Purulent adenoiditis: features of symptoms of acute, subacute and chronic forms of pathology. Adenoids in children - do they always need to be removed? What to do if a child has adenoiditis

Most parents know or have at least heard what adenoids are in children, the symptoms of which cannot go unnoticed. When to see a doctor, how to treat, should surgery be preferred? All these questions are of great interest to moms and dads. In recent years, more and more specialists are trying to carry out treatment primarily using conservative methods.

Nature has provided a special system for protecting the body from infection entering through the respiratory tract. This is the so-called pharyngeal ring, which consists of 5 tonsils (two palatine, two tubal, lingual and nasopharyngeal) and areas of lymphoid tissue on the posterior wall of the pharynx.

Lymphoid tissue is a collection of connective tissue saturated with lymphocytes and macrophages responsible for cellular immunity. When infectious pathogens enter the respiratory tract, immune cells capture and destroy “enemies” that are trying to enter the body.

In childhood, the protective function is especially developed in the nasopharyngeal (pharyngeal) tonsil. After 10-12 years, it gradually decreases in size, and by 18 years, only small pieces of lymphoid tissue remain. The greatest load falls on this amygdala. When the amygdala does not cope with its function, its tissue grows (vegetation period) and the function is restored.

If the baby is often sick with colds, the nasopharyngeal tonsil grows to a significant size - it hypertrophies - this is how adenoids are formed. Pathological hypertrophy of the adenoids causes a violation of nasal breathing and the accumulation of pathogenic viruses and bacteria in its tissue. The growths begin to become inflamed regularly. The cause may be hypothermia, stress, or overwork of the child. An acute inflammatory process (acute adenoiditis) quickly becomes chronic with recurring relapses. The nasopharyngeal tonsil loses its protective function and itself becomes a focus of infection.

Causes of the disease

The most common causes of enlargement of the nasopharyngeal tonsil are:

immaturity of the immune system and associated frequent viral and bacterial infections of the upper respiratory tract and respiratory tract;
decreased immunity due to lack of proper care for the baby: overheating, constant stay indoors, rare walks in the fresh air, eating disorders (irregular meals, eating a lot of sweets, etc.);
unfavorable living conditions: cramped, stuffy, damp room.

All this leads to the development of frequent acute respiratory viral infections with bacterial complications and hypertrophy of the nasopharyngeal tonsil.

Degrees of adenoids in children

Adenoids in children, the symptoms and treatment of which should be known to all parents, grow gradually. This is a tumor-like mass that often has the appearance of a cock's comb, growing in all directions and filling the mouths of the auditory tubes. There are three degrees of their increase:

I degree— lymphoid tissue covers the upper part of the vomer (the bony part of the nasal septum);

II degree— growths reach two thirds of the opener;

III degree— cover the entire opener.

Signs of adenoids:

adenoids of the 1st degree - impaired nasal breathing only during sleep, the appearance of snoring during sleep;
adenoids of the 2nd degree - impaired nasal breathing both at night and during the day; the mouth is open, some puffiness of the face appears;
adenoids of the 3rd degree – speech and hearing impairments are added; voice disturbances: it becomes muffled, the baby does not pronounce certain words clearly; drooping jaws in children can lead to improper formation of the dentition; with large growths, hearing impairment appears; prolonged absence of nasal breathing leads to disorders of the central nervous system (CNS), since the brain does not receive the required amount of oxygen; the baby becomes lethargic, apathetic, has difficulty learning new knowledge and skills, and lags behind in school.

Characteristic appearance: the face is puffy, edematous, the mouth is open, the nasolabial folds are smoothed out, the jaw droops slightly (the so-called “adenoid face”)

The symptoms and treatment of a disease such as inflammation of the adenoids (adenoiditis) in children are well known to pediatricians. The process can be acute or chronic. Acute adenoiditis begins with a rise in temperature to 38-39˚C, nasal congestion, and hearing loss. On days 2–3, the patient develops mucopurulent nasal discharge, and the submandibular lymph nodes may become enlarged. The disease usually lasts for about a week.

With repeated inflammatory processes, chronic adenoiditis is quickly formed with periodically recurring relapses of the disease. Relapses have the same symptoms as an acute inflammatory process, occur with a slight fever or even with its complete absence. The following symptoms are characteristic:

long-term exacerbations (relapses) with subfebrile (low) temperature;
frequent spread of infection to other parts of the respiratory tract; otitis, bronchitis, laryngitis, etc. develop;
constant nasal congestion and thick mucopurulent discharge; mucus is partially released from the nose, and partially flows down the back wall of the throat;
obsessive dry cough, especially at night - a sign of leakage of secretions into the larynx;
prolonged enlargement of nearby lymph nodes (submandibular, cervical, occipital);
lethargy, apathy, poor appetite, vomiting often occurs during meals.

Why are adenoids dangerous?

The danger of proliferation of the nasopharyngeal tonsil is that:

nasal breathing is impaired, which entails disorders of the central nervous system and the baby’s lag in physical and mental development; young children begin to speak late, speak indistinctly, which disrupts their communication with peers; schoolchildren are apathetic and fall behind in their studies;
a constant source of infection in the body; this leads to the spread of infectious and inflammatory processes to other organs of the respiratory system;

Long-term inflammatory processes contribute to sensitization (allergization) of the body and the formation of allergic diseases.

Complications

Complications are associated with the spread of infection to other ENT organs and parts of the respiratory system. In chronic adenoiditis, the disease is often complicated by otitis media, sinusitis (sinusitis, sinusitis), bronchitis, laryngitis, pharyngitis, tonsillitis, and pneumonia. Speech and hearing impairments and changes in the dental system are also characteristic.

Bronchial asthma, eczema, allergic rhinitis, and allergic conjunctivitis also often develop against the background of adenoiditis.

Long-term hearing impairment and impaired nasal breathing lead to disruption of the child’s overall development.

Diagnostic methods

The diagnosis is based on:

characteristic complaints;
examination by an otolaryngologist; a finger examination is carried out to determine the size of the growths, as well as examination using special mirrors;
endoscopic examination using optical equipment, which allows us to examine vegetations in detail, determine their degree and the presence of an inflammatory process;
radiography of the paranasal sinuses - carried out to exclude sinusitis, which may have the same manifestations as adenoiditis or be its complication;
laboratory diagnostics - inoculation of nasal secretions on nutrient media in order to identify infectious agents and their sensitivity to various antibiotics.

Conservative treatment

You should consult an otolaryngologist about how to treat adenoids. If adenoids develop in children, treatment will depend on the general condition of the patient, the presence or absence of exacerbation of adenoiditis and the degree of proliferation of lymphoid tissue. So, what is the treatment?

