tonsil (adenoid), which leads to its hypertrophy. Most often, the pathology is diagnosed in 5-8% of children aged 3 to 10 years. It is important to notice and eliminate inflammation in time, since chronic adenoiditis in children can subsequently lead to frequent diseases of the ENT organs, deformation of the facial skull, speech impairment and other pathologies.
The nasopharyngeal tonsil is a tubercle consisting of lymphatic tissue covered with stratified ciliated epithelium, which secretes mucus. Normally, the nasopharyngeal tonsil is not visible without special optical instruments.
Classification of adenoiditis
Depending on the severity of the inflammatory process, the following forms are distinguished:
- spicy. This form is inherent catarrhal symptoms in the area of the nasopharyngeal tonsil. Acute adenoiditis in children develops against the background acute infections respiratory tract caused by both viruses and bacteria. In terms of duration, the acute form corresponds to the duration of ARVI, and on average is about a week;
- subacute Lasts more than three weeks, accompanied by low temperature(up to 38°C) and inflammation is observed not only in the nasopharyngeal tonsil, but also in other structures of the lymphatic ring. The inflammatory process in a subacute form often develops in children who already have hypertrophied tonsils;
- chronic. It is characterized by a long course of over six months. Not only the adenoids suffer, but also nearby organs, so the symptoms of adenoiditis are often accompanied by signs of diseases of the ENT organs and respiratory tract: bronchitis, laryngitis, otitis, sinusitis.
According to the nature of the lesion in the chronic form of adenoiditis in children, the following varieties are distinguished:
- catarrhal type of inflammation;
- exudative-serous;
- purulent.
A separate form in this list is the allergic form of adenoiditis, which develops in combination with allergic symptoms due to the body’s increased susceptibility to any of the factors external environment. Often, apart from allergic rhinitis, children will not be bothered by other symptoms.
According to criteria based on assessing the size of the nasopharyngeal tonsil and the degree of nasal breathing impairment, the following degrees of hypertrophy are determined:
- 1st degree: enlarged tonsils cover one third of the bone of the nasal septum or the general cavity of the nasal passages;
- 2nd degree: the adenoid covers half of the bony part of the nasal septum;
- 3rd degree: the adenoid occupies two-thirds of the bony part of the nasal septum along its length;
- Grade 4 is characterized by impaired nasal breathing due to almost complete covering of the nasal passages by adenoid growths.
What factors cause adenoiditis in children
The immediate cause of the development of the inflammatory process is pathogenic microorganisms: bacteria (Staphylococcus aureus, streptococcus), viruses and fungi. Factors predisposing to the disease are the following problems:
- the child has exudative-catarrhal or allergic diathesis;
- a decrease in the body’s defenses, which is caused by lack of breastfeeding, an unbalanced diet consisting mainly of carbohydrate foods, as well as common underlying diseases, such as rickets, hypovitaminosis or gastroesophageal reflux;
- harmful environmental factors. A big role among them belongs to dry and warm polluted air, as well as the lack of ventilation of the room in which the child resides;
- frequently recurring rhinitis and inflammatory diseases of the respiratory tract. According to Dr. Komarovsky, it is untreated acute respiratory viral infections that most often become the cause of chronic adenoiditis in a child.
Signs of an acute form of the disease in a child
Acute adenoiditis in children begins against the background of symptoms of infection of the upper respiratory tract and is accompanied by an increase in body temperature to 38-39 ° C, general intoxication of the body (weakness, fatigue, loss of appetite), as well as discomfort or pain when swallowing.
Adenoids - School of Dr. Komarovsky
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Treatment regimen for stage I-III adenoids in children.
Adenoids. Non-surgical treatment of adenoids. ENT doctor Tkach Yuri Nikolaevich
Local inflammation may be purulent or catarrhal in nature. So, with catarrhal acute adenoiditis, the child will complain of both nasal congestion and runny nose, hearing loss, and hoarseness of the voice. The formation of mucus that flows down the back wall of the throat, leading to paroxysmal coughing.
Parents can independently note the presence of snoring during sleep, as well as a painful enlargement of the submandibular lymph nodes. With the development of a purulent form of adenoiditis, the discharge from transparent turns yellow-green with an unpleasant odor. The duration of catarrhal adenoiditis is on average about a week, and purulent adenoiditis can last up to 20 days.
In children under one year of age acute inflammation nasopharyngeal tonsil is rare, however, if this happens, the disease is accompanied by severe intoxication, refusal to eat due to nasal congestion, belching and dyspeptic symptoms. Acute adenoiditis is contagious to other children, which is associated with ARVI. Take this into account and limit the sick child’s contact with other children.
Symptoms of the disease
The disease is considered chronic if it lasts more than one month or if its episodes occur more than three times a year. Characteristic features If the disease has become chronic, parents will complain:
- runny nose with liquid discharge from the nose, mucous or purulent in nature;
- cough with sputum production, which is more common in the morning or at night. This is caused by obstructed flow of mucus through the nasal passages;
- difficulty breathing through the nose. Manifests itself as snoring or loud snoring during sleep. For the same reason, the child will have a nasal voice and a constantly open mouth;
- discomfort in the nasopharynx. Range discomfort varies from slight soreness to severe pressing pain without its exact location. Discomfort becomes pronounced during the act of swallowing;
- increase in body temperature. For chronic form characterized by a gradual increase in temperature with other symptoms of adenoiditis.
