Chronic adenoiditis in children: symptoms, treatment, prevention.

In the postoperative period, not only the patient’s care itself, but also his nutrition is of great importance. For this reason, parents should seriously address this issue for the speedy recovery of the child.

Care

After surgery to remove adenoids, the child needs parental care. Their main task is, first of all, to prevent aspiration of blood (its entry into the respiratory tract). To do this you need to proceed as follows:

Place the baby on the bed and turn him on his side.
A towel or clean cloth should be placed under the small patient's head into which he will spit out blood and mucous secretions.
A cold towel (for example, wrapped in ice, or soaked in ice water) should be applied to the face on the side where the adenoids were removed. This manipulation will have a hemostatic effect.

3 hours after the procedure, the otolaryngologist performs a follow-up examination using a pharyngoscope. If the patient does not have bleeding or swelling of the mucous membranes, he is discharged from the hospital.

From the moment the child is discharged, all responsibility for his condition and well-being falls entirely on the shoulders of the parents. For 2 weeks after removal of adenoids in children, they must be taken to see an ENT doctor to monitor their health and assess the wound healing process.

To ensure that wounds heal faster and the child is not at risk of developing serious complications, parents should:

exclude all hard, spicy and too salty foods from the baby’s diet, as they irritate the mucous membranes of the nasopharynx;
monitor moderate physical activity in the child - its sharp increase can provoke postoperative bleeding in the ENT organs;
strictly follow the instructions given by the doctor regarding drug therapy;
promptly use vasoconstrictor drops prescribed by an otolaryngologist;
do not forget about regular ventilation and humidification of the air in the room where the child is.

After surgery, babies and older children often experience an increase in body temperature. To reduce it, you should not use drugs that contain acetylsalicylic acid. This substance thins the blood, which can cause excessive nosebleeds.

What can and cannot be eaten after surgery?

To speed up the healing of wounds in the nose, the child should drink and eat more:

fresh fruit and vegetable purees or juices;
light soft broths;
herbal infusions or teas;
steamed soups and cutlets.

In this case, you should avoid eating:

canned vegetables and fruits;
pickled vegetables;
confectionery products;
different types of canned food;
sour fruits and vegetables.

You should not give your child sweets, as they contain a large amount of sugars, which create favorable conditions for the proliferation of putrefactive microflora.

Complications

When giving consent to an operation to remove adenoids, parents must take into account the possibility of developing complications of this type of surgical intervention.

The most common adverse effects of adenotomy include:

The opening of nosebleeds, which occurs due to premature cessation of the use of vasoconstrictor drops.
The occurrence of an inflammatory process in the larynx and pharynx, which can lead to the formation of ulcers. The main symptom is an unpleasant, putrid odor from the mouth. If there is purulent exudate in the tissues of the child’s laryngopharynx, it is necessary to immediately contact an otolaryngologist, since such a condition is fraught with the development of a retropharyngeal or peritonsillar abscess (abscess).
An allergic reaction to drug abuse, accompanied by swelling of the soft tissues of the nasopharynx.
Paresis of the soft palate. Surgery to remove adenoids in children has a negative impact on the elasticity of epithelial tissues, as a result of which it is significantly reduced. Because of this, open rhinophony may develop with accompanying disorders of swallowing, nasal breathing and even speech.

Many parents are panicked by the fact that the postoperative period when the child’s adenoids are removed is accompanied by a putrid odor from the mouth and nose. Unfortunately, this happens often, and may indicate that atrophic epipharyngitis is occurring. This pathology is accompanied by thinning of the mucous membrane of the nasopharynx, which causes the patient to have dry mouth, as well as difficult and painful swallowing.

If the smell is very strong and for quite a long time, you should immediately consult a doctor. Perhaps the child has not yet developed a purulent abscess, so the situation needs to be corrected as quickly as possible.

Other complications of adenotomy are:

febrile or pyretic fever;
the onset of the inflammatory process due to infection;
lymphadenitis or lymphadenopathy;
cicatricial stenoses of the nasopharynx caused by damage to soft tissues by an adenoid (an instrument for removing adenoids).

Causes of relapses

Sometimes it happens that the tissues of the nasopharyngeal tonsil begin to grow again. This happens rarely - approximately 2-3% of cases. Most often, the cause of relapse of adenoiditis is an inflammatory process caused by a powerful allergic reaction.

Also, children with:

bronchial asthma;
hives;
atopic dermatitis;
recurrent bronchitis.

In children who are prone to developing allergic reactions, tonsil tissue grows much more intensely than in children who do not suffer from such disorders. For this reason, removal of adenoids in this category of patients is prescribed only as a last resort. In the absence of strict indications, surgery is inappropriate and sometimes even dangerous.

Regrowth of adenoids can occur 3 months after their removal. At this time, it is very important to notice the first alarming signs of pathology and promptly contact a pediatric otolaryngologist. The child begins to suffer from severe nasal congestion, and it is observed not only at night, but also during the day.

Parents should remember that the younger the child, the higher the risk of adenoid recurrence. At the same time, difficult nasal breathing is the lesser of the evils. In severe cases, tonsil tissue can become malignant, leading to the onset of an oncological process in the nasopharynx. A child can be saved from this only by a qualified otolaryngologist who will prepare the patient for the procedure of adenoid removal and perform the operation with minimal risk to his health.