During exacerbation adenoiditis is prescribed complex treatment at home, including:

nasal drops (from three years of age, sprays) with sea water (Aqua Maris, Aqualor, Quicks, etc.); drop a full pipette of drops (or several injections) into both nostrils, then blow your nose thoroughly;
vasoconstrictor drops (Otrivin, Nazivin, etc.); they are instilled three times a day after rinsing the nose with sea water; drops must be age appropriate; therapy should not be continued for more than 5 days in a row - this can lead to persistent long-term dilation of blood vessels and the appearance of edema;
antibacterial therapy; for mild exacerbations, drops and sprays with local action (Isofra) are prescribed; in case of severe tissue swelling, preference is given to the combined Polydex spray; if the exacerbation is severe, local treatment is combined with the prescription of general (systemic) antibacterial therapy.

After the temperature drops Physiotherapeutic procedures are prescribed, for example, laser treatment. The laser effectively relieves inflammation and swelling, thereby restoring nasal breathing. In addition, procedures are prescribed for ultraviolet irradiation (UVR) of the nose and pharynx, which suppress infection, endonasal electrophoresis with medicinal solutions that eliminate inflammation and swelling (with potassium iodide, diphenhydramine, etc.), deep heating using inductothermy, UHF, etc.

Beyond exacerbation conservative treatment is also carried out, the purpose of which is to prevent exacerbations and further proliferation of lymphoid tissue. For this purpose the following are also prescribed:

various physiotherapeutic procedures. Laser therapy courses are especially effective;
immunomodulators that help strengthen general and local immunity: IRS-19, Broncho-Munal, Ribomunil, etc.

How to reduce adenoids without surgery? In recent years, local glucocorticoid hormones in the form of sprays have been used to prevent their growth. The peculiarity of these drugs is the absence of systemic effects on the body. For example, Nasonex spray can not only stop the proliferation of lymphoid tissue, but also reduce its volume.

Surgical treatment

Surgical removal of growths is carried out strictly according to indications, and not at the request of the parents. Indications for removal are:

breathing disorders, including stopping during sleep for 10 seconds or more (apnea);
persistent hearing impairment, including after elimination of inflammatory edema;
constantly worsening otitis media;
threat of development of dental anomalies;
retardation in physical and mental development;
with exacerbation of adenoiditis more than 4 times a year, despite complete conservative treatment.

You can learn how adenoids are removed by watching a video of the operation:

The operation to remove the adnoids is called adenotomy. For children, this operation is performed in a hospital under general anesthesia. It can be carried out in the traditional way using a Beckmann loop sharpened from the inside. But today this operation is often performed using more modern tools: a laser knife and a shaver (a tool with a rapidly rotating blade). The most modern method of adenotomy is coblation. This operation is performed using cold plasma. The plasma cloud destroys growths with high precision without touching them.

More and more clinics are performing adenotomy endoscopically, allowing you to see the surgeon’s work on the screen. This way you can remove all vegetations of lymphoid tissue as accurately as possible and prevent relapse of the disease.

In the postoperative period Dr. Komarovsky recommends:

exclude foods that irritate the mucous membrane of the pharynx (nuts, seeds, crackers, etc.);
exclude sweets and sugary carbonated drinks; you can eat half-melted ice cream;
after discharge from the hospital, it is better not to visit the children's group for 1 - 2 weeks;
For six months you need to beware of colds and viral infections.

Traditional methods of treatment

Treatment with folk remedies has a long tradition, but it must be carried out under the supervision of an ENT doctor. Here are some recipes:

nasal rinsing can be done with a 2% soda or saline solution (a teaspoon of soda or salt per glass of water), infusions of chamomile flowers, calendula officinalis (brew at the rate of a tablespoon per glass of boiling water);
drink the following heated medicinal solution during the day: add a teaspoon of honey, a raw egg beaten into foam and a tablespoon of melted butter to a glass of milk; suitable for schoolchildren;
aloe juice; break off an aloe leaf, keep in a dark place for several hours and instill a few drops into both nostrils 3-4 times a day; Suitable for children of any age, relieves inflammation and swelling well;
beet juice; Pure beet juice cannot be instilled; it is diluted with water at the rate of 1:3; instill in the same way as aloe juice; has antiseptic and anti-inflammatory effects.

It is worth remembering that folk remedies will help relieve inflammation and swelling, but not reduce the volume of growths.

Prevention

Prevention of this disease is the prevention of adenoiditis. To do this, you need to strengthen your immune system with:

hardening; children should walk in the fresh air as often and as long as possible so that outdoor games alternate with rest;
vitamin and mineral complexes, which are best taken in the spring, when the body needs them most;
proper nutrition.

To avoid viral infections, during the cold season, you should not visit crowded places (shops, pharmacies, etc.).

If parents have a suspicion of adenoids in children, the symptoms of this disease should be confirmed by an otolaryngologist. He must decide what treatment, conservative or operative, is necessary for this child. If the doctor believes that the adenoids should be removed, parents should listen to his opinion.

Preschoolers and children of primary school age, due to their weak immune system and increased sensitivity of the body, are most susceptible to various diseases. One of the exclusively childhood ailments is adenoiditis - inflammation of the adenoids (pharyngeal tonsils).

During puberty, the body is rebuilt, the immune system gets stronger and easily suppresses most of the inflammatory processes in the tonsils. But it is difficult for infants to fight the proliferation of bacteria on their own.

Since the symptoms of adenoiditis occur only in children under 10 years of age, treatment of the disease should be as gentle as possible and at the same time effective. Parents of young children should be aware of all the symptoms of tonsil inflammation in order to immediately consult a doctor.

What is this?

Adenoiditis is an inflammatory disease that affects the nasopharyngeal tonsil. The process is localized on the posterior wall of the nasopharynx. Adenoiditis occurs in children from birth to primary school age.

The prevalence of the disease is more than 25 percent. This high rate is due to the hypertrophied shape of the tonsil in the nasopharynx. As a result, it constantly provokes an inflammatory process and also slows down recovery from various infectious diseases.

Interesting fact! With age, the adenoids atrophy, so this disease cannot occur in adults.

Young children are very susceptible to various types of infectious diseases. While the child's body develops and adapts to the environment, the child's immune system reacts very sensitively to various irritants, weakening under the onslaught of all kinds of microorganisms.

When the immune system is weakened, mucus filled with various viruses, bacteria and fungi may begin to accumulate on the inflamed tonsils. At this point, your chances of getting colds and flu increase.