With a long course of the disease, the so-called “adenoid face” is formed: smoothed folds of the nasolabial triangle, increased salivation, deformation of the facial part of the skull, malocclusion, phlegmatic facial expression. The problems accompanying chronic adenoiditis concern not only the physical, but also mental development child. Because the child becomes inattentive, indifferent, gets tired quickly and does poorly at school.
Diagnosis of acute and chronic forms of adenoiditis
Diagnosis of adenoiditis is carried out by an otolaryngologist, who, based on medical history, examination, anterior and posterior rhinoscopy, will determine the degree and nature of the disease, which is necessary to select a treatment regimen. If the inflammatory process is triggered by an allergen, then an allergological study will be required.
In addition, to evaluate the function auditory tube Acoustic impedance testing will be required. If a child or his parents complain of hearing loss, the doctor will conduct audiometry and otoacoustic emissions.
From laboratory research, which are of secondary importance for this disease, is relevant serological analysis blood, helping to determine the nature of the infectious agent of the disease.
How is acute adenoiditis treated?
Treatment of acute adenoiditis in children is carried out in combination with ARVI. Do not forget that the child must be cured completely in order to prevent complications in the form of chronic adenoditis or adenoids. The treatment plan includes local and general events. So, what needs to be done for local treatment:
- rinse. As a local effect on the inflammatory process, according to the recommendations of Dr. Komarovsky, rinsing the nose with an isotonic solution of salt water (Humer, Marimer, Aqualor) has a good effect. Such manipulation will not only physically help wash away microbes from the mucous membrane, but also has some anti-inflammatory effect, increases local immunity and promotes the active functioning of the villi of the ciliated epithelium. Alternatively, rinsing can be done with decoctions of medicinal herbs. In folk medicine, infusions based on anti-inflammatory herbs are used: chamomile, St. John's wort, coltsfoot, string and calendula;
- drip. Vasoconstrictor drugs are used in the form of drops or sprays (Nazol, Galazolin, Rinostop) - they will make it easier for the child to breathe and relieve swelling of the mucous membrane. As etiotropic therapy, local antibiotics are used in the form of aerosols - Bioparox, Polydex, Isofra. Some pediatricians practice the use of Albucid drops in children early years, which is associated with the wide antibacterial spectrum of action of this drug. To reduce the irritating effect of Albucid, it is recommended to dilute it with boiled water 1:1 and drip 2 drops 3-4 times a day.
Used for general treatment antihistamines(Diazolin, Claritin, Zodak), in the presence of an infectious process caused by bacteria - systemic antibiotics (Azithromycin, Amoxicillin). As aids use physiotherapy - electrophoresis, tube quartz, phototherapy and homeopathic medicines– Sinupret, Lymphomyosot.
Treatment of chronic adenoiditis in children
Just a few years ago, the treatment of chronic adenoiditis in children consisted of surgical removal of the tonsils. Now the aesculapians have reconsidered their attitude to adenotomy, taking into account the important protective function lymphatic ring, and established a clear list of indications for surgery. This includes: grade 2 hypertrophy, the presence of episodes of sleep apnea, as well as concomitant chronic purulent otitis media.
The option of surgical treatment is also considered if 1-2 courses of drug treatment are ineffective, if disorders appear in the nervous system, often repeated exacerbations of purulent adenoiditis, which is complicated by sinusitis, sinusitis or inflammation of the respiratory tract.
Two approaches are used to perform adenotomy. One of them, partial adenotomy, involves partial removal of the tonsil, which ensures patency of the nasal cavity and preservation immune function tonsils. The second method, adenectomy, is based on the complete removal of the pharyngeal tonsil. The method by which adenoiditis in children will be treated should be chosen by the doctor, taking into account the advantages of the methods, the degree of the disease and the condition of the child.
Conservative treatment of adenoiditis in children does not have strict standards and is carried out comprehensively, taking into account all aspects of the occurrence and development of the disease. The main directions of drug treatment of the chronic form are carried out similarly to acute adenoiditis.
Prevention of adenoiditis in a child
To prevent acute forms of adenoiditis and exacerbation of the chronic process, all factors leading to the disease should be taken into account.
- Firstly, parents need to provide comfortable conditions in the room where the child is: humidified cool air will the best prevention adenoiditis and ARVI.
- Secondly, it is recommended to introduce the child to a healthy lifestyle - all types are suitable physical activity involving prolonged exposure to fresh air.
- Thirdly, teach your child to rinse his nose saline solutions every day, rinsing your mouth after meals and brushing your teeth.
Preventing the disease now is better than long and painful treatment of the disease in the future!
Adenoiditis is a disease in which inflammation and proliferation of the nasopharyngeal tonsil (adenoids) occurs. In the vast majority of cases, the disease affects children 3-7 years of age.
If you allow adenoiditis to progress to chronic stage, this can lead to kidney disease, heart defects, rheumatism, disease of organs related to digestive tract etc.
