Treatment for adenoiditis in children

Posted on by admin

How to treat adenoids in a child: advice from a pediatrician

One of the most common diseases of the ENT organs that occur in children is adenoids. How to treat the pathology of the nasopharyngeal tonsils at home, if you simply cannot notice them with the naked eye?

Table of contents:

Indeed, without consultations and regular monitoring by a specialist, the disease cannot be overcome.

On average, the age of patients susceptible to this disease ranges from 1-15 years. At the same time, children of kindergarten age are most often brought to the doctor with inflamed tonsils, and over the past ten years there has been a tendency to diagnose the disease in children under three years of age.

Adenoids: disease or normal?

Before you understand how to treat adenoids in a child, you should pay attention to the various causes of this condition, which, in fact, cannot be called a disease. Many people do not know, but adenoids and tonsils are the same organs that perform immune functions. Being “guards” standing at the entrance to the respiratory tract, they prevent pathogenic microorganisms or harmful substances from entering the lungs. The enlargement of the tonsils is a local response of the body, defending itself from the attacks of pathogenic viruses, bacteria, exhaust gases, chemical compounds in the air, etc. This is not a pathology; on the contrary, the development of adenoids is an indicator of the normal functioning of the immune system. In addition, in childhood (up to approximately 7 years), the activity of the tonsils is increased, which also should not cause serious worries.

Causes and symptoms of adenoiditis

However, not all parents have to deal with this phenomenon and learn how to treat adenoids in children. Children who suffer from frequently enlarged tonsils, in most cases, have a genetic predisposition to the disease or constitutional features of the nasopharynx. And since the disease proceeds with minimal severity, or even its absence, contacting a doctor is postponed indefinitely. Enlarged tonsils do not cause an increase in body temperature, cough and runny nose may also be absent. As the adenoids develop, the child will feel discomfort when swallowing. But the problem of diagnosing the pathology is that children of early preschool age, who are included in the largest risk group for the disease, are not able to recognize the symptoms in themselves and report them to their parents. It is necessary to show your child to a doctor who will tell you whether there is a problem and how to treat adenoids correctly if the following signs occur:

  • the baby has difficulty breathing through his nose;
  • most often his mouth is open, especially during sleep;
  • absence of a runny nose or, conversely, long-term, non-treatable rhinitis.

It is quite logical to ask why then treat adenoids, if their enlargement is a normal protective reaction of the body. The tonsils produce lymphocytes that are so necessary for destroying microbes. But the need to treat adenoids is usually caused by their intensive growth, which can cause serious discomfort to the child. In advanced cases, when enlarged tissues close the lumen of the nasopharynx, children may develop hearing, breathing, and swallowing problems. In the absence of adequate therapeutic measures, adenoid vegetation threatens the child with bite deformation, changes in facial shape, development of speech defects, and even changes in the chemical composition of the blood.

Adenoid removal surgery: indications and contraindications

How to treat adenoids in a child 3, 7 or 15 years old? In all cases, there are only two options: surgically for the third degree of the disease or non-surgical. Adenoids in the early stages are treated with medication.

Removing adenoids causes fear not only among children, but also among parents. In any case, the decision to intervene with a surgeon must be made by the attending physician. Most often, adenotomy is resorted to when the life activity of a child with overgrown formations is problematic. In the chronic form of the disease (adenoiditis), on the contrary, it is recommended to treat the adenoids without surgery. As a rule, indications for removal of enlarged tonsils are frequent acute respiratory viral infections, otitis media, and relapses of the inflammatory process in the nasopharynx (at least once every three months). Surgery may be the only option if conservative treatment is ineffective, there are serious problems with nasal breathing, even if it stops during sleep.

In addition, before surgically treating adenoids in a child, it is important to ensure that there are no contraindications. Adenotomy is not performed in the following cases:

  • presence of blood and cardiovascular diseases in childhood history;
  • cold or respiratory illness;
  • spread of the influenza epidemic.

In addition, removal of inflamed tonsils cannot prevent the regrowth of adenoid tissue. To trigger a relapse, the slightest insignificant part of the adenoid left by the surgeon is enough. After removal of tissue in the nasopharynx, the likelihood of bleeding increases, so for several days after the intervention it is important to limit the physical activity of the small patient and minimize his exposure to the sun or in a stuffy room.

Before treating adenoids in a child at home, you should consult a doctor. The specialist must systematically examine the patient in order to monitor compliance with medical prescriptions. There are many ways to combat adenoiditis in children without surgery. Below are the most popular and effective ones.

What is the best way to rinse your nose?

Regardless of the severity of the disease, it is important to regularly rinse and moisturize the nasal passages. Performing this procedure makes breathing easier, but it can be done no more than 4-5 times during the day. To rinse a child’s nose, use saline solutions, which are sold in pharmacies or prepared independently at home. The preparation scheme is simple: 1 teaspoon of sea or table salt per 1 glass of warm boiled water. However, for treating a child, pharmaceutical nasal medications are more preferable. Their advantages:
  • one hundred percent sterility;
  • correct concentration (to treat nasal adenoids in a child, as a rule, 0.67 percent saline solutions are used - it is impossible to maintain such a proportion at home).

Among the drugs that are successfully used in the treatment of adenoids in children, it is worth noting:

Advice about rinsing the nasal passages with a douche or syringe is completely incorrect. It is impossible to listen to them if parents do not want to increase the risk of developing otitis media. That is why it is not recommended to rinse the nose of children under 7 years old with such devices. For infants and children under three years of age, it is advisable to moisturize the mucous membrane with a saline solution by drip. After three to four years, priority should be given to drugs in spray form. Only when the child learns to independently blow mucus from the nose can the Aquamaris or Dolphin systems be used for more effective rinsing.

Vasoconstrictors and antibiotics

For enlarged tonsils of the second degree, the use of vasoconstrictor drugs is added to moisturizing the mucous membrane and rinsing the nose, which will restore full breathing and eliminate swelling. Among the many drugs of this pharmacological group, children are especially often prescribed:

It is worth noting: vasoconstrictor nasal drops and sprays cannot be used for longer than 5-7 days. This rule applies not only to the treatment of adenoids, but also to any other diseases of the upper respiratory tract in children and adults. Such medications are addictive, which can cause the development of chronic rhinitis.

