The most common and delivering a lot of trouble ENT pathology to children is adenoids. Such a diagnosis is increasingly being made to babies from one year old and older, making their mother nervous and trying to see unknown formations. It is impossible to examine them with the naked eye, but a lot of not very pleasant symptoms make you seek the advice of a specialist.
What are adenoids
Absolutely all children have adenoids, and serve them as reliable protection against dangerous viruses and insidious microorganisms. Why is this immune organ a friend for some babies, and a source of ailments for others? Adenoids produce lymphocytes that fight infection and try not to let it go further than the nasopharynx. During this important process, the lymphoid tissue of the nasopharyngeal tonsil enlarges and becomes inflamed. After recovery, adenoids return to normal.
However, in the case of frequent colds, viral diseases or the transition of the disease to the chronic stage, the lymphoid tissue is constantly inflamed, enlarged and gradually grows. Sometimes its size reaches such an extent that it completely blocks the nasopharynx, allowing the child to breathe only through the mouth. Over time, adenoids become a constant source of infection, causing bronchitis, tonsillitis and even asthma.
Adenoids in children symptoms
The main sign of the presence of enlarged adenoids is a violation of nasal breathing. Forced to breathe through the mouth, the baby snores at night, suffers from nightmares, may experience signs of suffocation, gets up in the morning awake and tired. Daytime breathing through the mouth leads to constant illness, as the inhaled air does not clear and does not warm in the nose, which often causes tonsillitis, tonsillitis, pharyngitis and bronchitis. Even the appearance of the child changes, which is facilitated by a constantly open mouth. In addition to shortness of breath, adenoids are manifested by other symptoms:
- runny nose - quickly becomes chronic and annoys the baby almost constantly;
- hearing loss - enlarged lymphoid tissue partially, and sometimes completely, blocks the auditory tube. An attentive mother will definitely note that the baby constantly asks when he is being consulted, and will check with a specialist for the presence of adenoids;
- nasal and illegibility of speech;
- daytime drowsiness and fatigue, headache - the results of restless sleep;
- specific cough;
- frequent otitis media;
- reduced body resistance and a tendency to respiratory diseases.
Very often, adenoids cause physical and mental retardation, impaired correct speech, a significant decrease in academic performance.
Degrees of adenoids in children
The opener is a small bone plate that serves as the basis for the nasal septum. With the growth of adenoids, its full or partial covering occurs, on the basis of which the stage of an increase in adenoids is determined. According to the parameters of this indicator and the severity of symptoms, adenoids are usually divided into three degrees:
1. Breathing is difficult only at night, during the day the child feels normal. Lymphoid growths cover only the upper part of the opener.
2. In the daytime, the baby has problems with nasal breathing, at night he emits sniffles and snores. The coulter is covered by two-thirds.
3. Adenoids become a source of constant infection. There is no breathing through the nose, hearing impairment is noticeable, which is explained by the complete opener coverage.
As a rule, the detection of adenoids of the first degree does not require surgical intervention and complex treatment. The doctor prescribes vitamin therapy, taking calcium preparations, instillation of special drops in the nose. A regular visit to a specialist is recommended to monitor the condition of the lymphoid tissue. If adenoids of the II or III degrees are diagnosed, that is, their significant growth, the ENT doctor tries to choose the most suitable way to deal with an unpleasant ailment.
Adenoids of the 2nd degree in a child
Adenoids not only grow, from time to time they are able to inflame. In this case, an acute disease called adenoiditis occurs. Its signs:
- the thermometer column confidently overcomes the mark of 38 degrees;
- the appearance of liquid, with a possible admixture of blood, secretions that pass into the mucopurulent;
- it is difficult for the baby to fall asleep, he snores at night, short-term respiratory arrests occur - apnea.
The doctor prescribes treatment, which amenable to the disease, but with repeated exacerbations of the disease, adenoids have to be removed.
Adenoids of the second degree are manifested by significant difficulty in breathing, which increases at night. A constant lack of oxygen is explained by the baby's weakness and lethargy, drowsiness, developmental delay, fatigue and headache. The occurrence of bronchial asthma, nighttime urinary incontinence is possible, hearing and speech disorders are noted.
