Adenoids are the pharyngeal tonsil that is located in the human nasopharynx, it performs the most important functions in the body - it produces lymphocytes, immune cells that protect the mucous membrane of the nasopharynx from infections.
When there is a pathological increase in the nasopharyngeal tonsil, this disease in medicine is called adenoid hypertrophy, and with their inflammation - adenoiditis. The increase and inflammation of adenoids occurs in children aged 3-10 years, according to statistics, 5-8% of children suffer from this ailment, with both girls and boys with the same frequency.
With age, the frequency of morbidity is reduced, sometimes this disease occurs in adults, but much less often. If adenoids appear in children, the symptoms can be determined by the difficulty of breathing freely with the nose, the child begins to frequently get cold and viral diseases, snore at night, the voice becomes nasal, often there is otitis, developmental delay, bite, slurred speech, hearing impairment. Even the field of surgical removal of adenoids is possible for their repeated overgrowth.
What are adenoids?
Nasopharyngeal tonsils - adenoids, enter the pharyngeal ring and are located at the junction of the pharynx and nose. In adults, adenoids most often have tiny dimensions or generally atrophy. But in children, lymphoid formations are very well developed, as the immature immune system in childhood functions with increased load, trying to react as much as possible to the attacks of various bacteria and viruses. Through the nasopharynx, a great many different pathogenic microorganisms-viruses, bacteria, fungi penetrate the human body together with air, food, water, and the nasopharyngeal tonsil prevents their deep penetration and protects against the multiplication of microbes in the respiratory tract.
The causes of adenoids in children
The growth of adenoids in children is promoted by:
- Hereditary predisposition
in the child to the growth of the nasopharyngeal tonsil, to this immune pathology, which is also called lymphatic diathesis or lymphatics.
This deviation is due to the lymphatic-hypoplastic anomaly of the constitution, that is, disturbances in the structure of the lymphatic and endocrine system.
Therefore, with such a pathology, a decrease in thyroid function is often manifested, then in addition to adenoids in children, symptoms are supplemented by lethargy, swelling, apathy, and a tendency to fullness.
- Pathology of pregnancy and childbirth
The cause of adenoids in children is also seen by doctors in the birth trauma of a baby, pathological pregnancy, fetal hypoxia or asphyxia during labor . And also it is important what was the 1 trimester of pregnancy in the mother, especially the mother-borne viral diseases during the 7-9 weeks of pregnancy, the intake of antibiotics, toxic drugs at any gestation period of the baby.
- Feeding, vaccinations, diseases
Influence on the increase in adenoids in children has the character of infant feeding, vaccinations and various diseases at an early age, as well as overeating and abuse of sweet and chemical products.
- Against the background of childhood infectious diseases, such as scarlet fever , measles (see symptoms of measles in children ), whooping cough , diphtheria, possible secondary inflammation and adenoid growth in the child.
- Toxic effect on adenoids is caused by frequent ARVI, and other viruses, dissemination of adenoids by various pathogenic bacteria.
- Presence of allergic reactions in the family history and in the child in particular.
- Immune deficiency in the child.
- The general unfavorable ecological situation in the place of residence is polluted, gas-contaminated, dusty air, an abundance of household chemicals in the home, poor-quality furniture and plastic toxic products in everyday life.
Signs, symptoms of adenoids in children
Why is it important to distinguish adenoid hypertrophy from adenoiditis?
It is very important for mothers to distinguish between these two pathologies, for what? With adenoiditis, when the nasopharyngeal tonson is inflamed several times, many doctors recommend that parents delete it, but this can be successfully treated in conservative ways. But when there is hypertrophy of the nasopharyngeal tonsil in a significant (third) degree, it is not amenable to conservative treatment and causes complications - this pathology should be treated more often by an operative route.
Symptoms of adenoids in children - hypertrophy of pharyngeal tonsils
Persistent violation of breathing through the nose, a persistent runny nose, discharge from the nose serous nature, the child constantly or periodically breathes through the mouth.
The child most often sleeps with his mouth open, sleep becomes restless, with snoring, puffiness, with obstructive sleep apnea syndrome - breath holding in a dream. Therefore, children can often have nightmares, because of the westernization of the root of the tongue, there may be attacks of suffocation.
Due to the growth of the amygdala, breathing problems are aggravated, as there is congestive hyperemia of nearby soft tissues - soft palate, posterior palatine arch, nasal mucosa. Therefore, chronic rhinitis and frequent cough develop due to the flow of mucus from the nose along the back wall of the nasopharynx.
There are frequent inflammations of the hearing organs - otitis, hearing impairment, since the holes in the auditory tubes are covered by enlarged adenoids.
The appearance of violations in the timbre of the voice, it becomes nasal. Violation of phonation occurs when the adenoids become large enough.
Frequent inflammations of the paranasal sinuses are sinusitis, as well as sore throats, bronchitis, pneumonia. Appearance of an adenoid type of the face, that is a violation of the development of the facial skeleton - there is an indifferent expression on the face, the mouth that is constantly open. In cases of prolonged course of the disease, the lower jaw lengthens and becomes narrow, and the bite is also broken.