In addition to vasoconstrictor drops, other nasal medications are also used for second-degree adenoids (for example, Albucid, which has an effective bacteriostatic effect on the nasopharyngeal mucosa). In case of complications or after surgery to remove tonsils, patients are prescribed antibiotics from the amoxicillin group:

Drugs for the treatment of adenoids

On an individual basis, doctors can prescribe additional medications and give parents individual recommendations on how to treat adenoids in children. Komarovsky E. O., a well-known pediatrician, does not recommend starting therapy for adenoids with hormonal drugs from the first days. Such drugs have a number of contraindications, and therefore they are prescribed with caution to patients at any age. Most of them contain dexamethasone, which helps to quickly relieve symptoms even with a prolonged course of the disease. However, steroid medications are addictive and cause side effects. Children are often prescribed Sofradex - it is dripped into the nose for 7 days, after which it is recommended to switch to a course of inhalations.

Having enough experience and knowledge on how to treat adenoids in children without surgery, ENT specialists sometimes prescribe the silver drug “Protargol” to the child. This remedy has been popular among doctors for decades. The principle of action of Protargol nasal drops is to dry the surface of enlarged tonsils and gradually reduce their size. This drug is recommended for use in case of bacterial infection. Unlike hormonal drops, the duration of treatment with Protargol does not have strict restrictions.

Another remedy that is used to treat adenoids in a child is Lymphomyosot. It is also available in the form of drops, however, unlike the drugs described above, it is used sublingually (i.e. under the tongue) for a certain time before meals. It is not recommended to mix this drug with large amounts of liquid. The dosage depends on the age of the child and the weight of the child.

Using hydrogen peroxide for sore tonsils

There are other ways to treat adenoids in patients of a younger age group. At home, you can use the simplest, but no less effective remedy - hydrogen peroxide. It has antiseptic, bactericidal and disinfectant effects. To prepare the medicine, you will also need other components (baking soda and calendula tincture). Everything is thoroughly mixed, and the resulting mixture is dripped into the child’s nose. The procedure is carried out three times a day for 1-2 weeks. By the way, you can replace hydrogen peroxide with “Chlorhexidine” or “Miramistin”.

Additional measures for treating the disease

In combination with conservative treatment of adenoids, physiotherapy will give an excellent result. To make the child’s breathing easier, a course of procedures is prescribed:

It is believed that the Crimea and the Caucasus have ideal climatic conditions for adenoiditis in children. An annual stay in these resort regions with the purest mountain air will only benefit the baby. At the same time, we must not forget about dietary restrictions. The diet of children should consist of fresh vegetables, fruits, and dairy products. Minimize, and if possible eliminate, preferably baked goods and confectionery products.

Aromatherapy is another way in which adenoids are treated for children. Reviews about it are contradictory. Negative effects from the procedure most often occur due to parents’ ignorance of their child’s inclination to a particular product. If the baby does not have a pathological reaction to the oils presented below, you can safely instill any of them into the nasal passages. You can verify the safety of treatment using a simple allergy test (test on the back of your hand). If there is no reaction, then the following essential oils are suitable for therapy:

You can drip your nose with one of the oils or a mixture of them. In the latter case, it is important to make sure that there is no allergy to any of the components.

Let's learn to breathe through our nose!

To treat adenoids in children, they resort to massage of the collar area, which improves blood flow to the vessels and tissues of the nasopharynx. In addition, the child’s ability to breathe correctly plays an equally important role. To teach a child to breathe correctly, before a night or daytime sleep, his lower jaw is tied with an elastic bandage, which will prevent him from opening his mouth and forcing him to take in air through his nose. This should be done until the child begins to sleep with his mouth closed without a retainer.

Knowing how to treat adenoids at home with the help of medications, many forget about breathing exercises. Of course, not all kids will be able to do the exercises. But there is nothing complicated in such training. It is enough just to interest the child, give the therapeutic event a playful form, and everything will certainly work out. Before you begin, the main thing is to clear the child’s nose of mucus. The simplest exercises:

  1. We close one nostril, and at this time it is necessary to take 10 deep breaths and exhalations with the free one. Then repeat the procedure, changing half of the nose. It is advisable to practice with your baby in the fresh air.
  2. We also close one nostril, for example, the right one. When you are free, you need to inhale and hold your breath for a few seconds. Then close the left nostril, release the right one and exhale. Repeat 10 times.

We treat adenoids in children with folk remedies

Alternative medicine is considered no less effective in the fight against adenoiditis. Folk remedies are completely safe for children if they do not contain components to which the child is intolerant. Among the means that have been actively used for a long time, the most effective are:

  • Sea buckthorn oil. It relieves inflammation and moisturizes the nasopharyngeal mucosa. Before nasal use, it is advisable to warm the bottle of oil in your hand or in a water bath. Duration of the course – days.
  • Beetroot juice with honey. The mixture has an antiseptic and drying effect. To prepare the drops, you need the juice of one raw beet and a couple of teaspoons of honey, after complete dissolution of which the product is considered ready for use.
  • Eucalyptus infusion. Helps restore respiratory function and prevents the proliferation of pathogenic microflora. The infusion is prepared from eucalyptus leaves in the following ratio: 2 tbsp. l. raw materials used: 300 ml of boiling water. After an hour of infusion and straining, gargle several times throughout the day.

A specialist will help you make an informed decision about how to treat adenoids, with folk remedies or pharmaceuticals. Only if you unquestioningly follow the recommendations of the ENT doctor will it be possible to rid the child of the disease without surgery.

Source: http://www.syl.ru/article/345115/kak-lechit-adenoidyi-u-rebenka-sovetyi-pediatra

How to treat adenoids in a child?

