Adenoids in the nose in children
The content of the article:
- What causes adenoids
- Degrees of adenoid growths
- Symptoms of adenoids in the nose in a child
- Diagnostics
- Treatment
- Prevention
- Video
Adenoids in the nose in children are a common pathology, the development of which is associated with age-related imperfection of immunity and other features of the child's body. Children aged 2–7 years are most vulnerable to adenoids. Much less often this disease is diagnosed in older children and adults.
Parents often find hypertrophy of the nasopharyngeal tonsil in children at later stages, since at the initial stage of the disease, pronounced symptoms are usually absent, or so scarce that they do not pay attention to themselves. However, the most rapid and effective treatment of adenoids is carried out precisely at an early stage of their development, so it is important to know how to identify them in time and what to do if the child has signs of the disease.
What causes adenoids
The nasopharyngeal tonsil is part of the immune system, it consists of lymphoid tissue and its task is to filter the air entering the nasopharynx from infectious agents, preventing the spread of infection in the body. In children, immunity is at the stage of formation, it is still underdeveloped, therefore, often when infected, the amygdala becomes inflamed. Inflammation causes its hypertrophy, i.e. an increase. Normally, after the inflammatory process is resolved, the amygdala returns to its normal size. However, if the inflammatory process develops frequently, then the hypertrophy can become irreversible. In children, all tissues of the body are prone to overgrowth, including pathological, which is why adenoid growths are not uncommon for them.
Hypertrophied nasopharyngeal tonsil can completely block the lumen of the nasal passages
The emergence of adenoid vegetation is facilitated by frequent colds, childhood infections, adverse environmental factors (staying in dusty and stuffy rooms, living in ecologically unfavorable areas). A hereditary tendency is also noted.
Degrees of adenoid growths
How the adenoids in the nose look and how they manifest themselves depends on the degree of their growth. There are three such degrees in total:
- Adenoid vegetation overlaps less than 1/3 of the height of the nasal passages or vomer.
- The hypertrophied nasopharyngeal tonsil overlaps the vomer or the height of the nasal passages by more than ½.
- The adenoids overlap the height of the nasal passages or the vomer by more than 2/3.
In the latter case, in the photo of adenoids in the nose in children, you can see that the nasal passages at the level of the nasopharyngeal tonsil are almost completely blocked.
Symptoms of adenoids in the nose in a child
The main and first sign of the presence of adenoids is a persistent violation of nasal breathing. At the initial stages of the disease, this may be subtle, usually during this period, nasal breathing is generally preserved, and only in a horizontal position (during nighttime or daytime sleep) noisy breathing, puffing, and snoring are heard. At first, such signs appear from time to time, but as the adenoids grow, they become permanent.
As the pathology develops, nasal congestion and difficulty in nasal breathing begin to draw attention to themselves during wakefulness. Adenoids are often accompanied by mucous nasal discharge. Flowing down the back of the pharynx, they cause a reflex cough, especially in the morning and after naps.
Even later, others notice that the child practically does not breathe through his nose. His mouth is constantly parted. Sense of smell is impaired, appetite decreases. The voice becomes nasal. Due to sleep disturbances, aggravated by insufficient oxygen supply to the body, headaches, rapid fatigue, pallor of the skin, impairment of memory and attention, decreased performance, increased irritability, and moodiness may appear.
Due to the overlap of the auditory tube by the adenoids, such patients often develop otitis media, eustachitis, and hearing impairment.
The air, bypassing the nasal passages, is not cleared and not warmed, which is why children who constantly breathe through the mouth become susceptible to acute respiratory infections, which, in turn, increase hypertrophy of the nasopharyngeal tonsil.
Constant mouth breathing leads to the formation of a pathological bite (the upper incisors protrude forward) and a violation of the structure of the bones of the facial skeleton, chest. A prolonged absence of nasal breathing manifests itself externally: in such children, a constantly open mouth, an elongated lower jaw, and the outer corners of the eyes drooping down.
A constant focus of infection in the body can cause the spread of the pathological process to other organs and systems. Patients with adenoids often suffer from lingering laryngitis, pharyngitis, sinusitis, bronchitis, they have disorders of the cardiovascular, digestive system, and bedwetting is observed.