Useful video about adenoid removal

Every parent has heard how this behavior can be caused by anything: a cold, a bacterial infection, an allergic reaction, a congenital anomaly of the structure of the nose, and so on. An ENT doctor will help assess the baby’s condition and take measures aimed at eliminating these factors. One of the diagnoses that parents hear is chronic adenoiditis in children. Today you can learn a lot of useful information about this disease.

A few words about pathology

In children, the symptoms and treatment of which will be presented to your attention are caused by a number of factors. The cause of its occurrence may be a viral disease, bacterial infection, allergy, or even banal hypothermia. As soon as immunity decreases, chronic adenoiditis (in children) worsens. Therefore, often a common cold requires complex treatment.

In essence, adenoiditis is an inflammation of the nasopharyngeal tonsil. It is not visible to the ordinary eye, so the pathological process can only be recognized by certain symptoms. However, an ENT doctor can easily examine the lymphoid tissue and tell you about its condition. In most cases, chronic adenoiditis is caused by improper or untimely treatment of the acute form of the disease.

How many parents see the disease: symptoms

Chronic adenoiditis in children (a photo of the tonsil is provided for your reference) can easily be missed by parents. Many mothers and fathers mistakenly believe that inflammation of the nasopharyngeal tonsil is always accompanied by high fever, cough, green snot and other signs similar to cold symptoms. But this is far from true.

Often pathology can occur in a form hidden from parents. That is, the disease will definitely be seen by an otolaryngologist. Even a pediatrician can suspect pathology during a routine examination. Parents are waiting for some obvious signs of the disease to begin treatment.

It also happens that a child develops Incorrect treatment or the lack thereof leads to the disease becoming chronic. Severe symptoms are eliminated, and parents mistakenly believe that the child is on the mend. How can you determine that your student has chronic adenoiditis? In children, symptoms can be obvious or hidden. Let's look at them.

What can you discover on your own?

Unfortunately, parents are unable to reliably make this diagnosis if they do not have a medical education. But you should definitely be wary of the following symptoms:

the baby does not breathe through his nose, his mouth is always open;
during sleep, the child may make whistling sounds (from heavy breathing to snoring);
sleep becomes restless, anxious;
the child’s performance decreases, the desire for new knowledge disappears;
the child is apathetic, emotional, capricious;
the voice takes on a hoarse note.

In its acute form, chronic adenoiditis in children has the following symptoms: runny nose with copious discharge of thick mucus (sometimes it can emit an unpleasant odor), increased body temperature, and headaches. Long-term lack of treatment forms the so-called adenoid face. In this case, you may observe a child with smoothed nasolabial folds, a change in the shape of the skull, and a deformed bite. You should immediately reassure worried relatives: if chronic adenoiditis is treated correctly, these symptoms will not appear in children.

Signs diagnosed by a doctor

As you already know, only an experienced doctor can definitely determine the problem. Show your baby to an otolaryngologist. During the examination, the specialist may see the following signs of the disease:

Thick mucus (can be cloudy, greenish or purulent) flows down the back wall of the throat;
the nasal passages are hyperemic, inflamed and swollen;
redness of the peripharyngeal ring;
enlarged tonsils in the throat and lymph nodes located near the source of infection;
eczema at the base of the nasal passages.

During palpation, the doctor feels the enlarged tonsil. It may be slightly larger than normal, average, or block nasal breathing completely. In accordance with this diagnosis, the stage of the disease is established. The doctor then takes a smear for laboratory testing. Its result will show which microorganisms cause the pathology and which drugs can eliminate it.

Is it necessary to treat chronic adenoiditis?

You can hear from some parents that they do not want to treat chronic adenoiditis in children. The symptoms, moms and dads say, will go away on their own with age. And in some cases this opinion turns out to be correct. But doctors do not recommend completely abandoning therapy. It is imperative to treat exacerbation of adenoiditis and regularly carry out its prevention. In fact, this pathology really is age-related. Chronic adenoiditis most often affects children aged 3 to 7 years. This is exactly the age when a child begins to join large groups (kindergartens). It's no secret that children there often get sick. In this way they acquire immunity. Despite all the conclusions and reasoning about the pathology, it will be useful for every parent to know how to treat chronic adenoiditis in a child.

Preparations for topical use

A disease such as chronic adenoiditis in a child (3 years old or older) requires constant cleansing of the tonsils. If such procedures are not carried out, bacteria will multiply continuously. This process will lead to the fact that lymphoid tissue will become an independent source of disease, a carrier of infection. Now there are a lot of convenient products for washing the nasal passages and cleansing the adenoids in children (Aquamaris, Dolphin, Aqualor, Rinostop). All of them can be used without a doctor's prescription. In case of a latent course of the disease, it is enough to carry out hygiene procedures in the morning and evening. But exacerbation of the pathology involves washing the nasal passages up to 6-8 times a day, followed by the use of medications.

Chronic purulent adenoiditis in a child requires the use of antimicrobial agents, antiseptics and anti-inflammatory drugs.

"Isofra" is an antibiotic for local use. It comes in the form of a spray, but can be used as drops by turning the bottle upside down.
"Polydexa" is a drug with an antibacterial effect that has the ability to make breathing easier (due to the content of phenylephrine). Allowed for children from 2.5 years old.
“Protargol” or “Sialor” are drops based on silver ions. They have a drying, antiseptic effect. Used from birth (if there are no contraindications).
"Avamys" - Has an anti-inflammatory, anti-edematous effect. Appointed from 2 years of age.
“Pinosol” is a herbal oil medicine that has a regenerating and anti-inflammatory effect. Prescribed for children from 3 years of age.

