About adenoiditis in children

It is impossible to determine whether a child has adenoiditis with the naked eye.

If the treatment of purulent adenoiditis in children is not started in a timely manner, the inflammatory process can lead to very serious consequences:

Classification

Enlargement of the nasopharyngeal tonsil has different origins and also occurs in different ways.

There are 3 degrees of adenoid hypertrophy:

• first - the adenoids slightly cover the upper part of the bony nasal septum (vomer);

In the chronic course of the disease the following are observed:

Secondary signs of the disease are:

Signs of illness

In infants, adenoiditis is extremely rare, but it is severe. The baby becomes lethargic, loses appetite, and may experience abdominal pain and indigestion.

In children over 3 years of age, the main attention should be paid to the frequency of colds and changes in behavior. A strong inflammatory process in the nasopharyngeal tonsils may not be observed.

But even with a slight enlargement of the adenoids, difficulty breathing and snoring during sleep, coughing attacks after exercise and nasal congestion without a runny nose are sure to appear. The child is often capricious and eats poorly.

Older children may complain of a sore nose and throat and fatigue. Their performance at school drops, irritability appears, and their temperature may rise.

Diagnostics

Only a specialist can make a correct diagnosis after a thorough examination. For this purpose, special mirrors or flexible endoscopes are used, inserted into the child’s nasopharynx cavity.

Digital examination and computed tomography may be performed.

Signs of inflammation are also diagnosed by a general blood test: a large number of lymphocytes indicates a viral disease, and an increase in the number of neutrophils indicates a bacterial one.

Often, a throat swab is taken to determine sensitivity to antibiotics. In case of severe inflammation, blood biochemistry is performed. In some cases, an x-ray of the nasopharynx may be necessary.

How to treat: methods and schemes

With growth of 1-2 degrees, conservative treatment of adenoiditis in children is used. If the pharyngeal tonsils are constantly inflamed and enlarged to degree 3, then adenotomy (surgical removal) is resorted to.

For non-surgical treatment, anti-inflammatory and homeopathic medicines, physiotherapy, massage and laser therapy are used.

First of all, vasoconstrictor nasal drops are prescribed: Naphthyzin, Nazivin, Sanorin, Vibrocil, Xilen, etc. They are used only on the recommendation of a doctor, no more than 5-7 days.

Before use, it is necessary to rinse the nasal cavity with sea water (Aqualor, Aquamaris) or furacillin solution.

Immediately after the vasoconstrictor drugs, antimicrobial agents are dripped into the nose: Albucid, Hexoral, Bioparox, Protargol. In severe cases of adenoiditis in children, topical hormonal drugs (Nasonex) may be prescribed during treatment.

Often, when symptoms of adenoiditis are detected in children, antiallergic drugs (Suprastin, Loratadine, Fenistil), homeopathic (Lymphomyosot or Tonsilotren) and anti-inflammatory (Erespal) are prescribed.

If adenoiditis in children is bacterial in nature, then treatment cannot be done without antibiotics (Amoxiclav, Azithromycin, Zinnat, etc.). In case of a viral infection, children must be prescribed antiviral drugs (Viferon, Ruferon, Anaferon). Be sure to include vitamin and mineral complexes.

Along with drug treatment, physiotherapy (UHF or electrophoresis with diphenhydramine), inhalations, herbal teas, breathing exercises and massage are prescribed. Inhalations can also be done at home. For adenoiditis, inhalations with the addition of essential oils of eucalyptus or pine help a lot.

For older children, it is good to brew teas from herbs, such as chamomile and sage. If there is no allergy to plants, you can give your child various herbal mixtures based on marshmallow root, St. John's wort and coltsfoot herbs, birch leaves and rinse the nose with a weak alcohol solution of propolis.

During the treatment period, it is necessary to follow a diet, that is, exclude all allergenic foods from the diet: chocolate, citrus fruits, sweets, nuts and seafood. You can eat fresh vegetables and fruits, cereals, soups, and dairy products.