And if a child cannot breathe through his nose, cold and unpurified air enters the respiratory tract, which increases the risk of developing an inflammatory process in the body.

Clots of mucus on the tonsils are called adenoids, and the inflammatory process that develops in them is adenoiditis.

It should be noted that adenoiditis is a childhood disease that quite often affects the pharyngeal tonsils of a child under the age of 10 years. During puberty, the child’s body is rebuilt and the immune system successfully suppresses the proliferation of bacteria in the tonsils.

In the nasopharynx of a newborn child, instead of lymphoid tissue, there are spherical accumulations of lymphocytes. The Pirogov-Waldeyer ring begins its active development in infancy.

The pharyngeal tonsil forms faster than others, since it is the first to encounter airborne irritants.

The body of children experiences an increased immune load (diseases, vaccinations). In response, the lymphoid tissue of the tonsil is mobilized and increases in volume. This process is natural, but the frequent increased production of antibodies at the local level leads to pathological growth (hypertrophy).

Classification

There are three degrees of adenoiditis, which differ in the size of the tonsil:

First degree. This is the mildest form of the disease, the child's nose breathes freely, the overgrown tonsil closes the nasopharynx by only a third. During sleep, the child breathes through the mouth, because from the influx of venous blood in the supine position, the tonsil increases in size and covers most of the nasopharynx.
Second degree. The nasopharynx is half closed.
Third degree. The tonsil grows to such an extent that the nasopharynx is completely blocked and the child cannot breathe through the nose. The disease brings particular discomfort at night, when the child constantly coughs and chokes.

There is also acute and chronic adenoiditis. The acute form begins with a significant increase in temperature (at the level of 39 ° C). There is a burning sensation in the nasopharynx and the nose is stuffy. Your ears may also hurt. Acute adenoiditis lasts up to 5 days and can develop into otitis media.

The chronic form of the disease can be triggered by frequent acute respiratory viral infections. The baby feels all the signs of intoxication, allergies can develop and the kidneys become inflamed.

A mild form of the disease usually develops as a result of hypothermia, SARS, seasonal weakening of the immune system and manifests itself in a slight increase (inflammation) of the pharyngeal tonsils: the child can remain active, does not complain of headache, temperature and other symptoms characteristic of the inflammatory process.

But the disease should not be ignored: if nothing is done, mild inflammation can turn into an acute form. Symptoms of acute adenoiditis are very typical: breathing is disturbed, the temperature rises, sleep becomes intermittent, children begin to complain of headaches and fatigue.

The cause of the development of a chronic disease can be untreated acute adenoiditis, bronchial asthma, allergies (in particular, hay fever), general weakening of the immune system, vitamin deficiency or poor nutrition. It is important to start treatment on time to prevent complications from developing.

Chronic adenoiditis can manifest itself in different clinical and morphological variants, depending on the type of reaction that predominates, immunological reactivity, and the degree of allergization.

Acute adenoiditis is a retronasal sore throat. Chronic adenoiditis has several classifications:

Depending on the nature of the inflammatory reaction of adenoid tissue, there is lymphoplasmacytic, lymphocytic-eosinophilic with weak exudation, and lymphoreticular.
Catarrhal, mucopurulent, exudative-serous.
Based on the severity of signs of local inflammation, subcompensated, compensated and decompensated adenoiditis, lacurial and superficial adenoiditis are distinguished.

Causes

The main cause of adenoiditis in children is coccal flora in the nasopharynx (streptococci, pneumococci, staphylococci and various viruses). Acute forms of adenoiditis, taking into account frequent acute respiratory viral infections, develop into a chronic disease.

Children with allergic diathesis also suffer from adenoiditis. Hypertrophy of the tonsil can be caused by a reaction to food and household allergens.

Bad air also affects the condition of the nasopharynx, temperature changes, lack of ventilation and other factors contribute to the development of adenoiditis.

The exact cause of the pathological proliferation of adenoids is unknown, but a number of provoking factors have been identified:

Diseases that cause damage to the epithelium of the nasopharynx (whooping cough, measles, scarlet fever, diphtheria), rhinovirus, herpes virus and adenovirus and bacteria: Staphylococcus aureus, Haemophilus influenzae, pneumococci, streptococci.
Hereditary lymphatic-hypoplastic anomaly of the constitution. This condition, in which the lymph nodes are persistently enlarged, is characterized by dysfunction of the endocrine, cardiovascular system. Such children are lethargic, edematous, and prone to obesity.
Gastroesophageal reflux. Regular reflux of gastric contents into the nasopharynx leads to disruption of the mechanisms of local immunity.
Allergies. Adenoiditis is diagnosed in 35% of allergic children.
Congenital anomalies (deviated nasal septum).
Unfavorable environmental conditions under which the nasopharynx is constantly irritated by polluted air.
Lack of vitamin D, diet high in carbohydrates.
Early weaning of the baby from breastfeeding.

Any factors that reduce the body's resistance, disrupt its ability to adequately respond to external conditions, can provoke the growth of adenoids.

Symptoms

Acute adenoiditis (retronasal angina) during initial development is accompanied by signs of SARS:

the temperature rises sharply;
breathing is disturbed: first transparent, and then mucopurulent snot appear;
sore throat, cough;
The lymph nodes under the lower jaw and on the neck may become enlarged.

Important! Often, exudative (with discharge) otitis media joins, but the child does not always complain of ear pain or hearing loss.

Since there are two forms of adenoiditis (acute and chronic), we will describe the symptoms of each of them. It should be noted that this division is very arbitrary, because acute inflammation of the pharyngeal tonsils can eventually become chronic, and chronic, on the contrary, sometimes give relapses.

So, the symptoms of acute adenoiditis in a child are as follows:

heat;
pain when swallowing;
feeling of nasal congestion;
runny nose and coughing fits;
when examining the throat, slight redness of the upper tissues is observed;
mucopurulent discharge from the nasopharynx;
headache;
general fatigue and loss of strength.

If exacerbations are frequent, adenoiditis becomes chronic. The inflammatory process in this form often spreads to the pharynx, larynx, and bronchi, causing attacks of night cough and periodic increases in temperature.

Symptoms of chronic adenoiditis:

frequent colds and sore throats;
nasal congestion;
runny nose (sometimes with purulent discharge);
changes in voice and speech sound;
recurrent otitis media (ear inflammation) or hearing loss;
the child is lethargic, does not sleep well and always breathes through his mouth.

An obsessive cough, intoxication, and hyperthermia appear. The child often complains of headache, pain behind the soft palate, which is observed when swallowing, pain in the depths of the nose.