Vasoconstrictor drops should not be used in the treatment of chronic adenoiditis. They can be used for no more than 3-5 days, and after this time all symptoms of the disease will return. The use of such drugs in this case is useless.

Antibiotics - is there a need?

Exacerbation of chronic adenoiditis in children almost always requires the use of antibacterial drugs. Ideally, before prescribing them, the doctor sends the child for analysis - bacteriological culture. Thanks to this study, drugs will be selected as accurately as possible. The diagnostic result will show which medications can eliminate the causative agent of the disease.

Often doctors do without such problems. They simply prescribe broad-spectrum antibiotics based on the child's age. Practice shows that macrolides (Sumamed, Azitrus, Azithromycin) have become effective medications in the treatment of chronic inflammation. If a child has a high fever, it is better to use penicillins (Augmentin, Amoxiclav, Flemoxin). Remember that all antibiotics must be prescribed by a doctor. By giving such products to your baby yourself, you can harm him.

Boost your child's immunity

When treating chronic adenoiditis, a child needs vitamins. If possible, it is better to get them from natural products: vegetables and fruits. Vitamin C is found in many citrus fruits, greens, and cabbage. It helps support the immune system and strengthens the protective function. B vitamins are involved in hematopoiesis, which is important during tissue regeneration. Vitamin E, present in fish and some nuts, will speed up the healing of tonsils. If you cannot provide adequate nutrition, then it is necessary to give your child vitamin complexes. The doctor will tell you which ones are suitable for your child. These could be Vitrum, Multitabs, Vitamishki, Pikovit tablets or something else. It is important to choose a complex according to age.

Disputes about the possibility of using immunomodulators for chronic adenoiditis continue to this day. Many modern doctors prefer to prescribe drugs such as “Reaferon”, “Interferon”, “Likopid” or homeopathy “Aflubin”, “Anaferon”. Other experts are inclined to believe that such drugs do not allow the immune system to recover on its own. Whether to give immunomodulators or not is a personal matter for each parent.

Surgical interventions

Chronic conditions can be corrected through surgery. Some parents say that their child had their adenoids removed, after which all the problems were resolved. Others report that the operation was in vain, since after a while everything returned to normal. Perhaps this is the fault of the doctors who perform the operation?

One way or another, adenotomy is performed under anesthesia. Using long forceps, the tonsils are only partially removed. The manipulation is carried out without any incisions, access is through the pharynx and nostrils. The indication for surgical intervention is the final stage of the disease, when the child’s nasal breathing is completely blocked by inflamed adenoids.

Chronic adenoiditis in children: treatment (Komarovsky)

What can a famous pediatrician tell you about a well-known disease? Many parents and grandparents listen to Evgeny Komarovsky. The doctor says that adenotomy is a last resort, which, to put it mildly, is not welcome for several reasons:

adenoids are tonsils that perform an important protective function of the body;
surgical intervention is a serious stress for the child and his parents;
there is no guarantee that after some time the tonsils will not grow back (and this will only be your fault, not a medical error).

It is impossible to completely cure chronic adenoiditis in children with surgical intervention. Komarovsky in his programs talks about how to improve a child’s condition. The specialist talks about preventive methods that will help reduce the frequency of relapses. And after a while (with age) you will be able to completely forget about what adenoiditis is.

Disease Prevention

Preventive measures must be carried out constantly. The main recommendations given by doctors are as follows.

Hardening strengthens the body's resistance. The procedures can be very different: from walking on the floor barefoot to dousing with cold water. Find personalized activities for your child.
Eat well and drink plenty of fluids. The baby’s body must receive a whole complex of vitamins and minerals. Food should be healthy and varied. Regular drinking prevents the colonization of tonsils by pathogenic microorganisms.
Treatment of the nose with bacterial lysates. The well-known drug “Irs-19” contains microorganisms that will help prevent frequent colds and runny nose.
Reception of bacteriophages. These products are viruses that effectively destroy germs and bacteria. Bacteriophages are new, but have already proven themselves to be good.
Trip to resorts. It is beneficial for a child to breathe sea air. If possible, visit sanatoriums. Some children are given free vouchers for treatment for certain indications.

Dr. Komarovsky recommends organizing comfortable conditions for the baby. It is necessary to ventilate the room in which the child is located more often. Warm and dry air promotes the proliferation of pathogenic microorganisms, so the room temperature should be no higher than 23 degrees, and humidity no lower than 60%.

Adenoiditis is an inflammation of the pharyngeal tonsil (adenoids). The disease most often occurs in children under 12 years of age. It is very important to recognize the disease and promptly begin treatment, because the chronic form can cause complications and provoke the development of other diseases in the nasopharyngeal region and middle ear.

In this article we will figure out how to treat adenoiditis in a child.

Types of diseases and methods of their treatment

Like most diseases, adenoiditis can have acute and chronic forms. Acute manifests itself in the form of retronasal sore throat, chronic can be expressed by different symptoms. Manifestations depend on the body’s specific reactions to the inflammatory process, the state of the immune system and the degree of allergization. So, what are the symptoms of different forms of adenoid inflammation in children and what treatment is necessary in each case?

Symptoms and treatment of acute adenoiditis in children

Streptococcal and respiratory diseases provoke the development of acute forms. As a rule, inflammation of the palatine tonsils occurs, but isolated inflammation is also possible.