The famous pediatrician Komarovsky talks about the necessary treatment of acute and chronic forms of adenoiditis in children in this video:

If drug therapy does not bring results, adenotomy is indicated. Before surgery, it is necessary to relieve inflammation of the adenoids. The procedure is performed under local anesthesia. For symptoms of allergic adenoiditis in children, surgery is not advisable.

Forecast and preventive measures

After the operation, you must observe strict bed rest for several days, avoid spicy, salty, hot and sweet foods.

Avoid physical activity for 2-3 weeks. When taking medications, a course of treatment is required.

Prevention of adenoiditis in children:

With proper treatment, acute adenoiditis does not cause complications. It is important to start treatment on time to prevent the development of a chronic form of the disease.

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Source: http://malutka.pro/bolezni/lor/adenoidit.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/

   Chronic adenoiditis in children: symptoms, treatment, prevention

   Inflammation of the nasopharyngeal tonsil is a disease that most often develops in children. Usually adenoiditis is disguised as an acute respiratory viral infection or a cold, so it often goes unnoticed. This leads to the disease becoming chronic, the consequences of which can be very serious.

   Chronic adenoiditis in children

   The role of the pharyngeal tonsil for the health of children is very important. By producing protective antibodies, this organ creates a living barrier to infections entering the body. When visiting children's institutions, the child is exposed to a constant attack of viruses and bacteria. The overworked pharyngeal tonsil grows and adenoids form. The latter become inflamed with frequent infectious diseases, resulting in the development of adenoiditis.

   The chronic form of the disease has a long course and most often occurs in children 3–10 years old.

   In chronic adenoiditis, the inflamed pharyngeal tonsil blocks the lumen of the nasopharynx, which leads to impaired nasal breathing and a constant runny nose. The child begins to breathe through his mouth and may snore or sniffle at night. In some cases, due to the accumulation of mucus in the larynx, a severe cough is observed.

   According to medical research, 20% of preschool children suffer from a chronic form of adenoiditis. During adolescence, the nasopharyngeal tonsil decreases. By about age 20, it atrophies.

   Chronic adenoiditis is often accompanied by inflammation of the middle ear, which can result in hearing loss.

   Causes and risk factors

   Acute adenoiditis develops as a result of frequent viral infections. The transition of pathology to a chronic form is facilitated by a weakening of the child’s immune system, persistent acute respiratory viral infections, allergic diseases, as well as the following factors:

   • early transfer of the baby to artificial feeding;
   • poor nutrition with excess carbohydrates;
   • lack of vitamin D;
   • presence of chronic infections;
   • hypothermia;
   • unfavorable environmental situation;
   • dry or too humid air in the apartment;
   • hormonal imbalance.

   Against the background of acute respiratory viral infections, chronic adenoiditis can worsen due to the active proliferation of pathogenic bacteria in the lymphoid tissue.

   Symptoms of the disease

   The transition from acute to chronic adenoiditis is accompanied by the following symptoms:

   • constantly open mouth;
   • decreased appetite;
   • sleep problems;
   • nasal congestion, which leads to snoring and snoring;
   • persistent rhinitis with pus or mucus;
   • low-grade fever (37-37.9°C);
   • retardation in physical and mental development;
   • headache;
   • night coughing attacks due to the accumulation of mucus in the larynx;
   • increased fatigue;
   • hearing loss as a result of associated ear diseases.

   In the chronic form of the disease, disturbances in the child’s speech are also observed. It is difficult for the baby to pronounce nasal consonants; he speaks abruptly and muffled.

   The presence of chronic adenoiditis in a child can be judged by its appearance. The baby develops an “adenoid face” - the lower jaw droops, salivation increases, the bite is disturbed, and swelling appears.

   Since nasal breathing is impaired, oxygen starvation occurs. Because of this, in children with this pathology, the chest narrows and protrudes forward.