Adenoiditis (adenoid growths) is a bacterial inflammation of the nasopharyngeal tonsil, an increase in its size, leading to difficulty breathing, purulent mucous discharge from the nose and even snoring.

Most often, adenoiditis appears in children aged three to seven years and curing it, especially when it is not noticed immediately, can be extremely difficult.

What are adenoids?

In a normal state, adenoids are lymphoid tissue in the nasopharynx, an immune organ that produces immunoglobulins, and they, in turn, neutralize viruses that enter the body.

With healthy development in children, from about 8-9 years old, the adenoids begin to gradually decrease in size, and over the years they atrophy, having fulfilled their function.

Symptoms of adenoiditis

The presence of inflamed tonsils in a child is a sure sign that the immune system is sounding the alarm.

The disease can be identified in a timely manner by the following symptoms:

  • the child breathes through his mouth;
  • nasal breathing is difficult;
  • nasality appeared in the voice;
  • snore;
  • sniffling.

The child may not have a runny nose.

Stages of adenoiditis

Depending on the proliferation of inflamed tonsils, adenoiditis is divided into three degrees:

  1. The swelling covers approximately a third of the nasopharynx, while the child’s breathing is free, there are no hearing impairments, and breathing discomfort occurs only during sleep.
  2. Swelling closes about half of the nasopharynx, hearing deteriorates, breathing during sleep becomes difficult, and snoring appears.
  3. The adenoids cease to perform immune function, swelling completely blocks the nasopharynx, breathing and hearing are severely impaired.

If no measures are taken in the first stages of the disease in children, inflammation will spread not only to adjacent organs, but also to all systems of the body.

Possible complications of the disease

What changes and complications can occur if adenoids are not treated:

Chronic and purulent otitis media

The tonsils are located in close proximity to the Eustachian (auditory) tube, as a result, inflamed adenoids block the mouth of the auditory canal, and the child begins to hear worse).

Infections

In an inflamed state, the adenoids cease to perform their protective function, after which the pharynx becomes an ideal environment for the activity of viruses and microbes. Infections weaken all body systems and contribute to the emergence of chronic infectious and allergic diseases.

Frequent colds

Mucous secretions in the nasopharynx are a protective reaction of the body; pathogenic bacteria are eliminated with them. With adenoiditis, the outflow of mucus is difficult, which creates favorable conditions for the development of colds.

Children with inflamed adenoids often get sick, and their recovery periods are short-lived.

Anemia

With frequent breathing through the mouth, the chest begins to develop incorrectly, which leads to anemia.

Reduced performance

Due to difficulty breathing, the child’s body does not receive about 15-20% of oxygen, resulting in oxygen starvation, which negatively affects the functioning of the brain.

Children with adenoids suffer from increased fatigue and are less attentive in class.

Speech disorders

Inflamed tonsils negatively affect the development of the facial bones of the skull and teeth; in science there is even a term: “adenoid type of face.” Due to irreversible structural changes, the child’s speech becomes defective, he stops pronouncing some sounds, has a nasal sound, and speaks through his nose.

It is very important to notice signs of speech impairment in time, since parents often get used to the child’s incorrect articulation and consider it normal.

Respiratory system diseases

Mucus accumulated in the nasopharynx descends into the respiratory tract, causing various inflammatory processes: rhinitis, laryngitis, pharyngitis, bronchitis, tracheitis.

Diagnosis of adenoiditis

Adenoids cannot always be seen with the naked eye; their inflammation can only be reliably diagnosed by an otolaryngologist using an X-ray of the nasopharynx or endoscopy.

At the moment, endoscopy (examination of the nasopharynx using a rhinoscope, i.e. a special camera) is the most accurate diagnostic method and is safe even for the smallest children. There is also an old and still popular method: a special mirror placed in the oral cavity.

How to treat inflamed adenoids?

Surgery to remove tonsils

The practice of removing tonsils remains quite common, but modern experience in the treatment of adenoids has recognized this practice as outdated.

Why is removal considered an outdated treatment method?

The reasons for this conclusion are as follows:

  1. Tonsils cannot be completely removed, as the tissue tends to regenerate.
  2. The operation does not solve the problem (it is not the cause of the disease that is eliminated, but the consequence, the symptom); repeated removal is often required.
  3. Adenoids are a natural barrier to the penetration of viruses into the body (doctors say that when adenoids are removed at the age of 3-5, children begin to get sick much more often).
  4. The surgical method is a shock to the child’s psyche; moreover, complications may arise, such as paralysis of the upper palate, fusion of the soft palate and the posterior wall of the pharynx, stenosis, scarring of the auditory tubes, and others.
  1. Not always the cause of snoring and difficulty breathing is adenoiditis (it can be chronic sinusitis, allergies, a deviated nasal septum, or even a tumor).

How is the operation performed?

Adenotomy is a last resort when all others have failed. It is carried out with a scalpel or laser (this is the most common method), and is prescribed only in the case of third degree adenoiditis and a serious threat to the child’s life.

In what cases should adenotomy not be performed?

Remember that any surgical intervention in children under the age of five is undesirable, as it can cause mental disorders from stuttering to various phobias.

Particular attention should be paid to the fact that adenotomy is often contraindicated for children with asthmatic and allergic diseases: removal of the tonsils can lead to complications and worsening of the child’s condition.

Non-surgical methods

Today there are ways to effectively treat inflamed tonsils without surgery. Therefore, if the doctor made a diagnosis without making sure that it was adenoids, or immediately wrote out a referral for surgery, you should contact another specialist, since reliable data about the disease can only be obtained after an examination.

Remember that in addition to otolaryngology, it is worth checking the child for allergic reactions; it is quite possible that extensive inflammation of the nasopharynx is a consequence of prolonged exposure to allergens on the body. The tests are expensive but can help avoid surgery.

Homeopathy

First of all, parents should try to cure the child with the help of homeopathic medicines.

Studies have shown that homeopathic medicines can cause a short-term outflow of lymph from the nasopharynx, but they help reduce the size of the tonsils only in 10% of cases.