The first symptom of the acute form is an increase in temperature to 39 °C or higher.
When swallowing, the patient feels a stinging pain in the depths of the nose.
In most cases, a runny nose and nasal congestion appear, and a paroxysmal cough is possible at night. Read about devices for treating runny nose.
The patient often suffers from headaches that originate behind the soft palate.
On the second or third day of illness, when examining the pharynx, you may notice swelling of the posterior arches and redness of the posterior wall.
Purulent mucus begins to secrete from the nasopharynx.
Possible hearing loss and ear pain.

U infants The acute form of odenoiditis is very difficult. The situation is aggravated by difficulties in making a diagnosis.

You can recognize the disease by drowsiness; it is difficult for the baby to suck and it hurts to swallow.
The child gets full faster, he may have a tummy ache and indigestion.
Quite often, the cervical and submandibular lymph nodes become enlarged; this can interfere with the normal functioning of the muscles of the thoracic region and provoke an unnatural position of the head.

To diagnose adenoiditis, doctors conduct a bacteriological examination of smears from the nasopharynx and palatine tonsils. Treatment of acute adenoiditis in infants is primarily aimed at resumption of nasal breathing. Depending on the patient’s condition, the presence of allergies and other contraindications, antibiotics are prescribed, which must be taken under the supervision of doctors.

Features of the chronic form of the disease

This form of the disease is a consequence of acute adenoiditis. Often the disease is combined with an enlarged pharyngeal tonsil.

The presence of chronic adenoiditis is manifested by difficulty in nasal breathing. The child has a constant catarrhal runny nose; purulent runny nose may occur less frequently. Outside periods of exacerbation, the child’s condition can be characterized as satisfactory. Parents should pay attention to indirect symptoms:

Lethargy. The child constantly wants to sleep, but has difficulty falling asleep and waking up at night.
Increased fatigue.
Decreased appetite.
Headache.
Night cough.
Speech impairment. The baby has difficulty pronouncing consonants.
Attention disturbance, retardation in physical and mental development. For unknown reasons, a child may begin to study worse.

During periods of exacerbation, which occur frequently and are accompanied by an increase in temperature, the symptoms are similar to those of acute adenoiditis. After treatment, you feel better, but the disease remains.

Treatment of chronic adenoiditis in children consists of eliminating the source of bacteria in order to prevent the formation of an inflammatory process in the nasal cavity, nasopharynx, traeoronchial tree and middle ear. In children, therapy is carried out using medications and procedures that should be carried out with great caution due to the danger of opening the abscess. Vasoconstrictor nasal drops and sprays, disinfectants for the nasopharynx (silver proteinate, 0.15 iodinol solution, 20% glucose solution, collargol) are prescribed. 4 times a year you should undergo a cycle of complex therapy aimed at strengthening the immune system and eliminating allergic manifestations of the disease.

Conservative treatment of enlarged adenoids in children

This type of treatment is recommended if the nasopharyngeal tonsil is slightly enlarged or if there are contraindications to surgery. Conservative treatment can be general or local.

Local Treatment of adenoiditis in children involves the use of antimicrobial and anti-inflammatory drugs in the form of drops and sprays. Drops (1-2% solution of Galazolin, Ephedrine, Sanorin, 0.05% solution of Naphthyzin and others) are used for 5-7 days. In combination with instillation, it is recommended to rinse the nose (furatsilin solution, 1-2% Protargol, Albucid).
In recent years, pharmaceutical laboratories have developed innovative drugs. It is increasingly recommended for the treatment of adenoids in children. Nasonex. The drug is part of a group of substances similar to natural hormones (steroids), which are produced by the body and help relieve swelling and reduce pain. Nasonex nasal spray does not penetrate the mucous membrane and does not enter the blood. This feature eliminates side effects, due to which hormonal therapy is prescribed only in exceptional cases. In addition to the obvious anti-inflammatory effect, the drug has the ability to reduce allergic reactions.
General Treatment consists of taking general restoratives. These include antihistamines (Suprastin, Fenkarol), immunostimulants, vitamins and microelements. Additionally, physiotherapeutic procedures are used: ultraviolet irradiation, electrophoresis with solutions of diphenhydramine or potassium iodide, helium-neon laser, UHF of the nose.

Surgical methods: surgery and laser

Surgery to remove adenoids is recommended to be performed as early as possible after the formation is detected and diagnosed. So far, this method of treatment is the most effective, because adenoids will not disappear anywhere and will pose a danger to the child’s health.

Shown surgical intervention in the absence of success in conservative treatment, breathing problems and complications.
Contraindications Some blood diseases may require surgery. Also, you will have to wait to remove the adenoids if the child is sick or has recently suffered acute infectious and skin diseases.

Due to the growth characteristics of the child’s body, operations are recommended to be performed before 3 years, from 5 to 6, from 9 to 10 and after 14 years. Before surgery, in order to avoid complications, it is necessary to cure the inflammation of the adenoid and sanitize the cavity. The operation lasts 15-20 minutes with local anesthesia.

Laser removal adenoids has a number of advantages over the traditional method:

The recovery period after surgery is reduced.
Minimal blood loss.
The surgeon's actions are more precise.
The area of the injured area is reduced.
Complete sterility and reduced risk of complications.

Laser removal of adenoids in children can be used in two ways:

Coagulation. A focused beam is used. Recommended for removing large formations.
Valorization. The upper layers of the adenoids are burned with steam using a carbon dioxide laser. Recommended for early stages and small-sized lesions.

Doctors do not have a clear opinion regarding the advisability of treating adenoids in children with laser. Some doctors consider it ineffective.

