Almost 25% of children and their parents hear in the otolaryngologist's office that the baby's adenoids are enlarged. These formations are combined with the nasopharyngeal mucosa. In a he althy child, they are actively functioning. It is the adenoids that are the first to encounter various toxins, bacteria, allergens, microbes and launch a protective mechanism.
Classification of problems
Inflammation of the adenoids experts call adenoiditis. But even in the absence of an active pathological process, they can be increased. The doctor can say that adenoids are 2-3 degrees in children. In this case, this nasopharyngeal tonsil can be harmful.
Otolaryngologists can tell on examination that a child has adenoids:
- 1 degree, provided that they cover no more than 1/3 of the nasopharynx, only the upper part of the vomer (the plate that forms the back of the nasal septum) is covered;
- Grade 2, usually edemacovers half of the nasopharynx, 2/3 of the vomer overlap;
- 3 degrees, almost the entire nasopharynx is blocked.
As they increase, accompanying problems develop. So, adenoids of the 3rd degree in children cause difficulty breathing, hearing deteriorates noticeably. With stage 2 hypertrophy, snoring appears in a dream, frequent coughing. Nasal breathing is markedly impaired. With grade 3 adenoids, air enters the lungs only through the mouth.
Signs of disease
Parents can also suspect that a child has enlarged palatine tonsils. Most often this problem occurs in children aged 3-7 years. But it can also bother teenagers. The following symptoms indicate that adenoids of 2-3 degrees have developed in children:
- difficult nasal breathing, the child breathes mainly through the mouth;
- protracted recurring runny nose;
- deterioration of sleep, snoring becomes audible;
- the appearance of nasality;
- slurred speech;
- hearing loss;
- apathy, fatigue, lethargy;
- headache complaints.
Noticing one or more symptoms, it is advisable to show the child to the ENT. This doctor can make an accurate diagnosis and, if necessary, prescribe treatment.
Disease diagnosis
The usual visual examination is not enough to understand that grade 3 adenoids in children. But most otolaryngologists do not have the equipment to make an accurate diagnosis. They can only use the finger method. Butit is considered uninformative. In ordinary clinics, as a rule, they recommend taking x-rays. With this method, you can visualize the increase in these tonsils, but determine if the inflammatory process does not come out.
One of the diagnostic methods is pharyngoscopy. This is an examination of the oropharynx with a spatula and a special laryngeal mirror. Such a study allows you to assess the condition of the nasopharynx and identify adenoids of 2-3 degrees in children. Treatment can be prescribed after such an examination.
Anterior rhinoscopy can also be performed. It requires a special nasal dilator. During the procedure, you can assess the condition of the nasal passages, septum. If vasoconstrictor drugs are instilled before the study, then you can see the back of the nasopharynx and adenoids.
Posterior rhinoscopy, which is performed using a fiberscope and a nasal mirror, is practically not done for children. Although this method is considered harmless and informative.
Modern examination methods
Establish an accurate diagnosis and determine the degree of enlargement of the nasopharyngeal tonsil using computed tomography. This is a rather expensive method of examination, but it is informative. True, they use it extremely rarely.
The most progressive way is endoscopic examination. It is this diagnostic method that allows us to confirm that grade 3 adenoids in children. Photos of problem areas in this study are not at all difficult to make.
For hima small tube is inserted into the nasal cavity, at the end of which a video camera is located. With its help, you can not only determine the size of the adenoids, but also clarify their location. Also, the doctor can see if there is inflammation and check if this process extends to the auditory tubes.
Purpose of adenoids
Many parents mistakenly believe that the nasopharyngeal tonsils are an absolutely useless formation that should be removed. But they are not quite right. Of course, if a diagnosis of grade 3 adenoids is made in children, the doctor will recommend removing them. But in some cases, you can try to get rid of the problem by conservative methods.
Often, adenoids begin to grow against the background of persistent infectious diseases. They are part of local immunity. The nasopharyngeal tonsil is a kind of barrier that can cope with viruses even before they enter the body. Local cellular immunity develops in this gland. It is a natural barrier to pathogens.
Adenoids themselves are an important part of the immune system. If there is an opportunity to restore their work and calm the inflammatory process, then it should be used.
Failures in local immunity
Of course, overly enlarged grade 3 adenoids in children can no longer fulfill their purpose. The outflow of lymph is disturbed, the glandular tissues grow, and the inflammatory process practically does not subside.
In this caseadenoids can no longer be a barrier to bacteria. Mucus in the nasal cavity begins to linger due to disturbances in the functioning of the mucociliary apparatus. But it is with it that a significant part of the trapped microorganisms, dust particles, potential allergens is removed.