   Adenoiditis in chronic form can sometimes be accompanied by bronchial asthma, pharyngitis and tonsillitis, since due to a constantly open mouth, the air cannot be cleared of germs and dust that settle on the trachea and larynx.

   Also, with this pathology, the inflammatory process can spread to the nasal cavity. This causes copious discharge that irritates the skin above the upper lip, causing this area of ​​the face to become red, thick and covered with microcracks.

   Diagnostics

   An otolaryngologist treats this disease. To establish a diagnosis, the doctor needs to analyze the complaints and examine the child. The presence of adenoiditis can be suspected by the following signs:

   • redness, swelling of the pharyngeal tonsil;
   • pus and mucous discharge.

   To make an accurate diagnosis, additional diagnostic methods may be needed:

   • posterior rhinoscopy. Allows you to assess how much the adenoids have grown and determine hyperemia (redness), swelling, and the presence of pus. For the study, a special mirror is used, which helps to examine the posterior parts of the nasal cavity;
   • X-ray examination of the nasopharynx. Used for differential diagnosis of adenoiditis and sinusitis, as well as to assess the degree of proliferation of adenoids;
   • endoscopy of the nasopharynx. The method accurately identifies the size and condition of the adenoids and mucous membrane. During the examination, an elastic tube with a miniature video camera is used;
   • nasopharyngeal swab. Determines the causative agent of the disease and sensitivity to medications;
   • audiometry and otoacoustic emission method. Such studies are carried out if the patient has a significant decrease in hearing acuity.

   Adenoiditis must be differentiated from diseases such as chronic rhinitis, sinusitis, sinusitis, and in adolescents, from juvenile angiofibroma (a benign tumor in the nose).

   Therapy methods

   Drugs for the treatment of chronic inflammation of the tonsils in a child should be prescribed by a doctor. The most effective is complex therapy using antihistamines and local antibacterial agents.

   Medicines for the treatment of chronic adenoiditis - table

   • Rinazoline;
   • Nazivin;
   • Otrivin Baby.
   • Fenistil;
   • Suprastinex;
   • Erius;
   • Zodak;
   • Loratadine;
   • Cetirizine.
   • Miramistin;
   • Protargol;
   • Collargol.
   • Klacid;
   • Augmentin;
   • Ospen;
   • Sumamed.
   • Sinupret;
   • Barberry comp.
   • Anaferon;
   • Ergoferon;
   • Viferon.
   • Jungle Kids;
   • Neuromultivitis;
   • Pikovit;
   • Polivit Baby.

   Drugs for the treatment of chronic inflammation of the tonsils - gallery

   Washing

   Rinsing the nose with special solutions can be used not only to treat the disease, but also to prevent it.

   Rinsing the nasopharynx allows you to get rid of mucus and germs, eliminates nasal congestion, and helps reduce the degree of inflammation.

   The procedure is carried out two to three times a day, during an exacerbation - five to six times.

   For rinsing you can use:

   • a syringe or a baby aspirator;
   • Esmarch's mug;
   • a syringe without a needle;
   • special pharmaceutical devices.

   Mineral water, salt solution, and infusions of medicinal herbs are used as a washing solution.

   When rinsing a child’s nasopharynx, it is necessary to strictly follow the technique of the procedure, since if fluid gets into the auditory tube, inflammation of the middle ear and hearing impairment may develop.

   Physiotherapy

   Depending on how severe the disease is, the severity of the inflammatory process, and the size of the adenoids, the otolaryngologist will select the most effective physiotherapeutic procedure. The most common method is laser therapy. During this procedure, a helium-neon laser is used to heat the inflamed adenoids. This treatment kills germs and helps reduce swelling and inflammation.

   For the procedure to be effective, certain conditions must be met:

   • the laser must be delivered directly to the adenoids with a special light guide tube. When irradiating through the bridge of the nose, it is difficult to achieve a positive effect;
   • Before the procedure, it is necessary to clean the adenoids from pus and mucus with saline solution.