Folk remedies: simple natural recipes

One of the most effective folk remedies for treating adenoids in children is recognized propolis. You can use different recipes:

Mix propolis with butter or vegetable oil (1/10) and cook the mixture in a water bath; the medicine should boil for about 25 minutes. You can smear the mixture on your nose, wet cotton or bandage swabs, which are held in the nasal passages for about half an hour.
For an alcohol tincture, 200 ml of boiled, cooled water should be mixed with 1/4 teaspoon of baking soda. Add 20 drops of propolis alcohol tincture to the resulting mixture. The product is used to rinse the nose (3 times a day).

Traditional healers believe that regular use fish oil helps stop the growth of adenoids.

The most affordable juices are very effective:

Aloe or Kalanchoe. Freshly squeezed juice is mixed in equal proportions with warm boiled water. The mixture can be instilled into the nose (every 3 hours) and used for gargling. Read about the treatment of Kalanchoe runny nose.
Instilling freshly squeezed juice into your nose gives excellent results. beets(3 times a day).
It is recommended to drink the juice mixture on an empty stomach carrots and spinach(carrots – 10 tbsp., spinach – 6 tbsp.).

Will help cure adenoiditis and strengthen the body with inhalations pine buds. 20 g of kidneys are crushed and poured into a glass of boiling water. The mixture is prepared in a water bath for 20 minutes, after which it is infused for about half an hour.

Effective homeopathic medicines

Treatment of adenoids with homeopathy in children is most often intended to eliminate the infection, improve metabolic processes and restore the child’s immunity.

Barberry Comp Job Baby– a complex drug. There have been cases of resorption of even neglected adenoids.
Complex aerosol Euphorbium compositum Nazentropen S prevents exacerbation of adenoiditis and relieves inflammation, improves metabolic processes.
It is recommended to use it as a monotherapy Thuja oil.

Dr. Komarovsky will talk about the treatment of adenoiditis in children in the video below.

There are a lot of ways to treat adenoiditis; depending on the form of the disease, indications and general health of the child, an experienced doctor will choose the best therapy. The task of parents is to notice the disease in time and follow the doctor’s recommendations. This will help avoid complications.

Chronic and acute adenoiditis in childhood is a very likely occurrence, because this disease is directly related to hypertrophy of the pharyngeal tonsil, or, as is more commonly heard, with the adenoids. Any ARVI or sore throat in a child with adenoids can provoke inflammation in the nasopharynx, and the problem can often be completely eliminated only through surgery.

Features of the disease

Adenoiditis refers to inflammation of an enlarged (hyperplastic) pharyngeal tonsil. Adenoiditis can be acute and chronic, but all painful symptoms are predominantly associated with the acute form of the pathology. Most often, the disease occurs in children from 2 to 6 years old, as well as in children of primary school age. In adults with a pathologically overgrown tonsil that has not been removed, adenoiditis can also occur.

Adenoiditis is often called retronasal (pharyngeal) sore throat. Indeed, the disease develops similarly to acute tonsillitis and can also be purulent. Since perverted immunological reactions constantly occur in the enlarged nasopharyngeal tonsil, accompanied by allergic and infectious processes, each subsequent episode of retronasal tonsillitis is recognized as an exacerbation of chronic adenoiditis.

It should be borne in mind that acute adenoiditis can occur in different ways, which depends on the form of chronic adenoiditis the patient has, immune status and the degree of allergization of the body. Depending on the type of course of the acute form of the disease, it can be:

catarrhal;
serous;
purulent.

According to the severity of local symptoms of inflammation, adenoiditis can be:

superficial;
lacunar.

Causes of acute adenoiditis

Hypertrophic processes in the pharyngeal tonsil in children can be associated with a variety of reasons:

allergic reactions;
frequent ARVI;
artificial feeding;
vitamin deficiencies, predominance of carbohydrates in the diet;
previous rickets;
diathesis;
living in unfavorable environmental conditions.

Only those children or adults who have an enlarged tonsil may experience retronasal tonsillitis. The acute form of the disease develops when pathogenic microflora is activated in the nasopharynx after hypothermia or a viral disease. Most often, adenoiditis is a complication of ARVI or influenza, and in many cases it occurs in parallel with other diseases of the pharynx, respiratory tract or nose (tonsillitis, pharyngitis, tracheitis, etc.). The causative agents are pneumococci, streptococci, staphylococci, and microbial associations.

Under the influence of regular inflammatory processes in the nasopharynx, combined with impaired local immunity in children, the pharyngeal tonsil becomes a focus of chronic infection. Bacterial flora constantly lives in its folds and lacunae, which causes an exacerbation of adenoiditis at the slightest hypothermia or viral exposure.

Symptoms of the disease

Retronasal tonsillitis can occur in different types, and most often it develops like catarrhal tonsillitis, but purulent phenomena can occur in the absence of proper treatment. The symptoms of the disease are as follows:

increased body temperature (up to 37-39 degrees);
poor sleep;
decreased appetite;
lethargy, apathy;
headache;
nasal congestion;
snoring during sleep;
discharge of mucus from the nose;
mucus running down the back of the throat;
accumulation of phlegm in the throat, nausea and vomiting against this background;
obsessive coughing attacks, especially at night; Find out how to treat cough with adenoiditis
hoarseness of voice;
hearing loss;
pain in the throat, in the ears, in the depths of the nose;
pain when swallowing in the soft palate;
enlarged lymph nodes under the jaw, their soreness.