There is also an accumulation of viscous fluid in the nasopharynx, an aching and dull pain in the back of the head, pain and tickling in the throat, and hearing decreases. Nasal breathing is sharply disrupted, and an obsessive dry cough occurs.

Important! Breastfed babies may suckle very poorly or refuse to eat at all.

Diagnostics

To make a diagnosis of “Adenoiditis,” an ENT examination is performed, and a number of instrumental and laboratory tests are also prescribed. The first include rhinoscopy, fibroendoscopy of the tonsil in the nasopharynx, as well as rigid endoscopy.

Microbiological and cytological examination of smears from the nasopharynx is also carried out to determine the pathological flora that contributed to the enlargement of the tonsil.

After the interview, the doctor will perform an initial examination: check the throat and nasal passages (anterior rhinoscopy), look into the nasopharynx using a mirror on a holder (posterior rhinoscopy), and assess the condition of the ear canals with an otoscope.

Accurate diagnosis is guaranteed by endoscopic examination. The technique for doing it is as follows:

a painkiller test is done within 15 minutes;
a vasoconstrictor and anesthetic are injected into the nasal cavity;
A very thin wire with a camera (endoscope) is inserted.

It is problematic to perform an endoscopy on a child under 5 years of age. You can take an x-ray, but it is impossible to determine the degree of adenoid hypertrophy from it.

The inflamed tonsil is larger in volume, so the final diagnosis is made based on examination after the exacerbation has stopped.

Also, to diagnose adenoditis, smears from the surface of adenoid vegetations are examined to determine the quantitative ratio of inflamed cells.

Immunological studies are carried out - the number of circulating immune complexes, the amount of IgM, IgA in the blood plasma, and the number of B-lymphocytes are determined.

Microbiological examinations of smears from the surface of adenoid tissue are carried out to determine the microflora and their sensitivity to antibiotics.

Treatment

Treating adenoiditis at home without consulting a specialist can lead to serious consequences. For example, the child’s general condition will worsen and his performance will decrease.

Due to a lack of oxygen in the blood, the functioning of the brain and vascular system of the eyes can be affected, leading to drowsiness, fatigue and absent-minded attention. Well, the most terrible consequences are considered to be speech impairment and inflammation of the middle ear.

Interesting to know! There are two methods of treating adenoids: conservative, aimed at relieving symptoms and relieving inflammation, and surgical.

Treatment of adenoiditis is aimed at eliminating the focus of bacteria in the tonsils. Various methods are used to treat the acute form of the disease.

Non-drug treatment includes the use of tube quartz and electrophoresis on the lymph nodes. This method is combined with a sanitary resort holiday and various health activities aimed at increasing tone and generally strengthening the immune system.
Drug treatment includes the use of antibiotics and vasoconstrictor nasal drops and is aimed at destroying bacteria that multiply on the tonsils. At this stage, immunotherapy is carried out using various homeopathic medicines.

In case of a protracted chronic form of a disease such as adenoiditis, treatment can also be surgical, aimed at complete removal of the adenoids.

Conservative

This treatment is primarily aimed at reducing swelling and inflammation in the tonsil. Sea salt solutions are widely used for rinsing the nasal cavity and nasopharynx (Dolphin, Humer, Aquamaris, Nosol). In addition to nasal rinsing, homeopathic medications are prescribed to improve the outflow of mucus (“Tsinabsin”).

Interesting to know! Laser and cryotherapy are also widely used in the treatment of adenoiditis.

Treatment of adenoiditis, which occurs in an acute form with purulent discharge, in most cases involves taking antibiotics, and is therefore carried out under the supervision of a specialist. The doctor will select the appropriate drug, taking into account the patient’s age, and describe in detail the antibiotic treatment regimen.

There is no need to be afraid of medications: modern antibiotics have a fairly gentle effect on the body, and with the correct dosage, the risk of side effects is minimal.

In addition to the main drug, the otolaryngologist may prescribe nasal drops, vitamin therapy and local procedures (for example, rinsing the nasopharynx with decoctions of medicinal herbs with pronounced antiseptic properties - St. John's wort, wormwood, chamomile, calendula, yarrow).

Important! To ensure that unpleasant symptoms do not return and the treatment of acute adenoiditis in children is successful, do not get carried away with self-medication: folk remedies are good only as a supplement to a course of antibiotic therapy.

For acute adenoiditis, the same treatment is prescribed as treatment for angina. At the very beginning of the disease, they try to do everything to prevent the development of a suppurative process and limit the development of the inflammatory process.

If there is a fluctuation, then the abscess is opened. Irrigation therapy, hyposensitizing detoxification, antibacterial therapy, and aerosol inhalation are used.

Surgical

In special cases, when conservative treatment is ineffective, persistent complications and a significant deterioration in the child’s quality of life, surgery to remove the adenoids is indicated. However, before doing this, be sure to conduct a study of the causes of adenoiditis in order to exclude the allergic nature of the disease.

This is done because allergic adenoiditis is not eliminated surgically, since this does not get rid of the causes of the disease. It is enough to simply eliminate the allergen from the child’s environment and environment.

The operation to remove harmful clots of mucus is considered quite simple in a technical sense and represents a radical elimination of the source of infection.

The downside of this treatment option is the possibility of numerous relapses.

Important! Most often, the disease returns if the doctor left even the slightest trace of infected mucus.

In this case, it will grow again quite quickly and cause a new surge of adenoiditis.

Operation methods:

Adenoids are cut off with a special semicircular device - an adenotom, inserted through the oral cavity. The procedure is performed under local anesthesia and takes about a minute.
Endoscopic method. Adenoids are removed using electrocoagulation (loop) or shaver (blade). The procedure lasts 5-10 minutes and general anesthesia is usually used.

It is impossible to remove all lymphoid tissue completely with an adenotomy; it is likely to grow again. The risk of relapse depends on the child's age:

the highest – at 2 years;
minor – 5-6 years;
low – after 7 years.

patients who have been diagnosed with bronchial asthma or an allergic reaction, since there is a high probability of their health deteriorating after surgery;
within a month after any preventive vaccinations;
with anomalies in the development of the soft or hard palate;
for blood diseases; under 2 years of age;
for acute infectious diseases of the respiratory tract.

Important! Removal of the adenoids weakens the immune system, and often after the operation the child begins to get sick, as parents say, “everything in a row.”

After the operation, the child is under the supervision of a doctor for 2 hours, and if there is no bleeding, he is discharged home. A gentle diet is prescribed for about 5 days, it is recommended to take drugs that improve blood clotting, instill vasoconstrictor drops, and avoid physical stress.