Most commonly prescribed drugs:

  • protargol, which has a “drying” effect (drop 5-7 drops with the head tilted back and hold it in this position for 2 minutes), collargol,
  • dioxidine (dilute 1:1 with saline solution),
  • rhinosept,
  • albucid,
  • pinosol,
  • sofradex,
  • the most effective is Job-baby granules;

Complex treatment

It is produced using methods developed in special clinics and consists of a number of procedures.

  1. Application of agents that suppress inflammation. Drops such as tea tree drops and special sprays such as Avamys spray are suitable.
  2. Rinsing - removing pus from the surface of the mucous membranes: introducing a solution (1-2 tablespoons of sea salt per glass of warm water) into one nostril and suctioning it from the other. It is important that the procedure is carried out by a doctor, otherwise the pus can be driven even deeper.
  3. Physiotherapy - quartzing the nose and throat, as well as laser therapy - passing a light guide into the throat through the nose.

Spa therapy

The method is expensive, but it really helps to strengthen the child’s health: firstly, salty sea water, saturated with iodine, quickly and effectively relieves inflammation of the mucous membranes; diving is also very useful.

Sunbathing, a warm southern climate and fruits rich in vitamins will help strengthen the immune system, that is, they will eliminate the very cause of inflammation of the adenoids.

Of course, a couple of weeks of rest cannot completely get rid of inflammation, so this method should be considered auxiliary.

Folk remedies

In addition, folk remedies that help cure adenoiditis at home are also very effective.

Solutions for nasal instillation

  • Русский
  • solution of thuja oil (namely a solution, thuja for the nose, and not the oil itself, since it is quite caustic; drop 2-3 drops into the nose);
  • mumiyo (1 tablet in 1/3 glass of water, drop into the nose 3-4 times a day, the result is noticeable after 2-3 weeks);
  • beet juice (drip into the nose);
  • Kalanchoe juice (houseplant; drip into the nose);
  • decoctions of herbs: calendula, sage, eucalyptus, St. John's wort (drip into the nose, also add a few drops of honey to the decoction);
  • celandine (rip out several plants by the roots during the flowering period, wash, grind, squeeze out the juice (this is easier to do through gauze), leave the pulp in a jar under a water seal to ferment for a couple of weeks at room temperature, then filter again; the resulting liquid can last for a long time stored in the refrigerator; drop 3-4 drops into children’s noses (possibly a slight and short-lived burning sensation); drip for 2-3 weeks).

Oral preparations

  • Русский
  • badger, mutton or pork fat/lard (eat; quickly and effectively strengthens the immune system, adenoiditis disappears);
  • infusion of black currant leaves (30 g of dried leaves, pour 1/2 liter of boiling water, let it brew for 30 minutes; drink one glass warm 3 times a day before meals);
  • fish oil (to slow down the growth of adenoids);

Inhalations

Also effective against inflammation of the tonsils are steam inhalations with eucalyptus liquid for inhalation, Kalanchoe juice, calendula or soda (twice a day).

Prevention of adenoiditis and measures to strengthen the immune system

In the case where the tonsils have already been removed and/or there is concern that the adenoids will become inflamed again, it is necessary to take preventive measures and measures to strengthen the immune system.

These include:

  1. Multivitamins (especially vitamins C and D, as well as preparations high in calcium);
  2. Honey (consumed orally; honey contains almost the entire periodic table, it has a general strengthening effect on the body);
  1. Hardening (for example, a swimming pool, dousing with cold water, etc.; with this method you need to be especially careful, the main thing is to harden the body gradually);
  2. Active sports (athletics, dancing, figure skating, football, etc.; in addition, doctors have developed entire sets of exercises that strengthen and heal the respiratory system);
  3. Comprehensive nutrition;
  4. Timely compliance with hygiene rules;
  5. Regular medical examination.

Summing up

We must remember that each person’s body is unique, one thing helps one, another helps another. Curing a disease is not always easy, but it is always possible. In any case, when faced with a problem, we are obliged to solve it, even if this requires trying dozens of ways.

I would like the tips and treatment methods listed in the article to be useful to you, parents. Health to you and your kids!

Source: http://otvetprost.com/577-kak-lechit-adenoidy-u-detej.html

Adenoiditis: causes, signs, diagnosis, how to treat

Adenoiditis is an inflammation of the unpaired tonsil, located at the boundary between the upper and posterior walls of the nasopharynx. An increase in size of the nasopharyngeal tonsil without signs of inflammation is simply called adenoids.

Tonsils (tonsils) are islands of concentrated subepithelial arrangement of lymphoid tissue. In the form of tubercles, they protrude into the lumen of the oral cavity and nasopharynx. Their main role is a barrier on the border between aggressive factors (pathogens) of the surrounding world and the internal environment of the body.

The nasopharyngeal tonsil is an unpaired organ that is included, along with others (lingual and paired tubal and palatine) in the pharyngeal lymphatic ring.

An important difference from other tonsils is that they are covered with multirow columnar ciliated epithelium, capable of producing mucus.

In a normal, physiological state, without additional optical devices, this amygdala cannot be seen.

Statistics

Adenoiditis is classified as a childhood disease, since the most common age range of those affected is between 3-15 years. In isolated cases, adenoiditis is diagnosed both in more mature and early (up to infancy) age. The prevalence of the disease averages 3.5-8% of the child population, with approximately equal numbers of affected boys and girls.

Adenoiditis in adults, as a rule, is a consequence of untreated inflammation of the nasopharyngeal tonsil in childhood. In cases where the symptoms of this disease develop in an adult for the first time, tumor lesions of the nasopharynx should first be excluded by contacting a specialist in a timely manner.