The catarrhal form of the disease, with proper therapy, ends in recovery by 3-7 days, the purulent form can last for 15-20 days. It is possible to distinguish it if the discharge from the nose and mucus from the throat become yellow-green in color and have an unpleasant odor. In this case, the body temperature may rise again even after normalization and has an undulating course.

In young children, acute adenoiditis can develop as subglottic laryngitis and is often accompanied by attacks of suffocation. In infants, retronasal sore throat is rare, but if it occurs, it is always accompanied by severe intoxication, impaired sucking, dysphagia, and dyspeptic symptoms.

Possible complications

Long-term adenoiditis, like ordinary sore throat, can be complicated by glomerulonephritis, heart defects, rheumatism, endocarditis, and gastrointestinal diseases. Local complications of acute retronasal sore throat are also possible. Thus, children have wider and shorter Eustachian tubes than adults, so infection from the nasopharynx easily penetrates into the ear and leads to otitis and eustachitis. In addition, the consequences of acute adenoiditis very often include sinusitis, laryngotracheitis, bronchitis, bronchopneumonia, and in children under 5 years of age - retropharyngeal abscess. The disease often recurs in the presence of adenoids, and each new exacerbation threatens with the above complications.

Carrying out diagnostics

To diagnose “retronasal tonsillitis” and determine the degree of adenoids, the otolaryngologist performs pharyngoscopy, rhinoscopy and posterior rhinoscopy, and digital examination of the nasopharynx. Also, according to indications, the following examination methods may be recommended:

X-ray or CT scan of the nasopharynx;
endoscopic examination of the nose and nasopharynx;
general blood analysis;
a smear from the pharyngeal mucosa to determine the microflora and its sensitivity to antibiotics (bacterial culture);
consultation with an allergist, immunologist and relevant blood tests.

During posterior or endoscopic rhinoscopy and examination of the pharynx during acute adenoiditis, the doctor detects the following objective signs:

hyperemia and swelling of the pharyngeal tonsil;
the presence of infiltrates, plaque, viscous discharge in the grooves on the surface of the tonsil;
redness of the palatine arches, lateral ridges, posterior wall of the pharynx, enlargement of the follicles on the pharynx;
the presence of mucus with pus flowing down the back wall;
swelling of the uvula, its elongation.

In infants, retronasal sore throat should be distinguished from the atypical course of influenza and acute tonsillitis. Differential diagnosis in all categories of patients is made with retropharyngeal abscess, scarlet fever, whooping cough, measles, and polio.

Treatment methods

The goal of therapy for retronasal sore throat is to eliminate the bacterial infection and prevent further spread of the inflammatory process to neighboring organs (paranasal sinuses, nasal cavity, ear, auditory tube, trachea, larynx, etc.). Typically, treatment of acute adenoiditis is successfully carried out at home without hospitalization. The basis of therapy consists of various medications:

taking antibiotics to stop the infectious process (Amoxicillin, Flemoclav, Sumamed);
taking antihistamines, desensitizing drugs against edema and to reduce allergenicity of the body (Zyrtec, Diazolin, Zodak, Claritin);
irrigating the nose with saline solutions to reduce swelling and inflammation, removing mucus (Marimer, Aqualor), rinsing the nose with infusions of anti-inflammatory herbs;
the use of aerosols and sprays with antiseptics in the throat to accelerate the penetration of active substances into the inflammation (Miramistin, Bioparox, Hexoral, Stopangin);
instillation of vasoconstrictor drops into the nose to reduce swelling and normalize breathing (Nazol, Galazolin, Oxymetazoline, Rinostop);
nasal irrigation with local antiseptic and drying solutions (Protargol, Collargol, Iodinol);
taking homeopathic remedies to speed up recovery and prevent relapses (Sinupret, Lymphomyosot);
physiotherapy - tube quartz, laser treatment, electrophoresis, diathermy, phototherapy;
for a long-term course of adenoiditis - massage the pharyngeal tonsil for 3-5 seconds every day for 2-5 days (usually leads to a quick end to the disease).

Laser treatment of adenoids in children can replace pills and other medications, as well as delay or completely eliminate surgery.

After the acute phase of adenoiditis subsides, if there is no need for surgery, courses of therapy with immunomodulators (local and systemic), restoratives, antihistamines, vitamins, aerosols based on aloe, kalanchoe, propolis, etc. should be carried out 2-4 times a year. Also a doctor may decide on long-term therapy with nasal glucocorticosteroids, immunotherapy with interferons, globulins, etc.

Features of treatment in children

In general, conservative therapy in children and adults is carried out according to the same standards. A feature of drug treatment in children under 2 years of age is a strict ban on the use of sprays, which often cause bronchospasm and laryngospasm.

Hospitalization for adenoiditis is carried out in children under one year of age, as well as when a retropharyngeal abscess develops against the background of retronasal tonsillitis. Also, the child will have to be admitted to the hospital if it is necessary to excise adenoid vegetations. In childhood, recurrent adenoiditis is a direct indication for adenoid removal. In addition, adenotomy is necessary in the following cases:
persistent progressive hyperplasia of the pharyngeal tonsil;
regular complications of adenoiditis from the nose, sinuses, ear, trachea, etc.;
development of secondary complications due to the presence of streptococcal infection (on the heart, kidneys, joints and others);

lack of effect from conservative therapy.