   An equally effective method is ozone therapy. In this case, ozone gas is used, which:

   • stops the reproduction and growth of pathogenic microorganisms;
   • helps restore local immunity;
   • accelerates the healing and restoration of the nasopharyngeal mucosa.

   Ozone easily dissolves in water; this composition is used to rinse the nasopharynx.

   In addition, other physiotherapeutic methods are used:

   1. Ural Federal District. During the procedure, ultraviolet rays are used, which have bactericidal properties. The positive effect is observed after 3–8 hours.
   2. Ultrahigh frequency therapy. Under the influence of continuous or pulsed ultra-high frequency currents, the inflammatory process is eliminated, pain is reduced, and local immunity is increased. This method is indicated during periods of exacerbation of adenoiditis.
   3. Magnetotherapy. Helps increase the body's defenses and accelerate cell recovery.
   4. Electrophoresis. A method in which medications (antiseptic, antihistamines, anti-inflammatory drugs) are administered through the skin and mucous membranes using an electric current.
   5. EHF therapy is the use of electromagnetic waves in the millimeter range. Eliminates swelling, improves immunity.

   Folk remedies

   For mild cases of the disease, folk recipes can be used as an addition to traditional treatment.

   Traditional medicine can be used as an auxiliary therapy only after consultation with your doctor.

   1. Salt solution. Regular rinsing with the solution dries out the wounds formed on the tonsil due to illness. To prepare, a teaspoon of salt is diluted in a liter of water. The procedure is repeated three times a day.
   2. Aloe juice. Before the procedure, the nasal passages are washed with salt water. After this, 3-5 drops of freshly squeezed juice are instilled into each nostril. The course of treatment is 60 days.
   3. Sea buckthorn oil. The oil is instilled into each nasal passage, three drops twice a day. The course of treatment is three weeks.
   4. Propolis. Used to rinse the nose. To prepare the solution:
      • 20 drops of pharmaceutical tincture are diluted in a glass of warm water;
      • add ¼ teaspoon of soda;
      • Using a syringe or syringe, rinse the nasopharynx 2-3 times a day.
   5. Beetroot and honey. To prepare the product:
      • natural honey is mixed with beet juice (1:2);
      • used for instillation (3-5 drops three times a day). The course of treatment is two to three weeks.
   6. Tincture of calendula. A teaspoon of pharmaceutical tincture is diluted with salted water (0.5 l) and the nose is washed twice a day.
   7. Collection of herbs for rinsing. To prepare the infusion:
      • mix chamomile flowers (3 tsp) and linden flowers (2 tbsp);
      • pour boiling water (1 cup);
      • leave for 20 minutes, filter;
      • rinse the nasopharynx three times a day. The course of treatment is a week.
   8. Infusion of medicinal herbs:
      • take 100 g of chamomile, mint, sage, coltsfoot, wheatgrass;
      • 3 tbsp. l. the mixture is poured with boiling water (750 ml);
      • leave for 20 minutes, filter;
      • Drink a glass of infusion three times a day after meals until complete healing.
   9. Inhalation with essential oils. For this purpose, you can use eucalyptus or lemon oil. Place two or three drops of oil into the inhaler bowl and breathe for 10 minutes.

   For the youngest children, reduce the dose of essential oil by one. The duration of the procedure is halved.

   Traditional medicine for chronic inflammation of the adenoids - gallery

   Breathing exercises

   Breathing exercises help to avoid the transition of the acute stage of the disease to the chronic stage. In chronic cases, it allows you to maintain nasal breathing and prevents the development of adenoid hypertrophy. Exercises must be performed during remission.

   The goal of gymnastics is to teach the baby to breathe correctly through the nose, during which the body is saturated with oxygen, lymph flows out and the adenoids shrink.