In the first days, there may be an increase in temperature, nasal congestion, and nasal sound.

ethnoscience

For a disease such as adenoiditis, treatment may include various folk remedies. To do this, infusions and decoctions are prepared from herbs, which the child needs to rinse and bury in his nose.

To make breathing easier through the nose, you can prepare several remedies according to traditional medicine recipes:

Folk remedies have repeatedly proven their effectiveness, but before using them, you must always consult with your doctor, who will determine the degree of development of the disease and evaluate all the consequences. But the best way to deal with such an unpleasant disease is its prevention.

Important! In case of adenoiditis, it is necessary to ensure that the child’s body receives the maximum amount of vitamins and beneficial microelements. You should focus on fruits, vegetables and berries that are in season.

Prevention

If conservative treatment turns out to be effective (completely eliminates or minimizes the manifestations of the disease), concentrate on prevention and wait a little - as a rule, from the age of 10-12 years, the adenoids return to normal and do not bother children at all.

Until then, it is necessary to provide them with protection from hypothermia (but without fanaticism, because moderate hardening is healthier than wrapping them up) and infections, conduct preventive courses of fortification, and monitor their diet and daily routine.

Adenoid growths are a consequence of weakened childhood immunity. According to Dr. Komarovsky, the effectiveness of pharmaceutical immunomodulators is questionable. The popular pediatrician agrees with his colleagues that a child’s health is a matter of lifestyle and environment.

To prevent adenoids, Komarovsky advises:

provide clean, healthy, not overheated air in the child’s bedroom: remove carpets, install a humidifier, ventilate regularly;
at least 2 hours of daily walks;
treat acute respiratory infections, check the condition of the tonsils;
balance your diet (less refined food).

These measures will help to avoid both the proliferation of adenoids and relapses after removal.

The human body is designed in such a way as to protect itself as much as possible from the penetration of pathogenic microorganisms. However, sometimes protective barriers are modified and become a health hazard themselves. Adenoiditis is one of the diseases that occurs in childhood due to changes in certain tissues of the body.

Adenoiditis is a dangerous disease, the advanced form of which requires surgical intervention

What is adenoiditis?

Pharyngeal tonsils protect a person from the effects of adverse external factors. They serve as a kind of filter that prevents germs from penetrating deep into the body. Due to various infections, tonsil tissue can grow. Enlarged nasopharyngeal tissues are commonly called adenoids.

The proliferation of lymphoid tissue is typical for children from 3 to 8 years old. In school-age children, the tonsils begin to shrink, so by the age of 13, adenoid growths completely disappear. However, sometimes the adenoids become inflamed. This pathology is called adenoiditis.

Causes of the disease

Enlarged tonsils in a child do not always lead to adenoiditis. Their small growth does not cause discomfort and does not require serious treatment. The inflammatory process in the adenoids occurs under the influence of infection against the background of weakened local immunity. The main causes of adenoiditis in children include:

frequent colds;
predisposition to allergies;
immaturity of the immune system in premature infants;
uncontrolled use of medications;
early refusal of breastfeeding;
chronic diseases;
pathologies of the structure of the nasopharynx (congenital or traumatic);
intrauterine fetal infections;

bad ecology;
systematic hypothermia;
pathologies of the upper respiratory tract;
lack of vitamins, poor nutrition;
being in a smoky room;
tonsillitis;
infectious diseases.

Classification and symptoms

Based on the level of prevalence in adjacent tissues, the following types of disease are distinguished:

superficial (minor inflammation of the adenoids);
compensated (the inflammatory process affects the palatine and pharyngeal tonsils);
subcompensated (manifested by deterioration of health, tonsillitis worsening);
decompensated (accompanied by inflammation of connective tissues and damage to internal organs).

The main symptoms of this type of disease: runny nose, itching and burning in the nose, cough. Adenoiditis due to allergies often takes a chronic form.

Degrees of adenoiditis

Adenoiditis in children takes different forms. The disease is distinguished by the degree of atrophy of the tonsils, the extent of the disease and the severity of inflammation, and the level of spread to adjacent tissues. The degree of change in lymphoid tissue is determined depending on how much the adenoids cover the cavity of the nasal passages:

1st degree – tonsils cover 1/3 of the nasal cavity;
2nd degree – growth reaches half of the cavity of the nasal passages;
3rd degree – adenoids cover 2/3 of the nasal septum;
4th degree - the tonsils almost completely cover the area of the nasal passages.

Depending on the extent and severity of inflammation, the disease occurs in acute, subacute and chronic forms.

Acute and subacute form

The acute course of the disease has the most striking symptoms and lasts 5-7 days. Acute adenoiditis occurs against the background of viral and bacterial infections. Symptoms of acute adenoiditis:

increase in body temperature up to 39 degrees;
nasal congestion;
coughing attacks that worsen at night;
discharge of mucus from the nasal passages;
headache;
ear pain;
swelling of the larynx.

Subacute adenoiditis lasts up to 3 weeks. Body temperature can reach 38 degrees, and inflammation affects adjacent lymphatic tissues. With subacute adenoiditis, signs of an acute form are observed, but the child experiences periods of weakening symptoms.

Chronic form

Chronic adenoiditis interferes with a child’s full life

Chronic adenoiditis in children occurs when the disease is not treated in a timely manner. Symptoms and signs of chronic disease:

duration up to six months or more;
subfebrile body temperature;
cough;
difficulty breathing through the nose;
hearing loss;
snoring during sleep;
runny nose accompanied by purulent discharge;
enlarged lymph nodes (we recommend reading:);
voice changes and speech disorders;
lack of appetite;
recurrent headaches;
deterioration of general condition;
frequent diseases of the upper respiratory tract and ENT organs (sore throat, otitis, sinusitis, bronchitis).

Chronic adenoiditis can take a catarrhal form (inflammation of the mucous membranes), exudative-serous (accompanied by the release of exudate), purulent (purulent inflammation appears).

Why is adenoiditis dangerous?

Untimely treatment of the disease leads to serious consequences for the child’s body. Children who suffer from chronic adenoiditis lag behind their peers in development.

Due to difficulty breathing, their chest is deformed and an “adenoid face” is formed, in which the folds of the nasolabial triangle are smoothed out, the lower jaw enlarges, and the bite changes.

With persistent adenoiditis, the child's salivation increases, and his facial expression becomes meaningless. The disease can lead to kidney damage, heart disease and gastrointestinal tract diseases. An infection in the throat affects the ear and leads to chronic ear infections. With adenoiditis, a child more often suffers from colds accompanied by complications (bronchitis, pneumonia, sinusitis, laryngotracheitis).