Classification of adenoiditis

According to the length of the disease:

  1. Acute adenoiditis. Accompanies and is one of the multiple manifestations of other acute respiratory diseases of both viral and bacterial origin and is limited to a duration of about 5-7 days. It is characterized mainly by catarrhal manifestations in the retronasal area against the background of episodes of temperature rise up to 39ºС.
  2. Subacute adenoiditis. It is more often observed in children with already hypertrophied adenoids. Several groups of tonsils of the pharyngeal ring are affected. The duration of inflammatory manifestations is on average about three weeks. For some time after recovery, the child may return to an evening increase in body temperature to a subfebrile level (37-38ºC).
  3. Chronic adenoiditis. The duration of the disease is six months or more. The classic symptoms of adenoiditis are accompanied by signs of damage to neighboring organs (otitis), inflammation of the air sinuses (sinusitis, frontal sinusitis, ethmoiditis, sphenoiditis) and respiratory tract (laryngitis, tracheitis, bronchitis).

Clinical and morphological types of chronic inflammation of the nasopharyngeal tonsil are the following forms:

  • Catarrhal adenoiditis;
  • Exudative-serous adenoiditis;
  • Purulent adenoiditis.

Allergic adenoiditis, which develops in combination with other manifestations of increased sensitivity of the body to any allergen, should be considered as a separate clinical and morphological unit. As a rule, it is limited to catarrhal manifestations in the form of allergic rhinitis (runny nose).

Based on the severity of clinical manifestations, extension to adjacent anatomical structures and the condition of the patient himself, the following types of adenoiditis are divided:

  1. Surface;
  2. Subcompensated;
  3. Compensated;
  4. Decompensated.
Upon examination, depending on the size of the nasopharyngeal tonsil and the severity of nasal breathing disturbance, otolaryngologists distinguish four degrees of adenoiditis.

1st degree - a hypertrophied tonsil covers 1/3 of the bony part of the nasal septum (vomer) or the total height of the nasal passages.

2nd degree - the tonsil covers up to 1/2 of the bony part of the nasal septum.

3rd degree - the tonsil covers the vomer by 2/3 along its entire length.

4th degree - the nasal passages (choanae) are almost completely covered by tonsil growths, making nasal breathing impossible.

Causes and predisposing factors

The main reasons include the following:

  • Low immune status of the child, which is caused by: refusal of breastfeeding, poor nutrition, which is predominantly carbohydrate in nature, among others, vitamin D deficiency with clinical manifestations in the form of rickets.
  • The child's tendency to exudative-type diathesis and allergies.
  • Frequent hypothermia.
  • Environmental factors (industrial air pollution, hot, unventilated rooms with dry dust).
  • Chronic runny nose and inflammatory diseases of other organs of the upper respiratory tract.

Symptoms of adenoiditis

  1. Runny nose. It manifests itself as liquid discharge from the nose of a mucous and purulent nature.
  2. Difficulty in nasal breathing. The patient may associate it with a runny nose, but it can also occur without pathological nasal discharge. In infants, this symptom is manifested by sluggish breastfeeding, or even a complete refusal to feed. In older children, when nasal breathing is difficult, the voice changes. It becomes nasal when most of the consonants in the child’s speech are heard as the letters “l”, “d”, “b”. The mouth of children remains constantly open. For this reason, the nasolabial folds are smoothed out and the face takes on an apathetic appearance. In the chronic course of adenoiditis, the formation of the facial skeleton is disrupted in such cases:
    1. the hard palate is laid narrow, with a high location;
    2. the upper jaw changes its shape and the bite is disrupted due to the protrusion of the incisors forward, like in a rabbit.

    This leads to a persistent violation of the pronunciation of sounds (articulation) in the future.

  3. Painful sensations in the deep parts of the nose. Their character and intensity vary: from light scratching and tickling to intense, pressing pain that turns into a feeling of headache without a clear localization of the source. Pain in the nose intensifies when swallowing movements.
  4. Cough. Cough with adenoiditis occurs more often at night or in the morning and is paroxysmal in nature. It is provoked by choking on mucus and pus, the outflow of which through the nasal passages is difficult.

    The diagnosis, in addition to the listed complaints, is confirmed by examining the throat using special mirrors. In addition, the doctor can use a digital examination of the nasopharynx to determine the severity of adenoiditis.

    There are some difficulties in diagnosing this disease when it occurs in a child’s infancy, for the reason that the manifestations of severe intoxication and high temperature come to the fore, with which his refusal to eat food is associated. In this case, enlarged lymph nodes in the neck and submandibular region help guide you to the right path of diagnostic search. This age is characterized by the transition of the disease to a chronic form with frequent relapses (exacerbations)

    At an older age, adenoiditis must be differentiated from diseases such as:

    • Choanal polyp;
    • Juvenile angiofibroma;
    • Congenital developmental defects (nasopharyngeal insufficiency, deviated nasal septum, hypertrophy of the nasal turbinates);
    • Scar processes after operations on the upper respiratory tract;
    • Tumor diseases of lymphoid tissues.

    Treatment of adenoiditis

    As recommended by Dr. Komarovsky, treatment of adenoiditis in children should begin when the first symptoms of the disease or suspicion of it occur.

    This is due, first of all, to the risk of complications in the heart and kidneys during the transition of the disease from an acute to a chronic form.

    Treatment of grade 1 and 2 inflammation of the adenoids is limited to conservative methods.

    It is aimed at relieving swelling of lymphoid tissue, reducing sensitivity to allergens, combating pathological microflora (viruses and microbes), and increasing immune status.

    This is achieved through a number of actions.

    1. Climatotherapy. A child’s stay on a summer vacation in the Crimea and on the Black Sea coast of the Caucasus has a beneficial effect on his recovery from adenoiditis, and also has a pronounced preventive effect, preventing the occurrence of this disease.
    2. Taking antihistamines (Suprastin, Pipolfen, etc.) and calcium gluconate.
    3. Anti-inflammatory drugs (Aspirin, Ibuklin, Paracetamol, etc.).
    4. Antibiotics. Prescribed for exudative-serous and purulent adenoiditis with severe symptoms of intoxication, as well as for exacerbation of chronic adenoiditis, taking into account the suspected pathogen.
    5. Local effect on adenoids:
      1. Vasoconstrictor drops (Naphazolin, Xylin); antiseptics (Protargol, Bioparox, etc.);
      2. Inhalation using the listed means;
      3. Pumping out mucus (in infants);
      4. Physiotherapy (quartz and laser therapy locally on the tonsils, electrophoresis and diameter with the use of drugs on regional lymph nodes).
    6. Multivitamin complexes and prevention of rickets.
    7. Adequate nutrition with a sufficient protein-carbohydrate ratio. In cases of allergic adenoiditis and a tendency to diathesis, it is necessary to remove foods that can cause this reaction from the child’s diet: citrus fruits, nuts, strawberries, cocoa, seafood.