   For chronic inflammation of the tonsil, the following simple exercises will be useful:

   1. Breathing through one nostril. The child, being in the starting position (sitting or standing), inhales through the right nostril (clipping the left one with a finger), exhales with the left, then vice versa.
   2. Gurgling. One end of a rubber tube (length - 40–50 cm, diameter - 1 cm) is immersed in the bottle, the other end is given to the child’s mouth. The baby inhales through his nose and exhales through his mouth (gurgles) for five minutes.
   3. Hedgehog. The child takes a deep breath and turns his head first one way, then the other. You can ask your child to imagine himself as a hedgehog looking for apples in the grass.
   4. Lifting crane. With his palms on his collarbones, the child inhales through his nose and raises his arms up. As he slowly exhales, he lowers his hands.
   5. Ball. Inhaling smoothly, the child inflates his stomach, and exhaling, deflates it.

   Each exercise is repeated 5-6 times.

   Exercises are best done in the morning. Before this, you need to thoroughly clean the nasal passages and drip vasoconstrictor drops into them.

   Breathing exercises using the Buteyko method - video

   Surgery

   In some cases, surgery may be necessary to treat chronic adenoiditis. An absolute indication for such a procedure is obstructive apnea syndrome (partial or complete cessation of breathing during sleep).

   In addition, surgery is recommended if other methods of treating chronic inflammation of the tonsil do not produce results within six months, with recurring otitis media of the middle ear, chronic sinusitis, or hearing loss.

   Adenotomy (removal of the hypertrophied tonsil) is performed in a hospital setting. Depending on how much the adenoids have grown, as well as on the baby’s age, his well-being, and overall health, the doctor may suggest one of the types of surgical intervention:

   1. Classic operation. The procedure is performed under local anesthesia using a special knife (Beckmann's adenotome), which resembles a loop. First, the doctor must thoroughly rinse the patient’s nasopharynx.
   2. Endoscopic surgery. The inflamed tonsil is removed using special endoscopic equipment, which allows you to examine the child’s nasopharynx, take pictures, and visually monitor the progress of the operation. In this case, general anesthesia is used.
   3. Laser adenotomy. Removal of an overgrown tonsil is carried out using laser radiation. During the procedure, the doctor can completely remove the nasopharyngeal tonsil, destroy it from the inside, or shrink the inflamed adenoids without completely removing it.

   In the postoperative period, excessive physical activity, visiting the pool, and eating sour and hot foods are prohibited.

   Possible consequences and complications

   If you do not consult a doctor in a timely manner and the wrong treatment tactics are chosen, serious complications and unpleasant consequences can occur:

   • the occurrence of asthma attacks during sleep due to insufficient oxygen supply;
   • development of otitis media. As a result of the growth of the tonsil, the auditory tubes that connect the middle ear to the nasopharynx are blocked;
   • decreased hearing acuity;
   • chronic tracheitis, bronchitis and laryngitis, which develop due to the constant secretion of mucus and pus;
   • sinusitis, sinusitis;
   • chronic tonsillitis;
   • changes in facial structure;
   • retardation in physical and mental development.

   Prevention

   It is possible to prevent the disease by following these recommendations:

   • at the first warning signs in a child (snoring during sleep, constant nasal congestion, open mouth), consult a doctor;
   • completely cure colds, inflammatory diseases of the nasopharynx;
   • increase the body's defenses through physical exercise, hardening, taking vitamin complexes, and a balanced diet;
   • limit the baby’s contact with patients with acute respiratory infections;
   • Carry out regular hygiene procedures (rinsing your nose with saline solution, brushing your teeth, gargling after eating).

   Chronic adenoiditis in children is a fairly serious pathology, which without proper treatment can result in various unpleasant complications and affect the normal development of the baby. Therefore, at the first warning symptoms, parents should seek medical help.

   Source: http://medvoice.ru/hronicheskiy-adenoidit-u-detey-simptomyi-lechenie-profilaktika/

   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

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