The reason that parents practically do not face the problem of acute adenoiditis until the child is three years old does not lie in the selectivity of the age preferences of the pathology. A certain milestone is at the junction of two periods - home, when the child is protected from infections by practical isolation from pathogens of the pathogenic environment, and social. The second of these stages of a child's life involves his stay in the environment of his peers. As a result, there are more potential dangers of infection, and the load on the baby's body increases many times over.
Tonsils and adenoids
The transition to social life in a child begins, as a rule, abruptly, against the background of a weakened immune apparatus. Faced with a huge number of unfamiliar bacterial irritants, the child's natural defenses, not accustomed to such an onslaught, begin to suffer.
In the nasopharyngeal system of a small person is the amygdala, which performs a barrier function between the external microbial environment and the fragile children's body. The capabilities of the protective body are notare limitless, and when, under the influence of provoking factors, the load on the amygdala increases, it begins to grow rapidly, forming into adenoids.
By the beginning of puberty, adenoids atrophy by themselves, and it is extremely rare to find them in an adult. But while their functionality is at the peak of activity, any strong provocation can lead to inflammation and the formation of acute adenoiditis.
At this stage, detecting and stopping the process is the first task of parents and medical workers. Lost time with a condescending attitude to the he alth of the child leads to irreversible pathologies in the formation of the facial part of the skull, chronic rhinitis, tonsillitis, inhibition of overall development and other disorders.
Forms and degrees of adenoiditis
Classification of adenoiditis implies the division of the disease according to the form of the course, the type of lesion and the severity of the condition:
- Acute adenoiditis. The temperature during a long course rises to 38 degrees, while all segments of the lymphatic ring fall into the area of inflammation. The acute form is observed after diagnosing a child with ARVI and other infectious or bacteriological infections. In the presence of congenital pathologies of the tonsils, adenoiditis in a subacute form can be recorded in infants.
- Chronic adenoiditis is marked by an increased duration, from six months. Symptoms can be significantly overwritten by multiple signs of concomitant ENT diseases, since this typeinflammation of the adenoids covers all parts of the respiratory tract and nearby organs.
Further, according to the scale of the complexity of the disease and the volume of damage to the nasopharyngeal tonsil, the level of the pathological condition is assessed:
- I degree - an inflamed tonsil blocks the third part of the nasal septum and airways.
- II degree - the second part of the septal bone is blocked by the adenoid.
- III degree - one third of the septum remains free from the inflamed organ.
- IV degree - means the complete inability to breathe through the nose due to the extensive coverage of the nasal septum by inflammation.
Symptoms
Acute adenoiditis in children is expressed by such obvious signs that it is impossible not to notice the process at the very initial stage. Even before the enlarged lymph nodes under the lower jaw become replacements and begin to react with pain to touch, the child’s breathing in a dream will be interrupted by snoring, and nasal discharge will change consistency and color to thick, unpleasant-smelling mucus.
Other symptoms will be:
- temperature fluctuations, or a steady rise to 38 degrees;
- the child begins to pronounce the sounds of a "gundos" voice, "rotting";
- there is a deterioration in the child's hearing - he asks again several times and perceives what he hears worse;
- in the morning the baby coughs without phlegm;
- a child who can clearly explain his condition may complain that ina lump in the throat is constantly felt, sometimes this sensation is accompanied by pain.
The so-called "adenoid face" appears in a child due to the extreme disregard of all previous signs by the parents. Such children are always noticeable by a special, as if meaningless or surprised expression, in which the mouth is always parted, and a swollen tubercle is formed between the upper raised lip and nose. With increased salivation, the chin of such children is always wet from the secreted salivary fluid.
Over time, if measures are not taken in this case, the configuration of the cranium changes. The lungs and the bone structure of the chest suffer from improper breathing.
Causes of disease
The disease does not occur from scratch, it is always preceded by inflammation of the nasopharyngeal tonsil. The causative agents of the process are pathogenic fungi or agents of viral infections, such as Staphylococcus aureus and Streptococcus bacteria. The degree of predisposition of the child to a response to damage by microorganisms is also important. Therefore, it is very important not to miss the beginning of the process and always take into account the circumstances that can lead to the formation of pathology:
- there is a risk of contracting SARS from another person;
- the child was freezing;
- frequent illnesses caused immunodeficiency;
- has a history of severe infectious diseases: scarlet fever or measles;
- there are chronic rhinitis, respiratory diseases;
- defectivefood;
- living conditions do not meet general hygiene standards;
- smoking in the presence of a child;
- there is a pronounced allergic susceptibility.
Based on the authoritative opinion of Dr. Komarovsky (the treatment of acute adenoiditis in children was the topic of his separate video conversation), it can be argued that the vast majority of recorded cases of the transition of the disease into a chronic form are due to inadequate therapy for acute respiratory viral infections.
Purulent adenoiditis
Under the influence of infectious pathogens of chlamydia, or based on a general immunodeficiency, due to which the body is not able to reject foreign cells, the adenoids begin to exude pus. After the accumulation of a large amount of liquid substance, the secretions descend into the throat, spread in the sinuses, and getting into the vessels along with the blood, they even begin to travel through the body, settling on the filtration organs - the liver and kidneys.
It is worth remembering that this stage of the disease is a natural continuation of the bright symptoms of an acute course, which means that the stage of decay of the inflamed tonsil could have been prevented.