Diagnostic measures

Adenoiditis is diagnosed based on symptoms. To confirm the diagnosis, a specialist examines the throat using special mirrors. The doctor determines the degree of growth of the adenoids by palpation of the nasopharynx. Additional diagnostic methods make it possible to determine the causative agent of the disease, the degree of damage to adjacent tissues and the presence of complications. These methods include:

general and biochemical blood test;
throat swab;
X-ray of the nasopharynx;
allergological examination (if an allergic nature of the disease is suspected);
assessment of the function of the auditory organ (acoustic impedance measurement, audiometry);
CT scan.

Adenoiditis is diagnosed during examination by a doctor; if necessary, a number of additional tests are prescribed

Complex treatment

Treatment of adenoiditis involves complex therapy of concomitant diseases. The treatment method is chosen by a specialist, based on the clinical manifestations of the disease, the pathogen, the degree of change in the lymphoid tissue and the age of the patient. When treating children, medications, homeopathic remedies, physiotherapy, traditional methods, and surgery are used.

Conservative therapy

Conservative therapy is used for adenoiditis of the 1st and 2nd degree of atrophy of the tonsils. The treatment complex includes taking medications that alleviate the patient’s general condition and eliminate inflammation. The entire nasopharynx is treated. The table describes medications used in conservative therapy.

Direction of therapy	Characteristics of drugs	List of medicines
Relieving swelling of the nasal mucosa, facilitating breathing	Vasoconstrictor nasal drops	Nazol, Naphthyzin, Vibrocil, Nazivin, Galazolin, Xylene
Increasing local immunity	Isotonic salt water solutions for nasal rinsing	Aqualor, Marimer, Aquamaris, Humer
Relieving local inflammation	Antiseptic drops	Bioparox, Protargol, Albucid, Polydexa (we recommend reading:)
Eliminating allergies	Antihistamines	Suprastin, Diazolin, Fenistil, Loratadine
Treatment of severe disease	Hormonal agents	Nasonex
Cough relief	Bronchodilators and antispasmodics	Erespal (we recommend reading:)
Eliminating the infection	Antibiotics	Azithromycin, Amoxiclav, Amoxicillin
Eliminating the infection	Antiviral drugs	Anaferon, Viferon
Decreased body temperature	Antipyretics	Paracetamol, Ibuprofen, Nurofen
Strengthening general immunity	Vitamin and mineral complexes	Vitrum Baby, Ferrosan

Homeopathy

Reception of homeopathic remedies is carried out in combination with conservative treatment and as a rehabilitation therapy after surgery. Homeopathy helps to relieve inflammation and prevent recurrence of the disease. Homeopathic remedies are selected depending on the age of the patient. Children are prescribed Lymphomiazot, Sinupret, Job-baby, Euphorbium compositum, Silicea-plus.

Physiotherapy

Physiotherapy is used as an aid. It is carried out simultaneously with drug treatment of the disease. Physiotherapy procedures are prescribed for a course of 5-10 days. Effective for adenoids: electrophoresis, phototherapy, tube quartz, diathermy, laser treatment. Physiotherapy is used both for acute adenoiditis and to prevent exacerbation of the chronic form.

Folk remedies

Folk remedies for the treatment of adenoiditis are used in the chronic course of the disease and to eliminate the symptoms of the acute stage. An effective folk method for treating adenoids in children is inhalation with herbal decoctions. To strengthen local immunity, it is recommended to consume fish oil.

In complex treatment of the disease, inhalations with decoctions of medicinal herbs have a positive effect.

A description of popular folk remedies for adenoiditis is presented in the table.

Treatment method	Composition, preparation	Application
Inhalations	Pour boiling water over chamomile or sage, add a few drops of pine or eucalyptus essential oil.	Inhale the vapors of the solution until the liquid cools completely 2 times a day.
Nose lubrication	Mix 1 part propolis with 10 parts butter, cook in a water bath for 25 minutes.	Lubricate the nasal passages with the mixture or insert tampons soaked in liquid for 30 minutes.
Nasal lavage	200 ml of clean water, 20 drops of propolis alcohol tincture, a quarter teaspoon of soda.	Rinse the nasal passages 2 times a day.
Herbal teas, herbal infusions	Make an infusion of sage, chamomile, herbal tea based on St. John's wort, marshmallow root, coltsfoot, dilute with water, add a little sugar.	Give to the child several times a day as tea.
Nasal drops	Grate raw beets and squeeze out the juice.	Drop into the nose 3 times a day.

Operation

The operation to remove adenoids involves complete or partial excision of the tonsils (we recommend reading:). Resection is performed with a scalpel or laser. Laser adenoidectomy is considered more gentle and is often used in the treatment of adenoiditis in children.

Indications for surgical intervention:

proliferation of tonsils to 3–4 degrees;
stopping breathing during sleep;
lack of positive dynamics with conservative treatment;
chronic adenoiditis, complicated by purulent otitis, sinusitis, inflammation of the respiratory tract, sinusitis;
spread of the inflammatory process to internal organs;
signs of deformation of the chest and face;
hearing impairment.

Prevention of adenoiditis in children

Prevention of adenoiditis in children includes:

strengthening the immune system (hardening, taking vitamins, moderate physical activity, walking in the fresh air);
timely treatment of colds and allergies;
complete nutrition;
vaccinations according to schedule;
summer holiday at sea;
removal of severely atrophied tonsils.

Purulent adenoiditis is an inflammatory process that occurs in the area of the pharyngeal tonsil. Inflammation is often of an infectious nature and is accompanied by the separation of purulent exudate.

If adenoiditis is treated incorrectly, complications may develop, including pathologies of the excretory system, diseases of the gastrointestinal tract, and disorders of the cardiovascular system.

More often, purulent adenoiditis occurs in children, but progression of the pathological process in adults is also possible.

Among the causes of purulent inflammation of the pharyngeal tonsil are the following factors:

Predominantly artificial feeding.
The predominance of carbohydrate foods in the diet.
Hypovitaminosis, especially vitamin D deficiency.
Rickets.
Diathesis (usually exudative).
Allergic diseases.
Hypothermia of the body.
Exposure to adverse environmental factors.

Acute adenoiditis often develops in young children due to the activation of pathological microflora in the nasopharyngeal area with general hypothermia of the body. In addition, the cause of the development of adenoiditis as a complication can be a previous infectious pathology.

Forms of adenoiditis

The main forms of this disease include acute, subacute and chronic adenoiditis. The acute form of the pathological process manifests itself as retronasal tonsillitis, and the chronic form involves a wide range of clinical symptoms.