Diagnostics
How to understand that a child has adenoids, and not a common cold? The adenoids are characterized by a long, many-month course. However, only a doctor can accurately diagnose, therefore, at the first suspicion of the presence of adenoids, you should immediately consult an otolaryngologist. The early stages of the disease, without an obvious clinical picture, are usually detected by a doctor during preventive examinations - for this reason, they should not be neglected.
Diagnosis is made after rhinoscopy
During rhinoscopy, the doctor can easily see adenoid vegetations and determine their degree by the height of the opener overlap. In most cases, this is sufficient to establish a diagnosis. To develop therapeutic tactics, a bacteriological examination of nasal secretions is performed, as well as a general analysis of the patient's blood and urine. In difficult diagnostic cases, an x-ray may be required.
Treatment
For the treatment of adenoids, conservative and surgical methods are used. Currently, most pediatricians, including the famous doctor Komarovsky, recommend giving preference to conservative therapy, and resorting to surgical intervention only if there are strict indications.
Conservative treatment of adenoids consists in regularly rinsing the nose, instilling drugs with a vasoconstrictor, anti-inflammatory, antiseptic effect into the nasal passages. If bacteriological examination has confirmed the presence of a bacterial infection, antibiotics are prescribed. From local antimicrobial drugs, Sofradex, Tobradex, etc. can be used.
How to rinse your nose? The most versatile, simple and effective remedy is saline solution. You can buy it at the pharmacy, or you can prepare it at home. To do this, dissolve ½-1 teaspoon of ordinary table salt in a glass of boiled water cooled to room temperature. For rinsing, use a disposable syringe without a needle or a small syringe. At the pharmacy, you can buy ready-made saline solution (saline), as well as salt-based nasal sprays. The latter are distinguished by a rather high cost, but they are most convenient to use. These include Aqua Maris, Aqualor, Quicks, Physiomer, Marimer, Otrivin, etc.
Decoctions of medicinal herbs with anti-inflammatory and drying effect (chamomile, oak bark, field horsetail, St. John's wort, string, calamus, eucalyptus, etc.) can also be used to wash the nose. Thuja oil-based nasal drops can help in some cases. However, it should be borne in mind that before using any folk remedies, you need to consult with your doctor, since they have a relatively high allergenicity.
You can rinse your nose with saline or herbal decoctions.
Can I warm my nose if it is stuffy? Thermal treatments can be effective, but they must be used with great care and only in the absence of acute inflammation. Therefore, it is better not to warm your nose at home, at least without the approval of your doctor. If necessary, the child is prescribed physiotherapeutic procedures: inhalation with a nebulizer, electrophoresis of drugs, ultra-high-frequency therapy, UFO therapy.
To breathe better through the nose, breathing exercises are prescribed. The same method is shown in the postoperative period if it is decided to resort to surgical treatment.
In the absence of the effect of prolonged and regular conservative therapy, with a prolonged absence of nasal breathing, developed hearing impairments, changes in the facial skeleton, and a lag in mental and physical development, surgical treatment of adenoids in children is indicated. The operation can be carried out by the classical method (excision with an adenotome), as well as by the endoscopic, laser method, as well as by the coblation method.
Adenotomy has no age restrictions; if indicated, it can be performed in patients of any age. Relative contraindications are infectious diseases (preliminary treatment is required), blood diseases (preliminary drug preparation is required), a month after vaccination, as well as malignant neoplasms and other severe pathologies in the stage of decompensation (the question of the possibility of adenotomy is decided on an individual basis).
Removal of adenoids can be carried out using classical or minimally invasive methods
It should be borne in mind that if the patient has adenoids removed, regardless of the method, this is not a guarantee of no relapse - this is one of the reasons why doctors do not consider adenotomy a universal solution to the problem.
Prevention
Prevention of adenoids consists in measures to strengthen the child's immunity: a healthy balanced diet, physical activity, a rational daily routine, hardening.
Video
We offer for viewing a video on the topic of the article.
Anna Aksenova Medical journalist About the author
Education: 2004-2007 "First Kiev Medical College" specialty "Laboratory Diagnostics".
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