Prevention of adenoiditis

You cannot self-medicate if adenoiditis occurs: this disease can have no less serious consequences than tonsillitis, so therapy for adenoiditis should be provided to a doctor. An important task for parents is to prevent adenoiditis, for which the following measures should be taken:
spend more time outdoors;
strengthen the immune system in every possible way;
eat right, take vitamins;
visit seaside resorts;
regularly rinse your nose with sea water;

After removal of the adenoids, time should be taken to prevent other diseases of the ENT organs that may occur due to the immune “shake-up” that the operation gives. 1-1.5 months after the intervention, you need to begin hardening, visiting salt caves, a swimming pool, and carrying out other activities recommended by a specialist.

Even the most cheerful showman Vadim Michkovsky became sad when his daughter was diagnosed with adenoids. Dr. Komarovsky will tell him about this disease. Why is it dangerous? What treatment options are there? And he will also answer additional questions.

Adenoids are nasopharyngeal tonsils. They are located in the vault of the nasopharynx and usually occupy 1/3 of its lumen.

What are adenoids for?

Adenoids in children are needed to protect the ENT organs from the invasion of pathogens. Adenoids are one of the important and necessary links in the immune chain of every person.

But sometimes, under the influence of various processes, adenoids in children begin to grow. The lesions of the adenoids become larger and larger and eventually begin to perform the exact opposite function - they become a wonderful refuge for all kinds of infections. Thus, the adenoids do not prevent germs from entering the bronchi and lungs. The baby gets sick more and more often. Often, enlarged adenoids are accompanied by enlarged tonsils. Overgrowth of adenoids can occur in children from one year to fifteen years of age. But most often adenoids are detected in children from three to seven years of age.

3 degrees of adenoid proliferation

1st DEGREE - during the day the child breathes quite freely, his mouth is closed, and during sleep, when the volume of the adenoids increases in a horizontal position of the body, it becomes harder for him to breathe, snoring appears.

2nd - 3rd DEGREE of growth, the choanae are half or completely covered (these are the posterior parts of the nose, the openings connecting the nasal cavities with the nasal part of the pharynx), children often snore in their sleep and are forced to breathe through their mouths around the clock.

Inflammation of the adenoids is called adenoiditis. It can be acute or chronic.

How can you tell if your child has enlarged or inflamed adenoids?

Remember if you have recently noticed the following signs in your child:

1. Difficulty in nasal breathing.

The child either periodically or constantly does not breathe through his nose. The child sleeps or is awake with his mouth open; during sleep, the child snores or snores.

2. Hearing loss.

The child will not hear. He asks again when parents or other people contact him. Moreover, sometimes parents perceive this as a child’s prank and even punish him, which naturally should not be done.

3. Periodic or constant runny nose.

The child has mucous (light, transparent) or purulent (thick yellow or green) nasal discharge.

4. There may be periodic or constant sore throat. More often, these symptoms are combined with impaired nasal breathing.

5. Frequently occurring colds, such as rhinitis, sinusitis, sore throat, acute respiratory infections, pharyngitis, tracheitis and others. The respiratory system is predominantly affected.

6. Frequently occurring acute otitis media or exacerbations of chronic otitis.

7. Constant nasality, impaired speech function.

8. Decreased performance and poor performance at school. This symptom does not always 100% indicate the presence of adenoids in a child, but is still a reason to contact an otolaryngologist.

What are the dangers of inflammation of the adenoids?

Inflamed adenoids can cause frequent acute respiratory infections, otitis, prolonged runny nose, inflammation of the paranasal sinuses, etc. Lack of nasal breathing can negatively affect the condition of the tonsils and lower respiratory tract.

What types of diagnostics are there for adenoids?

Adenoids are not visible during normal examination of the pharynx. In order to examine the adenoids, special instruments are needed. The most active growth of adenoids occurs between the ages of 3 and 7 years. Adenoids reach their maximum size by 10-12 years, then begin to shrink.

Treatment of adenoids

Currently, modern doctors have not yet developed an effective unified tactic for treating adenoids in children. The main treatment method for this disease is surgery - adenotomy. With conservative treatment (antibiotics, nasal drops), there is only a temporary cessation of the inflammatory process in the pharyngeal tonsil and a slight decrease in the size of the adenoids.

It's a different matter when it comes to chronic inflammation of the adenoid tissue, which is called adenoiditis. As a rule, this condition is combined with an increase in adenoid tissue, but not always. So, in its pure form, adenoiditis is subject to conservative treatment. The operation should be performed only when all therapeutic measures have proven ineffective, or in the presence of a combination of adenoiditis and adenoid vegetations.

Alternative treatments for adenoids

Homeopathic treatment
Efficacy has not been proven.
Laser removal of adenoids
Technically possible, but impractical. Removing the entire volume of the tonsil with a laser will lead to severe burns of surrounding tissues, more severe pain after surgery and more severe scarring.
Cryotherapy, liquid nitrogen removal, “cold treatment”
The point of the technique is to apply a tip with a very low temperature to the tonsil to cause necrosis and subsequent rejection of the tonsil tissue. It is very difficult from a technical point of view, uncontrollable, in the postoperative period there is more pain and swelling.

Can adenoids reappear after surgery?

Unfortunately, relapses (re-growth of adenoids) are quite common. This depends on a number of reasons.
The most important thing is the quality of the adenoid removal operation. If the surgeon does not completely remove the adenoid tissue, then even from the remaining “millimeter” the adenoids may re-grow. Therefore, the operation should be performed in a specialized children's hospital (hospital) by a qualified surgeon.