Symptoms of acute adenoiditis

Most often, acute purulent adenoiditis occurs after acute respiratory diseases, the cause of which in some cases is streptococcal infection. Isolated inflammation of the pharyngeal tonsil does not occur very often.

Acute adenoiditis is characterized by the following clinical symptoms:

High temperature (above 39 degrees) at the onset of the disease.
Sensation of rawness and moderate pain during swallowing deep in the nasal cavity.
Nasal congestion, prolonged runny nose.
Coughing attacks at night.
in the area of the back wall.
Swelling of the posterior palatine arches.
Copious purulent discharge from the nasopharynx.
During endoscopy and rhinoscopy, the specialist discovers a reddened, hypertrophied tonsil, the grooves of which are filled with pus.
Headache.
Soreness of the soft palate and pain radiating to the ears and posterior nasal cavity.

A persistent runny nose is one of the constant symptoms of pathology.

The acute inflammatory process is especially severe in infants. Timely prescription of correct therapy is hampered by the difficulty of making a correct diagnosis.

The clinical picture is quite nonspecific and includes the following manifestations:

difficulty sucking;
parenteral dyspepsia(stomach fullness, distension in the epigastrium, dysphagia, early satiety);
lymphadenopathy(enlarged and painful cervical and submandibular lymph nodes).

The acute form of adenoiditis lasts about five days. The pathology is prone to recurrent course, sometimes complicated by acute sinusitis and otitis media, damage to the trachea and bronchi. Complications include bronchopneumonia and laryngotrachebronchitis. In children under 4 years of age, a retropharyngeal abscess often develops.

Symptoms of subacute adenoiditis

Subacute adenoiditis lasts slightly longer than the acute form of the pathology. The disease is more common among children who have been diagnosed with severe hypertrophy of the pharyngeal lymphadenoid ring.

The onset of the pathological process is quite acute, often the disease develops after subsiding. The duration of subacute adenoiditis ranges from 15 to 20 days.

The disease begins with a long-term low-grade fever, sometimes the temperature in the evening hours rises to 38 degrees. The cervical and submandibular lymph nodes are swollen and sensitive to palpation.

There is a purulent runny nose with adenoids, it is protracted. In some cases, cough and otitis media occur. Sometimes the duration of the disease exceeds 20 days, the process drags on for up to several months.

Symptoms of chronic adenoiditis

Chronic adenoiditis is distinguished by the duration and range of accompanying symptoms. The patient's condition is complicated by inflammation of the middle ear, trachea, bronchi and paranasal sinuses.

Symptoms are determined by the predominant inflammatory reaction and immunological reactivity of the patient's body. Among the purulent forms of adenoiditis, mucopurulent and neutrophilic-macrophagic adenoiditis predominate.

Among the symptoms of chronic adenoiditis, the following should be highlighted:

Difficulty breathing through the nose.
Runny nose with purulent discharge.
Exacerbations of pathology, which are manifested by fluctuations in body temperature up to 38 degrees and an increase in runny nose.
Purulent inflammation of the middle ear.
Inflammation of the trachea and bronchi.

In case of exacerbation of chronic adenoiditis, symptoms characteristic of the acute form of the pathology appear.

Treatment smoothes clinical symptoms, but does not bring complete recovery.

Chronic adenoiditis is typical for older children. The disease provokes a deterioration of not only physical but also psychological health.

The child becomes more tired, headaches appear, appetite decreases, and attention is impaired. In addition, children may suffer from night cough and progressive eustachitis.

Treatment methods for purulent adenoiditis

Purulent adenoiditis can be detected during an examination by an otolaryngologist. The specialist will carry out the necessary diagnostic procedures and prescribe the correct course of therapy.

The goals of treating the purulent form of adenoiditis are:

elimination of the infectious agent;
preventing the spread of pathology to nearby organs.

Among the main methods of treatment for adenoids are the following:

Taking antibiotic drugs(Flemoclav, Amoxicillin, Sumamed). Antibiotics must be used strictly as prescribed by the doctor and according to the instructions.
Taking desensitizing medications, reducing swelling and allergization of the body (Diazolin, Zyrtec, Claritin). The price of these drugs varies over a fairly wide range.
Using saline solutions for nasal irrigation in order to reduce swelling and remove pus from the nasal cavity (Marimer).
The use of aerosol forms of drugs containing antiseptic substances(Bioparox, Stopangin, Hexoral).
Use of vasoconstrictor nasal drops(Rinostop, Nazol).
Irrigation of the nasal cavity with drying and antiseptic solutions(Collargol, Protargol).
Physiotherapeutic procedures(laser treatment, phototherapy, diathermy, electrophoresis).
Do-it-yourself pharyngeal tonsil massage(up to five days daily, a few seconds).

Nasal rinsing is an important step in the treatment of inflammation of the adenoids.

In rare cases it may be required. After surgery, sometimes remnants of adenoids remain, which can grow and provoke a relapse of the inflammatory process.

With timely detection of pathology, the likelihood of a quick recovery is higher. It is important to follow all medical prescriptions and recommendations and not neglect prescribed procedures and medications. You should not self-medicate, as this may worsen the condition. The video and photos in the article will help you understand the peculiarities of the clinic and treatment of purulent adenoiditis.

In the context of the modern development of new infections, the issue of adenoid vegetations is relevant. They often accompany children's adaptation to kindergarten or school. Let's consider the typical symptoms of adenoiditis and directions of treatment in children.

Before we treat adenoids, let’s remember the nature of its occurrence. When pathogenic flora enters the body by airborne droplets, the first barrier of the child’s immunity awaits it in the nasopharynx. This is a Pirogov-Waldeyer ring. It includes several accumulations of lymphoid tissue:

two palatine tonsils;
two tubal tonsils;
one pharyngeal;
lingual;
lateral ridges along the posterior wall of the pharynx.

The pharyngeal tonsil is considered an organ of the peripheral immune system. Together with the tonsils, it becomes a defense against antigens entering the oral cavity and upper respiratory tract. In lymphoid tissue, bacteria, viruses, and allergens are captured and inactivated.

Inflammation of the nasopharyngeal tonsil is called adenoiditis, and the growth (hyperplasia) of the organ is called adenoid vegetations.

The pharyngeal tonsil is most active in children under 12 years of age. This is why adenoiditis often occurs in children. The peak progression of adenoid disease in a child is from three to seven years. By the age of 16, involution (reverse development) of this gland occurs. Therefore, the chance of treating her infections increases at this age.

Causes of adenoids

Inside the pharyngeal tonsil in children, harmful flora is captured and destroyed. The outcome of the fight depends on the activity of antigenic stimulation from the outside and the intensity of the immune system. If loads on the lymphopharyngeal ring are frequent and prolonged, then the risk of acute adenoiditis in children is high.