The proliferation of adenoid tissue gradually affects the mechanism of breathing, because breathing through the mouth is somewhat superficial, and nasal breathing is deeper, then prolonged breathing through the mouth gradually leads to insufficient ventilation of the lungs and oxygen starvation, hypoxia of the brain.
Therefore, often a child's memory, mental abilities, attention is diminished, unmotivated fatigue, drowsiness, irritability appear. Children complain of intermittent headaches, poor schooling.
Prolonged hypertrophy of adenoids due to a decrease in the depth of inspiration leads to a violation of the formation of the chest, there is a so-called chicken breast.
In adenoids in children, the symptoms of the disease can also be anemia, gastrointestinal disturbances - appetite decreases, constipation, diarrhea are possible.
Symptoms of adenoiditis in children
- Against the background of enlarged adenoids, adenoiditis often occurs, with adenoids inflamed, fever, weakness, regional lymph nodes increase.
- Sometimes adenoiditis manifests only during ARI, then there is a violation of nasal breathing, mucous discharge from the nose and other symptoms of acute viral infection. In this case, after recovery, adenoids decrease in size.
There are three degrees of adenoids in children - hypertrophy of the pharyngeal tonsil
Adenoids in children can be increased to varying degrees, it is common to subdivide hypertrophy to 3 degrees. Doctors in other developed countries also allocate 4 degrees of adenoids, dividing grades 3 and 4 into a virtually occluded nasopharynx and a 100% closed posterior opening of the nasal passages. This division into degrees is determined by radiologists, since in the picture the magnitude of adenoids is the easiest to see - in the lumen of the nasopharynx there is a shadow of adenoids:
- — когда разрастание перекрывает 1/3 заднего отверстия носовых ходов или хоаны. 1 degree - when overgrowth overlaps 1/3 of the posterior opening of the nasal passages or of the choana. In this case, the child experiences difficulty breathing only during sleep, and even if he snores and breathes badly with his nose, with this degree of adenoids, there is no question of removal, most likely, it is a protracted rhinitis that can be treated conservatively.
- — когда аденоиды занимают от 1/3 до половины просвета носоглотки. 1-2 degree - when adenoids take from 1/3 to half of the lumen of the nasopharynx.
- — когда аденоиды у ребенка закрывают 66% просвета носоглотки. 2 degree - when the adenoids in a child close 66% of the lumen of the nasopharynx. From this, the child develops snoring, periodic breathing through the mouth even during the day, not picking up speech. Also it is not considered an indication for the operation.
- — когда глоточная миндалина закрывает практически весь просвет носоглотки. 3 degree - when the pharyngeal tonsil covers almost the entire lumen of the nasopharynx. Thus the child can not breathe a nose neither at night, nor in the afternoon. If the child sometimes breathes a nose, it not 3 degree, and a congestion of mucus which can occupy all nasopharynx.
Treatment options for adenoids in children
There are 2 main options for treatment of adenoids in children - surgical removal and conservative. More details on whether to agree to an operation to remove adenoids, on the methods of drug treatment can be found from our article - Treatment of adenoids in children
Conservative without surgical treatment of adenoids - the most correct, priority in the treatment of hypertrophy of the pharyngeal tonsil. Before agreeing to an operation, parents should use all possible treatments to avoid surgical intervention:
- Drug therapy for adenoids consists primarily in the careful removal of mucus, the detachable nose and nasopharynx. Only after cleansing, you can use local medicines, since the abundance of mucus significantly reduces the effectiveness of therapy.
- Laser therapy - today this method is considered very effective, and most doctors consider it safe, although no one knows long-term consequences of laser exposure, no long-term studies in its application have been made. Laser therapy reduces edema of lymphoid tissue, increases local immunity, reduces the inflammatory process in the adenoid tissue.
- Homeopathic remedies are the safest method of treatment, the effectiveness of which is very individual, one of the children is very good at homeopathy, for others it appears to be poorly effective. In any case, it should be used, because it is safe and it is possible to combine it with traditional treatment. It is especially recommended to take Lymphomyosot - a complex homeopathic preparation, the manufacturer of which is the famous German firm Heel, and also oil of thuja in adenoids is considered a very effective tool.
- Climatotherapy - treatment in the sanatoriums of the Crimea, Stavropol Territory, Sochi has a positive effect on the entire body, increases immunity and helps to reduce the proliferation of adenoids.
- Massage of the collar zone, face, respiratory gymnastics - are part of the complex treatment of adenoids in children.
- Physiotherapy is ultraviolet, electrophoresis, UHF procedures, which are prescribed by the doctor endonasally, usually for 10 procedures.
аденоидов возможно только в следующих случаях: Если все консервативное лечение не дало эффекта и аденоидит рецидивирует более 4 раз в год, если развиваются осложнения, такие как отит, синусит, если у ребенка случаются частые остановки или задержки дыхания во сне, частые ОРВИ и другие инфекционные заболевания. Surgical treatment of adenoids is possible only in the following cases: If all conservative treatment has no effect and adenoiditis recurs more than 4 times a year if complications such as otitis, sinusitis develop, if the child has frequent stops or breath holdings in a dream, frequent SARS and other infectious diseases. It is worthwhile to beware of laser removal of adenoids, since there is a possibility of a negative effect of the laser on the brain and surrounding tissues of the adenoid.