Grade 3 adenoids in a child contribute to the fact that pathological microorganisms linger in the nasopharynx. At the same time, local immunity is already suppressed by a constant inflammatory process. This is the main reason that the likelihood of developing the disease increases. As a result, a vicious circle is formed: due to the enlarged nasopharyngeal tonsil, diseases become more frequent, and due to diseases, the adenoids grow even more.
Ways to solve problems
As a rule, most otolaryngologists recommend removing grade 3 adenoids in children. But choosing this path, we must remember that they tend to grow. Of course, this doesn't happen to everyone. But there are patients whose problem comes back again after six months or a year.
Sometimes the nasopharyngeal tonsil is enlarged due to poor heredity. The tendency to overgrowth of this gland is transmitted at the gene level. Some babies are born with a weak Waldeyer ring. It includes lingual, tubal tonsils, as well as tonsils and adenoids.
Some doctors don't think surgery is necessary. They offer their own options on how to cure grade 3 adenoids in a child. As a rule, complex therapy is needed to suppress inflammation and reduce edema.
The growth of the nasopharyngeal tonsils is an exclusively childish problem. In most adults, this organ atrophies. After all, starting from the age of 12, the adenoids begin to decrease.
Conservative Therapy
Before recommending the removal of grade 3 adenoids in children, qualified doctors will offer parents a set of measures aimed at relieving swelling and reducing inflammation. In some cases, they help to cope with the problem without surgery.
The doctor prescribes vasoconstrictor drops, which must be used for 5-7 days. Suitable "Naftizin", "Ephedrine", "Sanorin", "Galazolin" and other children's options. After instillation, it is necessary to rinse the nasal cavity. This can be done with the help of special antiseptic solutions, for example, Furacilin or Dolphin. Do not confuse flushing with irrigation.
Simultaneously with instillation and washing, a general treatment is prescribed. It should be aimed at strengthening the immune system. General tonic, vitamins, immunostimulants and antihistamines are prescribed. Antiallergic medications should be taken if grade 3 adenoids are diagnosed in children. This treatment is necessary due to the fact that allergies are one of the main causes of the onset of pathological changes in these tonsils.
Physiotherapy also gives good results. Quartz treatment of the nasopharyngeal cavity, helium-neon laser therapy, UHF and electrophoresis with a solution of diphenhydramine, potassium iodide are considered effective.
Surgical treatment
Many doctors, seeing grade 3 adenoids in a 3-year-old child, send him immediately for surgery. But it is indicated in case of unsuccessful attempts at conservative treatment. Also remove these tonsils when:
- breathing through the nose is difficult or almost impossible;
- the child has constant colds or infectious diseases, including tonsillitis, tonsillitis, pneumonia, otitis media;
- develop complications in the paranasal sinuses (known as sinusitis);
- there is snoring and breath holding during sleep.
Before surgery, it is necessary to calm the inflammatory process, otherwise it will not be possible to remove the entire focus of the infection.
Deletion process
Surgical treatment can be performed on an outpatient basis (in a regular clinic) or in a hospital hospital. The operation is done under local or general anesthesia. It lasts no more than 20 minutes, and the process of cutting off the overgrown tissue takes up to 3 minutes. The operation is performed with the help of Beckman's adenotome. This is a special knife, made in the form of a ring, which captures the overgrown tissue of the nasopharyngeal tonsil. It cuts off in one motion.
During the operation, the child should sit with his head thrown back. She is held by a nurse, pressing down slightly from above so that the patient does not have the opportunity to rise. At the same time, the nostrils are closed with cotton.
Beckman's adenotome is inserted into the throat. It is advanced up to the stop and the fabric is cut off with a sharp movement back and down. After that, the cotton wool covering the nasal passagesis removed. After removal, the patient should blow their nose and breathe through the nose with their mouth closed.
But this is not the only option on how to cure grade 3 adenoids in a child. A more modern method is endoscopic removal. Such an operation is performed under visual control, the doctor can clearly see the location of the adenoids and completely remove them.
Folk methods
In addition to conservative and surgical treatment, there are also alternative methods of therapy. Many parents drip a mixture of 2 parts beetroot juice and 1 part honey into their nasal passages. For 2-3 weeks, it is necessary to instill 5 drops several times a day.
You can also use aloe juice. But such treatment should last several months. It is enough to instill 2-3 drops three times a day. Many people recommend gargling with an infusion of eucalyptus leaves. This must be done 3 times a day for six months.
There are other folk methods designed to reduce swollen glandular tissue of the tonsils. You can drip sea buckthorn, eucalyptus oil or an infusion made from birch leaves.