To detect acute purulent adenoiditis will help such characteristic features:
- constant nasal congestion in a child with incessant secretion of dark, earthy mucus;
- deterioration in the quality of sleep, the child often wakes up, and during sleep does not close his mouth completely;
- Temperature stays at 37.5 degrees;
- presentpersistent headaches;
- hearing loss;
- small children burp into profuse vomit, older children complain of frequent nausea, toilet visits become irregular due to frequent constipation or diarrhea.
For the treatment of acute adenoiditis in a purulent form, multiple washings of the nasopharyngeal apparatus are used and a full course of antibiotics is prescribed.
Subacute adenoiditis
Subacute adenoiditis, like chronic, is a state of unstable signs, with stages of remissions and relapses. But in the case of quickly taken therapeutic measures, noticeable improvements in the dynamics of the inflammatory decline occur within two weeks. This complication of acute adenoiditis at the beginning of the process goes in parallel with the development of lacunar tonsillitis.
Temperature in a child with subacute adenoiditis may persist for some time after the disappearance of the rest of the symptoms, and even during the recovery period. Physical examination will reveal enlarged, painful cervical and submandibular lymph nodes.
Diagnosis
When children have symptoms of adenoiditis, treatment and supportive measures do not always keep pace with the true diagnosis. In cases where an increase in submandibular lymph nodes is a pronounced sign, parents rush to show the child to the dentist. Complete sanitation of the oral cavity sometimes takes a lot of precious time, while the correct therapy of acute adenoiditis must beginimmediately.
The specialist to whom complaints should be addressed if at least two symptoms from the top lists are found is an otolaryngologist. The ENT doctor has all the required tools for an endoscopic examination, but parents need to be prepared for the fact that X-ray and laboratory studies will be required to clarify the diagnosis.
A big problem for many children is a simple physical examination, in which the doctor probes the adenoids with a contact, finger method. But this method is rarely practiced, since viewing pathological growths using posterior rhinoscopy (with a mirror, through the oral cavity) or a fiberscope (flexible endoscope) gives a fairly complete picture of the level and complexity of the disease.
A typical clinic that allows diagnosing a pathology and determining whether adenoids need to be removed from a child is shown in the degree of swelling of the pharyngeal tonsil, the formation of suppuration and the structure (looseness, density) of the diseased organ.
If adenoiditis occurs repeatedly, and there is a suspicion that the microflora of the tonsils does not accept treatment, a smear is taken from the mucosa to inoculate the bacterial environment in order to select adequate antibiotic therapy.
Treatment of adenoiditis
The main task facing doctors when diagnosing symptoms of adenoiditis in children is the treatment of the leading disease, which most often turns out to be SARS. This is included in the measures of general purpose, and actions aimed at arresting are considered local measures.painful manifestations.
Removal of alarming signs and pain syndrome of adenoiditis is facilitated by:
- Rinsing the nasopharynx with saline or products based on it. In order not to irritate the mucous membrane, s alt rinses are recommended to alternate with infusions and decoctions from medicinal plants that have proven themselves as antimicrobial. These are: sage, chamomile, calendula, St. John's wort.
- To stop the secretion of mucus from the nose, use (with a course of no more than a week) means for local vasoconstriction. These are: "Rinostop", "Dlyanos", "Nazol", "Nafthyzin" (for children). Forms of release can be any, but spray irrigation has the advantage of even distribution of liquid.
- Of local antibiotics, children's doctors continue to prescribe the tested "Albucid", but the burning sensation that occurs in children when using the remedy makes the therapy painful for both the child and the parents. Therefore, sprays have long and successfully acted as an alternative to the old drug: "Isofra", "Bioparox" (it has two nozzles in the kit - for irrigating the nose and throat), "Polydex".
The appointment of nasal steroids for the treatment of adenoiditis is considered as mandatory as the use of antibiotics, especially in recent times, when the choice of means allows you to take into account the individual characteristics of the child's body as much as possible. Among these drugs are "Nazofan", "Avamys", "Flixonase". special attentiondeserves the drug "Nasonex". In acute adenoiditis in children, the use of this remedy is justified by clinical recommendations. Also good compatibility with most narrow and broad spectrum drugs.
How to treat acute adenoiditis of the second and third degree of complexity in a child, the attending physician decides, but only after all conservative methods have been tried, and the result is lower than expected, the question of removing the inflamed tonsils by surgery may arise.
Complications and consequences
Acute adenoiditis in children, which has passed into the chronic phase, also has a depressing effect on the psycho-emotional state of the child. It becomes noticeable to those around him that he quickly “rolls down” in school performance, loss of interest in games, especially among peers.
In infants, the occurrence of adenoiditis is a rare phenomenon, but it is also pronounced and cannot be hidden from attentive eyes. The baby becomes restless, suffocates while crying, refuses to take food. Food that has already been consumed often comes out as profuse belching or even vomiting.
With advanced forms of the disease, it is possible to diagnose the most dangerous complication of acute purulent adenoiditis in a child - sepsis.
Prevention
Prevention of adenoiditis should begin with the birth of the baby, and continue all the time until the child reaches adolescence. In addition to constantly monitoring the behavior of the child during sleep (with his mouth closed or open, hesleeps, snores, or suffocates), it is necessary from time to time to arrange the sanitation of the nasopharynx with weak saline solutions. The measure is of particular relevance during influenza epidemics or when a child visits a kindergarten, where rhinitis is ubiquitous.
The timely treatment of any respiratory diseases caused by viruses is of great importance in preventing tonsil stress.