    Folk remedies for treating adenoiditis are limited to adding herbs that have an antimicrobial effect (chamomile, sage) to inhalations.

    In addition, for preventive purposes, rinsing the nose with saline solution (1 tablespoon of salt per 1 liter of water) and wet compresses on the throat using cold water are used.

    Previously, to ease breathing and relieve inflammatory processes, the so-called “mogol-mogol” was widely used, which included heated milk (0.5 l), honey (1 teaspoon), raw egg and butter. This well-mixed cocktail was drunk in small sips throughout the day. However, its effectiveness is controversial and is justified only as a local thermal effect on the nasopharynx during the recovery period.

    Surgical treatment of adenoiditis (adenoidectomy) is used for adenoid hypertrophy of grade 2 and higher.

    The operation consists of mechanical removal of the enlarged gland and its growths using a special Beckmann adenotome, which has different sizes depending on the age of the patient.

    The intervention is performed using both local anesthesia and general anesthesia.

    An hour or two after adenoidectomy, the patient can be discharged from the medical center.

    For the first five days after surgery, it is recommended to take chilled liquid food, ice cream is allowed. In the following days, temperature restrictions are lifted.

    • Severe nasal breathing disturbances;
    • Beginning deformation of the facial skeleton and chest;
    • Hearing impairment caused by hypertrophy of the nasopharyngeal tonsil;
    • Existing chronic inflammatory diseases of other organs of the upper respiratory tract.

    Absolute contraindications to surgery:

    1. Disorders of the blood coagulation system;
    2. Juvenile angiofibroma;
    3. Tumor diseases of the blood;
    4. Heart diseases with severe manifestations of circulatory failure.

    Relative contraindications to adenoidectomy:

    • Acute infectious diseases in a child;
    • Facial skin diseases;
    • Unfavorable epidemic situation (influenza epidemic, cases of measles in a children's group shortly before the planned operation).

    In these cases, the operation is performed after some time (1-2 months), after eliminating the risk factors.

    The most favorable age for adenoid removal is considered to be 5-7 years.

    Source: http://uhonos.ru/nos/bolezni-nosa/adenoidit/

    Adenoids in children: causes, symptoms and treatment

    A common reason for contacting a pediatric otolaryngologist is hypertrophy and inflammation of the pharyngeal tonsil. According to statistics, this disease accounts for about 50% of all diseases of the ENT organs in children of preschool and primary school age. Depending on the severity, it can lead to difficulty or even complete absence of nasal breathing in a child, frequent inflammation of the middle ear, hearing loss and other serious consequences. To treat adenoids, medications, surgical methods and physical therapy are used.

    Pharyngeal tonsil and its functions

    Tonsils are collections of lymphoid tissue localized in the nasopharynx and oral cavity. There are 6 of them in the human body: paired - palatine and tubal (2 pieces each), unpaired - lingual and pharyngeal. Together with lymphoid granules and lateral ridges on the posterior wall of the pharynx, they form a lymphatic pharyngeal ring surrounding the entrance to the respiratory and digestive tracts. The pharyngeal tonsil, the pathological growth of which is called adenoids, is attached at its base to the posterior wall of the nasopharynx at the point where the nasal cavity exits into the oral cavity. Unlike the palatine tonsils, it is not possible to see it without special equipment.

    Tonsils are part of the immune system and perform a barrier function, preventing further penetration of pathogenic agents into the body. They form lymphocytes - cells responsible for humoral and cellular immunity.

    In newborns and children in the first months of life, the tonsils are underdeveloped and do not function properly. Later, under the influence of pathogenic bacteria, viruses and toxins constantly attacking the small organism, the active development of all structures of the lymphatic pharyngeal ring begins. In this case, the pharyngeal tonsil is formed more actively than others, which is due to its location at the very beginning of the respiratory tract, in the zone of the body’s first contact with antigens. The folds of its mucous membrane thicken, lengthen, and take on the appearance of ridges separated by grooves. It reaches full development by 2–3 years.

    As the immune system develops and antibodies accumulate after 9–10 years, the pharyngeal lymphatic ring undergoes uneven reverse development. The size of the tonsils decreases significantly, the pharyngeal tonsil often completely atrophies, and their protective function is transferred to the receptors of the mucous membranes of the respiratory tract.

    Causes of adenoids

    The growth of adenoids occurs gradually. The most common cause of this phenomenon is frequent diseases of the upper respiratory tract (rhinitis, sinusitis, pharyngitis, laryngitis, tonsillitis, sinusitis and others). Each contact of the body with infection occurs with the active participation of the pharyngeal tonsil, which at the same time increases slightly in size. After recovery, when the inflammation passes, it returns to its original state. If during this period (2-3 weeks) the child falls ill again, then, not having time to return to its original size, the amygdala enlarges again, but larger. This leads to constant inflammation and growth of lymphoid tissue.

    In addition to frequent acute and chronic diseases of the upper respiratory tract, the following factors contribute to the occurrence of adenoids:

    • hereditary predisposition;
    • childhood infectious diseases (measles, rubella, scarlet fever, influenza, diphtheria, whooping cough);
    • severe pregnancy and childbirth (viral infections in the first trimester, leading to abnormalities in the development of the internal organs of the fetus, taking antibiotics and other harmful drugs, fetal hypoxia, birth injuries);
    • poor nutrition and overfeeding of the child (excess sweets, eating food with preservatives, stabilizers, dyes, flavors);
    • tendency to allergies;
    • weakened immunity due to chronic infections;
    • unfavorable environment (gases, dust, household chemicals, dry air).

