Grade 2 adenoids in children: treatment, causes, symptoms
The content of the article:
- Why do adenoids arise?
- Symptoms of the adenoids
- Diagnostics of the adenoids of the 2nd degree
- How to treat grade 2 adenoids in a child
- When surgery is needed
- Video
Grade 2 adenoids in children have pronounced symptoms. Since the first stage of the disease has practically no external manifestations (it can be detected by an otolaryngologist during examination), the disease is usually detected when the adenoid growths have reached the next stage.
Adenoids in children show susceptibility to respiratory infections
Adenoid vegetations usually occur in children at about 2 years of age, and the increased risk of their occurrence persists up to 8 years. This is a chronic disease, which practically does not manifest itself at the initial stage of development, but at a later stage causes considerable discomfort and can cause serious complications, including irreversible ones. Therefore, most often parents of children with second degree adenoids seek medical help.
Why do adenoids arise?
Adenoids are significantly enlarged tonsils in the nasopharynx. Tonsils are large nodes of lymphoid tissue, a peripheral organ of the immune system, in which the growth and proliferation of cells that provide immunity, that is, the body's defense, occurs. The nasopharyngeal tonsils are the first barrier to airborne infection. Weakened immunity, frequent inflammation, allergies and hypersensitivity lead to a significant proliferation of lymphoid tissue. Then they talk about compensatory hypertrophy of the tonsils.
Another reason for the enlargement of the tonsils is their inflammation - adenoiditis. This condition differs from ordinary adenoids by the presence of a systemic response of the body, an increase in temperature, a decrease in resistance, and involvement in the inflammatory process of the mucous membrane of the nasal passages and throat. This pathology requires treatment with anti-inflammatory drugs, but the therapy itself, with an adequate approach, takes much less time than the treatment of persistent hypertrophy.
When the adenoids enlarge so much that they block more than half of the lumen of the respiratory tract, the first clinical manifestations appear. In the photo, grade 2 adenoids in children fill from 1/3 to 2/3 of the lumen of the nasal passages.
Symptoms of the adenoids
The clinical picture depends on the degree of adenoids, there are three of them:
- Vegetation covers about 1/3 of the opener (unpaired bone of the posterior parts of the nose). Clinical manifestations at this stage of the disease are scarce or absent altogether. Characterized by frequent diseases of the upper respiratory tract, snoring at night, noisy breathing is possible. Symptoms are mostly seen when lying down. Airway patency is preserved.
- The adenoids cover more than half of the opener, about 2/3. Rare snoring at night is replaced by constant snoring, with physical exertion, breathing becomes noisy, puffing appears. The child often suffers from acute respiratory infections, a runny nose. Discharge from the nose can become almost permanent. Their flow down the back of the pharynx causes a reflex cough.
- Adenoids almost completely block the lumen of the respiratory tract, nasal breathing is absent, the patient is forced to breathe through the mouth almost all the time. The timbre of the voice changes - nasalness appears. Lack of nasal breathing leads to chronic hypoxia of the brain, which affects the child's behavior and can cause mental and physical retardation. The patient is susceptible to respiratory tract infections, as well as eustachitis and otitis media, hearing may deteriorate.
Prolonged hypoxia is extremely dangerous at an early age. The child's nervous system is actively developing and becoming more complex, while requiring a large amount of oxygen. When the brain does not receive it, development slows down - the child learns worse, suffers from attention deficit, concentrates poorly, and remembers poorly. Chronic hypoxia at 3 years and less is fraught with irreversible consequences.
When a child is forced to keep his mouth open all the time (adults say "the nose is clogged"), the so-called adenoid type of face is formed, which is characterized by a constantly open mouth, changes in cartilaginous structures and nose, lengthening of the lower jaw and pathological bite.
As you can see, the 2nd degree of adenoids is intermediate. This is the period when the treatment should be as active as possible.