There are two forms of adenoiditis:
- Acute adenoiditis is the rapid development of inflammation of the pharyngeal tonsil as a result of infection (viral or bacterial)
- Chronic adenoiditis is a prolonged inflammation of the adenoids, in which the body temperature may remain within normal limits. In this case it is observed:
- Drainage of mucus on the back wall of the nasopharynx
- Runny nose
- Nasal congestion
- Cough
- Possible hearing loss.
Causes of adenoiditis
Adenoiditis in children develops in the following cases:
- The presence of adenoids, i.e. pathologically enlarged pharyngeal tonsil
- ARVI disease:
- Upon contact with carriers of this disease
- As a result of hypothermia
- Reduced immunity
- Against the background of the following infectious diseases:
- Scarlet fever
- Whooping cough
- If you have the following risk factors:
- Chronic infections (chronic tonsillitis)
- Living in unfavorable environmental conditions
- Poor nutrition:
- Monotonous food with a lot of carbohydrates
- Lack of fresh vegetables and fruits in the menu
- Insufficient intake of vitamins into the body
- Bad habits (smoking)
- Tendency to allergies
- Artificial feeding
- Rickets
Symptoms of adenoiditis
At acute adenoiditis characteristic symptoms are:
- Mucopurulent discharge from the nasopharynx, visible during examination
- Moderate redness of the posterior pharyngeal wall, visible upon examination on the third day from the onset of the disease
- Swelling of the posterior palatine arches
- Feeling of slight pain and rawness in the depths of the nose during swallowing
- Nocturnal paroxysmal cough
- Difficulty in nasal breathing, runny nose
- Increased body temperature
- Hardware examination reveals an enlarged and reddened tonsil, filled with detachable grooves.
Quite often, acute adenoiditis is accompanied by hearing loss due to the involvement of the Eustachian (auditory) tube in the inflammatory process. The pain in the ear on the affected side is quite severe, with the discharge of pus.
Chronic adenoiditis develops as a result of acute inflammation of the adenoids.Its symptoms:
Treatment of adenoiditis
To restore normal nasal breathing, it is necessary to instill vasoconstrictor drops into the nose 3 times a day, which helps relieve swelling of the mucous surface and improve airway patency.The most popular means are:
- Xylene
- Galazolin
- Vibrocil
- Naphthyzin
- Sanorin, etc.
It is important to remember that the use of vasoconstrictor drugs should be limited to 6-7 days, because longer use of them can lead to drying and thinning of the nasal mucosa.
Before instilling drugs, you should clear your nose of mucus and crusts that have formed. Older children usually blow out the mucus on their own; little ones need to do this with a special rubber balloon.
A few minutes after using vasoconstrictors, the nose is cleaned again and antibacterial or antiseptic drugs are instilled:
- Albucid
- Protargol
- Bioparox
To treat chronic adenoiditis, the doctor prescribes antiallergic (antihistamine) drugs:
- Tavegil
- Claritin
- Suprastin
- Diazolin
- Pipolfen
Other conservative methods are also used to treat the disease:
- Special breathing exercises
- Prescription of antiviral medications (for ARVI)
- Phytotherapy
- Physiotherapy:
- Ozone therapy (antibacterial and antiviral effect)
- Laser therapy (relieving inflammation, improving blood circulation)
- Vitamin therapy. The following multivitamin preparations are used:
- Vitrum
- Multi-tabs
- Jungle, etc.
- In some cases, immunocorrective and desensitizing therapy is performed
- Systemic antibiotics for severe disease or the onset of various complications
- Cocoa
- Chocolate
- Nuts
- Strawberry
- Seafood
- Citrus
- Sweets
In cases where conservative treatment of adenoiditis in children has not led to the desired result, the doctor may refer you to surgical treatment, the purpose of which is to remove the adenoids.
The indications are:
- Frequent acute respiratory infections
- Chronic otitis media and/or sinusitis
- Development exudative otitis media which can cause hearing loss
- Inability to breathe freely through the nose
- Stopping breathing (apnea) during sleep
- Adenoid type of development of facial deformation:
- Open mouth
- Skull deformation
- Malocclusion
- Excessive visibility of gums and upper teeth
- Rapid progression of the disease
The operation can be performed in two ways:
- Traditional
- Endoscopic
The preferred method for removing adenoids is endoscopic, because... at traditional way the surgical area is poorly visible to the surgeon, and therefore incomplete removal of the adenoids is possible, which can lead to relapse of the disease.
Endoscopic adenotomy is performed under general anesthesia, its duration usually does not exceed one hour. After the operation, there may be an increase in body temperature, nasal congestion, as well as swelling of the nasopharyngeal mucosa may be observed for a week.
Prevention of adenoiditis
It boils down to this:
- Timely treatment of colds and respiratory infections
- Visit a doctor in a timely manner when the first symptoms of adenoiditis appear in children (snoring, sleeping with your mouth open, frequent nasal congestion)
- Nasal hygiene (rinsing with saline solutions) during epidemics of ARVI and influenza
- Hardening
- Taking vitamins and local immunomodulators in the winter season
- Balanced diet
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