    Children aged 3 to 7 years who attend children's groups and have constant contact with various infections are at risk of developing adenoids. In a small child, the airways are quite narrow and in the case of even slight swelling or enlargement of the pharyngeal tonsil, they can completely block and make breathing through the nose difficult or impossible. In older children, the incidence of this disease decreases sharply, because after 7 years the tonsils begin to atrophy, and the size of the nasopharynx, on the contrary, increases. Adenoids no longer interfere with breathing and cause discomfort.

    Adenoid grades

    Depending on the size of the adenoids, three degrees of the disease are distinguished:

    • 1st degree - the adenoids are small, covering no more than a third of the upper part of the nasopharynx, problems with nasal breathing in children occur only at night when the body is in a horizontal position;
    • 2nd degree - significant enlargement of the pharyngeal tonsil, blocking the lumen of the nasopharynx by about half, nasal breathing in children is difficult both day and night;
    • 3rd degree - adenoids occupy almost the entire lumen of the nasopharynx, the child is forced to breathe through the mouth around the clock.

    Symptoms of adenoids

    The most important and obvious sign by which parents can suspect adenoids in children is regular difficulty breathing through the nose and nasal congestion in the absence of any discharge from it. To confirm the diagnosis, the child should be shown to an otolaryngologist.

    Characteristic symptoms of adenoids in children are:

    • sleep disturbance, the child sleeps lightly with his mouth open, wakes up, may cry in his sleep;
    • snoring, snoring, holding your breath and attacks of suffocation during sleep;
    • dry mouth and dry cough in the morning;
    • change in voice timbre, nasal speech;
    • headache;
    • frequent rhinitis, pharyngitis, tonsillitis;
    • decreased appetite;
    • hearing loss, ear pain, frequent otitis due to blockage of the canal connecting the nasopharynx and the ear cavity;
    • lethargy, fatigue, irritability, moodiness.

    Against the background of adenoids, children develop a complication such as adenoiditis, or inflammation of the hypertrophied pharyngeal tonsil, which can be acute or chronic. In acute cases, it is accompanied by fever, pain and a burning sensation in the nasopharynx, weakness, nasal congestion, runny nose, mucopurulent discharge, and enlargement of nearby lymph nodes.

    Methods for diagnosing adenoids

    If you suspect adenoids in children, you should contact an ENT specialist. Diagnosis of the disease includes taking an anamnesis and instrumental examination. To assess the degree of adenoids, the condition of the mucosa, the presence or absence of an inflammatory process, the following methods are used: pharyngoscopy, anterior and posterior rhinoscopy, endoscopy, radiography.

    Pharyngoscopy consists of examining the pharyngeal cavity, pharynx and tonsils, which are also sometimes hypertrophied in children with adenoids.

    During anterior rhinoscopy, the doctor carefully examines the nasal passages, expanding them with a special nasal speculum. To analyze the condition of the adenoids with this method, the child is asked to swallow or say the word “lamp”, while the soft palate contracts, which causes the adenoids to vibrate.

    Posterior rhinoscopy is an examination of the nasopharynx and adenoids through the oropharynx using a nasopharyngeal speculum. The method is highly informative, allows you to assess the size and condition of the adenoids, however, in children it can cause a gag reflex and quite unpleasant sensations, which will interfere with the examination.

    The most modern and informative examination of adenoids is endoscopy. One of its advantages is its clarity: it allows parents to see their children’s adenoids on the screen. When performing endoscopy, the degree of adenoid vegetations and blockage of the nasal passages and auditory tubes, the reason for their enlargement, the presence of edema, pus, mucus, and the condition of neighboring organs are determined. The procedure is carried out under local anesthesia, as the doctor must insert a long tube 2–4 mm thick with a camera at the end into the nasal passage, which causes unpleasant and painful sensations in the child.

    Radiography, like digital examination, is currently practically not used to diagnose adenoids. It is harmful to the body, does not give an idea of ​​why the pharyngeal tonsil is enlarged, and can cause an incorrect assessment of the degree of its hypertrophy. Pus or mucus that has accumulated on the surface of the adenoids will appear exactly the same as the adenoids themselves in the image, which will mistakenly increase their size.

    If hearing impairment is detected in children and frequent otitis media, the doctor examines the ear cavity and sends for an audiogram.

    To truly assess the extent of adenoids, diagnosis must be carried out during a period when the child is healthy or at least 2-3 weeks have passed since recovery from the last illness (cold, acute respiratory viral infection, etc.).

    Treatment

    The treatment tactics for adenoids in children are determined by their degree, the severity of symptoms, and the development of complications in the child. Medication, physical therapy, or surgery (adenotomy) may be used.

    Drug treatment

    Treatment of adenoids with drugs is effective for the first, and less often, the second degree of adenoids, when their size is not too large, and there are no pronounced disturbances in free nasal breathing. In the third degree, it is carried out only if the child has contraindications to surgical removal of the adenoids.

    Drug therapy is aimed at relieving inflammation, swelling, eliminating a runny nose, cleansing the nasal cavity, and strengthening the immune system. The following groups of drugs are used for this:

    • vasoconstrictor drops (galazolin, farmazolin, naphthyzin, rinazolin, sanorin and others);
    • antihistamines (diazolin, suprastin, loratadine, Erius, Zyrtec, fenistil);
    • anti-inflammatory hormonal nasal sprays (Flix, Nasonex);
    • local antiseptics, nasal drops (protargol, collargol, albucid);
    • saline solutions for clearing snot and moisturizing the nasal cavity (Aquamaris, Marimer, Quix, Humer, Nazomarin);
    • means to strengthen the body (vitamins, immunostimulants).

    The enlargement of the pharyngeal tonsil in some children is not due to its growth, but to swelling caused by an allergic reaction of the body in response to certain allergens. Then, to restore its normal size, only local and systemic use of antihistamines is necessary.