Currently, the method of endoscopic removal of adenoids through special optical systems using special instruments under vision control is being introduced into practice. This allows the adenoid tissue to be completely removed. However, if a relapse does occur, you should not immediately blame the surgeon, as there are other reasons.

Practice shows that if adenotomy is performed at an earlier age, then the likelihood of recurrence of repeated adenoids is higher. It is more advisable to perform adenotomy in children after three years of age. However, if there are absolute indications, the operation is performed at any age.

Most often, relapses occur in children who suffer from allergies. It is difficult to find an explanation for this, but experience proves that this is so.

There are children who have individual characteristics characterized by increased proliferation of adenoid tissue. In this case, nothing can be done. Such features are determined genetically.

Very often, the presence of adenoid vegetations is combined with hypertrophy (enlargement) of the palatine tonsils. These organs are located in a person's throat and can be seen by everyone. In children, parallel growth of the adenoids and palatine tonsils is very often observed. Unfortunately, in this situation, the most effective method of treating adenoids is surgery.

Breathing exercises

Options for special breathing exercises that help strengthen the respiratory muscles, restore the correct breathing mechanism and eliminate the habit of breathing through the mouth.

Quite often, due to a long absence of normal nasal breathing, children, even after adenotomy, do not immediately begin to breathe through their nose.

To eliminate this habit, special breathing exercises have been developed.

Option 1:

1. Calm walking with extended inhalation and exhalation through the mouth.

2. Walking with breathing through the nose: First, inhale for one step, exhale for two steps, then inhale for two steps, exhale for three or four steps.

3. Run in place and squat with deep breathing through the nose.

4. Jogging: inhale for two or three steps, exhale for four.

5. Breathe alternately through the right and left half of the nose.

6. Hand jerks with the body turned to the sides, with a smooth inhalation and exhalation through the nose.

7. Movements of the hands along the lateral surfaces of the body with a deep breath through the mouth.

8. Bend the body to the sides while pronouncing the sounds “M” and “N” while exhaling.

9. Inhale and exhale jerkily through the nose.

Option 2:

Take a starting position so that your chest, neck and head form a straight line (stomach and chest protruded). With your right hand, feel the pulse on your left hand and perform the exercises, counting the pulse beats.

1. Inhale through the nose for 5 - 9 (gradually increasing to 10 - 12) pulse beats. Hold the air in your lungs for the same number of pulse beats, and slowly exhale through your nose, counting the same number of pulse beats as your breath was held. It is necessary to skip as many pulse beats as the breath was held and begin the next breath. Repeat the exercise 4 - 5 times and do 4 times a day, each time ending with the so-called cleansing, ventilating and clearing breath.

2. Inhale a mouthful of air, purse your lips as if to whistle (without puffing out your cheeks), exhale a little air forcefully, stop and hold your exhalation, then exhale little by little until the air leaves the lungs. Breathing exercises are not recommended before bedtime.

Option 3:

1. Walk for 1 minute. and more.

2. Squats (4-5 times or more).

3. Running (for 5 minutes or more.

4. Squats.

5. Deep breathing through the nose.

6. Sit on a bench, bend over and, as you exhale, touch the toes of your outstretched legs with your hands, return to the starting position, raising your outstretched arms above your head (5 - 8 times or more).

7. Exercises with the ball. While standing, raise the ball above your head, while inhaling, bend back, while exhaling, bend forward and put the ball on the floor (5-8 times or more).

8. Jumping: while inhaling, legs to the sides, while exhaling, legs together (5-8 times or more).

9. Lie on your back, raise your extended legs up and spread them to the sides (5 times or more).

10. Exercise “butterfly”: running - spread your arms to the sides and flap them like wings for 1/2 minute. and more.

11. Walking in place, raising your knees high and swinging your arms (20 times).

12. Walking with a gradual slowdown (2 min.).

13. Sit or lie down to rest (for a few minutes).

The duration of exercises should be strictly individual. Loads should be increased gradually, consulting the child with a specialist in physical therapy.

Option 4:

1. After rhythmic breathing, close your mouth tightly. Repeat the consonant sounds “b”, “v”, “m”, “p”, “t”, “zh”, “sch”, “f” at rhythmic intervals, while the air is pushed out through the nose.

2. Stand up and straighten up. Look ahead. Close the right nostril with the fingers of your right hand, slowly, smoothly inhale air through the left, then vice versa.

3. Prepare a glass of warm water for gargling. With each rinse, first pronounce the sound “a-a-a”, and then “o-o-o”. And so on every time until the water in the glass runs out. Perform before bedtime. In each lesson you can do one of the exercises you can do one of the exercises.

Option 5:

Close one half of your nose with your finger and take a sharp breath with the free half of your nose, exhale through your mouth. Repeat 8 times, then also sharply inhale 8 times with the other half of the nose, return to the opposite half again and inhale 8 times, and repeat 8 times for each half. During the day 8 times and 8 days in a row. Repeat the course as needed.

Conclusions: Even if your child has been diagnosed with enlarged adenoids, there is no need to panic. First, figure out what the degree of growth is. It is best to consult several specialists. If the diagnosis is disappointing and surgical removal is indicated, again you need to remain calm. Nowadays medicine has moved far from pulling out adenoids “live” and it is best for you to start looking for a good experienced surgeon.

If a child has the first degree of adenoid proliferation, then it is possible and necessary to undergo a course of treatment with special medications and procedures. The main thing is that the child does not feel fear, and knows that he has a kind and caring mother next to him and everything will be fine with him in any case.