Diagnostics of the adenoids of the 2nd degree
The presence of adenoid growths is determined by the method of rhinoscopy. As a rule, this is enough to determine the degree of growth. Nevertheless, in some cases, a clarifying diagnosis is necessary, for this purpose the following are carried out:
- endoscopic examination is a method that allows you to visualize the adenoids and surrounding tissues as accurately as possible. The endoscope easily penetrates into any cavity, which also allows you to identify the pathology of the auditory tubes, if any;
- radiography - rarely used, can provide additional information about the degree of obstruction of the airways.
In diagnostically difficult cases, endoscopy of the nasal passages is used.
How to treat grade 2 adenoids in a child
What if a child has second degree adenoids? Do you need surgery? Most experts, including the famous doctor Komarovsky, agree that surgical removal of adenoid growths is needed only when conservative treatment no longer works. Meanwhile, at stages 1 and 2, conservative therapy, according to experts, provides a good effect, which makes it possible to do without surgery.
Treatment should be comprehensive, that is, include both pathogenetic therapy (aimed at eliminating the cause of the pathology) and symptomatic (aimed at eliminating clinical manifestations).
Outside adenoiditis, that is, an active inflammatory process, mainly local treatment is used. The exception is when the adenoids are caused by allergies, then antihistamines must be taken orally.
In the treatment regimen for grade 2 adenoids in children, the main place is given to salt washes. This allows you to evacuate the contents of the nose, has a drying, antimicrobial effect. Pharmaceutical saline solutions (saline solution), sprays with sea water are suitable for washing, homemade saline solution, which is prepared by dissolving ½ teaspoon of salt in a glass of boiled water cooled to room temperature, is no less effective.
Saline solution for rinsing the nose is easy to make at home
For washing, you can also use folk remedies in the form of decoctions of medicinal plants with an antiseptic effect (oak bark, St. John's wort, anise, raspberry leaves, etc.). However, their use must be approached with caution, since, unlike saline, they can cause an allergic reaction.
In addition to regular flushing, vasoconstrictor or anti-inflammatory nasal drops may be prescribed. Sometimes it is recommended to instill a preparation of thuja oil into the nose.
An important component of the treatment of adenoids is physiotherapy - ultraviolet irradiation, UHF therapy, therapeutic electrophoresis, visiting the salt room, inhalation with drugs.
Respiratory gymnastics provides a good therapeutic effect. It helps to reduce edema, restores nasal breathing, and if carried out regularly (several months), especially in combination with salt washings, it can lead to involution of adenoid vegetations. The advantage of this method is the absence of contraindications and any drug load on the body.
Systemic anti-inflammatory and antibacterial are prescribed for adenoiditis. It should be understood that these drugs do not cure grade 2-3 adenoids, but only eliminate the inflammatory process and cannot replace local therapy.
When surgery is needed
Adenotomy - surgical removal of adenoids, performed according to medical indications and the exceptional ineffectiveness of conservative treatment. In about half of the cases, grade 2 adenoids remain untreated at this stage, and gradually progress to grade 3, when surgery becomes necessary. Indications for surgery are sleep apnea (temporary cessation of breathing during sleep), prolonged hypoxia of the brain, complete obstruction of the nasal passages, persistent infectious diseases of the respiratory tract, the formation of an adenoid type of face.
Removal of adenoids is a simple and quick operation that takes no more than 15 minutes. It is usually performed under local anesthesia (general anesthesia may be used if indicated). The rehabilitation period is short, it takes about a week. In the modern version, this intervention is carried out under endoscopic supervision, which significantly increases its effectiveness (less risk of recurrence) and reduces the likelihood of postoperative complications.
A new, more effective and safer method is the removal of adenoids with a laser. The painless procedure guarantees complete removal of the tonsil, minimal blood loss and absolute sterility.
Video
We offer for viewing a video on the topic of the article.
Nikita Gaidukov About the author
Education: 4th year student of the Faculty of Medicine No. 1, specializing in General Medicine, Vinnitsa National Medical University. N. I. Pirogov.
Work experience: Nurse of the cardiology department of the Tyachiv Regional Hospital No. 1, geneticist / molecular biologist in the Polymerase Chain Reaction Laboratory at VNMU named after N. I. Pirogov.
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