The choice of treatment method does not depend on the degree of increase in adenoids, but on their effect on the fragile body of the baby. If the adenoids do not inflame, their treatment is not carried out. The doctor focuses on the prevention of diseases, since without exacerbations, the growth of adenoids stops. If there are frequent recurrences of acute adenoiditis, complications join in, the baby is catastrophically lagging behind in development - the doctor offers surgical intervention.
Adenoids 3 degrees in a child
With a significant increase in adenoids, their effect on the child's body becomes more and more destructive. Constant inflammation contributes to the uninterrupted production of mucus and pus, which freely enter the respiratory system. Laryngitis, pharyngitis, tracheitis and bronchitis become frequent guests, purulent otitis also join them. The process of normal development of the bones of the facial skeleton is disrupted, and this affects the development of the baby's speech in the most unfavorable way. Inattentive parents do not always notice the arrogance that has arisen, and the inability to pronounce many letters is attributed to other reasons. A constantly open mouth changes the appearance of a hitherto attractive child, he begins to have psychological problems due to ridicule of his peers. There is no need to hope that the child will outgrow, at this stage an appeal to the doctor becomes a necessity.
Treatment of adenoids in children without surgery
The first degree of adenoids definitely does not require surgical intervention, at the discretion of the doctor - the second, as a rule, with the third degree, adenoids are removed. However, this does not mean at all that the visit to the doctor will end with a referral for surgery. There are many methods of conservative treatment, which very often give an effective result. It is used in the treatment of both local and general therapy:
- antimicrobial and anti-inflammatory drugs;
- vasoconstrictor drops in the nose;
- washing the nasal cavity with decoctions of herbs, sea water, furacilin or protargol;
- antihistamines;
- vitamin therapy;
- physiotherapeutic methods;
- climatotherapy.
Important! Adenoids cannot be heated! This can cause a rush of blood, an increase in edema and a deterioration in the baby's condition.
Parents should be aware that the proliferation of adenoids lasts until around the age of five and stops. After that, under certain conditions, they can begin to decrease and by the age of 14 completely disappear. However, in each specific case, the otorhinolaryngologist decides on the choice of the method of treatment, he also observes how the disease lends itself to conservative treatment. The doctor will never offer parents an operational way to solve the problem without having important indications for this.
The operation to remove adenoids in children
If adenotomy (an operation to remove adenoids) is chosen as the treatment method, mothers should not be very upset - usually the children tolerate it quite easily. The operation is currently performed under local or general anesthesia and lasts about half an hour. Based on the periods of growth of the body, most often the surgical method is used in children up to three years of age, at 5-6 years old and at 9-10 years of age. Before surgery, the oral cavity is sanitized and the inflammation of the pharyngeal tonsil is eliminated. This is necessary to prevent possible complications. The best time for surgery is 6-7 years, an earlier adenotomy does not guarantee that repeated growths will not appear.
After the operation, some unpleasant manifestations are possible:
- light bleeding;
- nasal congestion;
- pain in the ears.
All of them pass very quickly, and to prevent the appearance of unexpected complications, the doctor prescribes antibiotics. A child can be taken home the same day only after providing him with bed rest for a day. The recovery period takes about seven days, and physical activity and sun exposure should be limited for another week.
Unfortunately, relapses after surgery are possible. The reasons are:
- conducting an adenotomy before the age of three years - sometimes it is really necessary;
- a tendency to allergic reactions;
- incomplete removal of adenoids - even adenoids can grow from the millimeter residue of unpleasant growth.
It will not be out of place for mothers to learn that the prevention of the appearance of adenoids can be strengthened by the immune system - hardening, timely treatment of carious teeth, and avoiding frequent colds and infections. The regimen and full-quality nutrition are also your allies, but it is worth fighting with the existing allergy.
Adenoids in children, the opinion of Dr. Komarovsky
A favorite doctor, answering questions from concerned mothers, explained that the reason for the removal of adenoids was not the fact of their presence, but specific indications for surgery. Getting rid of enlarged adenoids at the age of three to four years is fraught with their reappearance. However, if there are hearing problems, there is no positive dynamics with conservative treatment and the child constantly breathes through the mouth, indications for surgery are undoubtedly present, and the baby's age is not an obstacle to its implementation.