    Sometimes doctors can prescribe homeopathic medicines for children to treat adenoids. In most cases, their use is effective only with long-term use in the first stage of the disease and for preventive purposes. With the second and even more so the third degree of adenoids, they, as a rule, do not bring any results. For adenoids, granules of the drugs “IOV-Malysh” and “Adenosan”, “Thuya-GF” oil, and “Euphorbium Compositum” nasal spray are usually prescribed.

    Folk remedies

    Folk remedies for adenoids can only be used after consultation with a doctor in the initial stages of the disease, which are not accompanied by any complications. The most effective of them are rinsing the nasal cavity with a solution of sea salt or herbal decoctions of oak bark, chamomile and calendula flowers, and eucalyptus leaves, which have anti-inflammatory, antiseptic and astringent effects.

    When using medicinal herbs, it should be taken into account that they can provoke an allergic reaction in children, which will further aggravate the course of the disease.

    Physiotherapy

    Physiotherapy for adenoids is used in conjunction with drug treatment to increase its effectiveness.

    Most often, children are prescribed laser therapy. The standard course of treatment consists of 10 sessions. It is recommended to take 3 courses per year. Low-intensity laser radiation helps reduce swelling and inflammation, normalizes nasal breathing, and has an antibacterial effect. Moreover, it extends not only to the adenoids, but also to the tissues surrounding them.

    In addition to laser therapy, ultraviolet irradiation and UHF on the nasal area, ozone therapy, and electrophoresis with medications can be used.

    Breathing exercises, spa treatment, climatic therapy, and seaside holidays are also useful for children with adenoids.

    Video: Treatment of adenoiditis with home remedies

    Adenotomy

    Removal of adenoids is the most effective treatment method for third-degree hypertrophy of the pharyngeal tonsil, when the child’s quality of life significantly deteriorates due to the lack of nasal breathing. The operation is carried out strictly according to indications in a planned manner under anesthesia in the inpatient conditions of the ENT department of a children's hospital. It does not take much time, and if there are no postoperative complications, the child is sent home on the same day.

    Indications for adenotomy are:

    • ineffectiveness of long-term drug therapy;
    • inflammation of the adenoids up to 4 times a year;
    • absence or significant difficulty in nasal breathing;
    • recurrent inflammation of the middle ear;
    • hearing impairment;
    • chronic sinusitis;
    • stopping breathing during night sleep;
    • deformation of the skeleton of the face and chest.

    Adenotomy is contraindicated if the child has:

    • congenital anomalies of the hard and soft palate;
    • increased tendency to bleed;
    • blood diseases;
    • severe cardiovascular pathologies;
    • inflammatory process in the adenoids.

    The operation is not performed during influenza epidemics and within a month after a routine vaccination.

    Currently, thanks to the advent of short-acting general anesthesia, adenotomy for children is almost always performed under general anesthesia, which avoids the psychological trauma that the child receives when performing the procedure under local anesthesia.

    The modern endoscopic technique for removing adenoids is low-traumatic, has a minimum of complications, allows the child to return to a normal lifestyle within a short time, and minimizes the likelihood of relapse. To prevent complications in the postoperative period it is necessary:

    1. Take medications prescribed by your doctor (vasoconstrictor and astringent nasal drops, antipyretics and painkillers).
    2. Limit physical activity for two weeks.
    3. Do not eat hot food with a hard consistency.
    4. Do not take baths for 3-4 days.
    5. Avoid exposure to open sun.
    6. Do not visit crowded places and children's groups.

    Video: How adenotomy is performed

    Complications of adenoids

    In the absence of timely and adequate treatment, adenoids in a child, especially grades 2 and 3, lead to the development of complications. Among them:

    • chronic inflammatory diseases of the upper respiratory tract;
    • increased risk of acute respiratory infections;
    • deformation of the maxillofacial skeleton (“adenoid face”);
    • hearing impairment caused by the adenoids blocking the opening of the auditory tube in the nose and impaired ventilation in the middle ear;
    • abnormal development of the chest;
    • frequent catarrhal and purulent otitis media;
    • speech disorders.

    Adenoids can cause retardation in mental and physical development due to insufficient oxygen supply to the brain due to problems with nasal breathing.

    Prevention

    Prevention of adenoids is especially important for children who are prone to allergies or have a hereditary predisposition to the occurrence of this disease. According to pediatrician E. O. Komarovsky, to prevent hypertrophy of the pharyngeal tonsil, it is very important to give the child time to restore its size after suffering from acute respiratory infections. To do this, after the symptoms of the disease disappear and the child’s well-being improves, you should not take the child to kindergarten the very next day, but you should stay at home for at least another week and during this period actively walk in the fresh air.

    Measures to prevent adenoids include playing sports that promote the development of the respiratory system (swimming, tennis, athletics), daily walks, maintaining optimal temperature and humidity levels in the apartment. It is important to eat foods rich in vitamins and microelements.

    Video: Pediatrician Komarovsky E. O. on the treatment and prevention of adenoids in children

    • This article is usually read

    Chicken pox, well known to everyone under the name chickenpox, belongs to the group of highly contagious infectious diseases.

    Quite often, parents are faced with the problem of redness and watery eyes in children. Of course, the question arises, ka.

    Many people experience the phenomenon of bruxism (grinding teeth during sleep). Bruxism attacks also occur in children. Most often they happen.

    If a child has dark circles under his eyes, then parents understand that something is wrong with him. Didn't sleep well, didn't eat well, or maybe...

    Without water, not a single process in the body can take place. It is part of all fabrics and facilitates the promotion of useful things.

    Everyone knows that for normal development a child needs adequate nutrition. In the minds of most parents, a bad appe.

    Rickets is a pathology that develops due to a lack of vitamin D (calciferol) in the body and is accompanied by adn.

    Anyone, especially a child, can easily become infected with worms. He dropped the cookie on the floor, picked it up and put it in his mouth. Even on the cleanest.

    • Most read

    Copyright ©17 Magazine for women “Prosto-Maria.ru”

    Any use of site materials is possible only if there is a direct, active link to the source

    Source: http://www.prosto-mariya.ru/adenoidy-u-detej-prichiny-simptomy-i-lechenie_1450.html