The development factor will directly influence the treatment of acute and chronic adenoiditis in children. The main reasons for the formation of adenoid vegetations:

acute viral infections;
chronic foci of inflammation of the nasopharynx in children (rhinitis, sinusitis, tonsillitis);
childhood infectious diseases (measles, chicken pox, scarlet fever);
living in areas with a cold, damp climate;
allergy;
congenital or acquired pathologies accompanied by immunodeficiency.

The provoking effect of intracellular infections is being studied. These are herpes viruses, Ebstein-Barr, chlamydia, mycoplasma. In children from the group who are often and long-term ill, there is a decrease in immune defense, and even purulent adenoids form.

Adenoid grades

The size of adenoids determines the symptoms of adenoiditis, the clinical picture and the amount of therapy. In children with vegetations or acute adenoiditis, it is customary to determine the degree of adenoids. They are classified based on the anatomical location of the growths:

The first degree involves reaching the level of the nasal passages and blocking up to 1/3 of the lumen.
The pharyngeal tonsil occupies 2/3 of the nasal passage.
Almost complete blockage of nasal breathing indicates the third degree of vegetation.

The level of adenoid spread, answers to the questions of how to treat and when to remove are determined by a pediatric otolaryngologist. Dr. Komarovsky recommends that the appearance of hearing impairment be regarded as grade 3 adenoids, even without an ENT examination.

Symptoms of adenoids

The signs of incipient adenoiditis are typical, which makes it easy to make a diagnosis. The clinic develops gradually, in accordance with the intensity of hyperplasia of the pharyngeal tonsil.

The first manifestations and main symptoms of adenoiditis:

Nasal congestion, runny nose.
Cough, usually morning, productive. Associated with the entry of inflammatory secretions from the adenoid to the back wall of the pharynx.
In the acute course of the disease, intoxication syndrome, fever, enlarged regional lymph nodes.
Sleep disturbance in the form of nocturnal suffocation, snoring. The reason for their occurrence is that at night venous blood stagnates in the tonsil tissue, the tissue swells and increases in size.
Poor aeration of the respiratory tract leads to long-term, frequent colds and infectious diseases.
With a long process, the so-called "adenoid" face is formed. This phenotype includes a protruding lower jaw, a slightly open mouth, and malocclusion.
Due to insufficient oxygenation in advanced cases, problems arise at the level of the central nervous system. The patient's memory and level of intellectual development suffer.
Speech disorders. The age of development of adenoiditis coincides with the age of active formation of speech skills. Restricted mobility of the soft palate and the inability to breathe freely lead to difficulty in reproducing consonant sounds.
signs of hearing loss appear, since the hyperplastic organ partially blocks the lumen of the auditory tube.

As can be seen from the above, the presence of adenoids and the development of their inflammation can lead to long-term serious problems. Therefore, interested parents should draw the pediatrician’s attention to the first, initial symptoms of the pathology.

Methods for diagnosing adenoids

Diagnosing adenoiditis in children is not technically difficult. Stages of diagnosis:

Methods for diagnosing adenoids	Result
Collection of complaints	Mouth breathing, night snoring, frequent rhinitis and coughing episodes for no apparent reason
History of the disease	Frequent prolonged ARVI, sinusitis.
Clinical examination	Exhaustion, lethargy, peculiarities of speech and voice timbre. Examination of the ENT organs using a rhinoscope allows you to determine the degree of adenoids, the flow of pathological mucus along the back wall of the pharynx.
Laboratory research	In acute adenoiditis - an increase in the level of leukocytes in the general blood test, accelerated ESR. In a chronic process, changes in the blood may not be observed.
Instrumented special methods	Flexible fiberoscopy, radiography of the facial bones, computed tomography. This is an auxiliary, not mandatory stage of the survey.

A pediatrician, a nurse, or even a mother may suspect an enlarged pharyngeal tonsil. Most often, it is parents who are the first to notice difficulty in nasal breathing and snoring during sleep. The final diagnosis is made by a pediatric otorhinolaryngologist.

Treatment

The goal of treatment of adenoids and adenoiditis is to normalize the general condition, restore adequate nasal breathing, and reduce the frequency of inflammatory processes in the nasopharynx. Children receive treatment on an outpatient basis, ENT departments or in-patient departments of infectious diseases hospitals. There are two types of therapy: conservative and surgical.

There are no universal remedies for the treatment of adenoids. The complex consists of the following areas:

antimicrobial agents;
anti-inflammatory drugs;
immunocorrection;
physiotherapy;
symptomatic care;
adenotomy.

Among surgical interventions, minimally invasive methods of removing the pharyngeal tonsil are widely used. Below we will dwell in detail on the various methods.

Drug treatment

Drug treatment is divided into local and systemic. Local methods are more gentle and have a local therapeutic effect. But in cases of purulent acute adenoiditis, a protracted course, one cannot do without prescribing systemic drugs.

Methods of local therapy:

Sanitation of the nasal passages. At home, this is rinsing the nasal cavity with saline solutions. They either use ready-made liquids (Humer, Salin,) or prepare their own. For the last option, add a teaspoon of sea or medicinal salt to 200 ml of warm water.
Using nasal drops. The direction of the drug depends on the leading symptom. These can be (Naphthyzin, Nazospray, Farmazolin), antimicrobials (Protargol, Isofra), steroids with anti-inflammatory effects (Nasonex).
Sanitation of the nasopharynx includes procedures of gargling, irrigation with sprays,. Preparations for the treatment of the throat - Chlorophyllipt, Orasept, Lisobakt, Givalex.

Vitamin complexes (Multi-Tabs, Pikovit, Alphabet) are used as general strengthening agents. If the infection does not respond to previous procedures, then oral antibacterial drugs are used. Medicines from groups with broad antimicrobial activity are prescribed.

Among the most effective antibiotics, the following are recommended:

semisynthetic penicillins - Amoxil, Amoxiclav, Flemoxin, Flemoclav.
macrolides - Sumamed, Azithromycin, Erythromycin.
cephalosporins - Ceftriaxone, Ceftum, Cefodox.

The course of treatment averages from 7 to 10 days. The dosage is selected by the doctor based on the child’s weight and the severity of the disease.

Folk remedies

To help official medicine, recipes are sometimes relevant. Here are some examples:

Gargle with warm brewed green tea 2 - 3 times a day.
Rinse the nose with a decoction of chamomile, oak bark, and calendula.
Instill beet, aloe or Kalanchoe juice into the nose, a few drops 3 times a day. Freshly squeezed juice is diluted with saline solution 1:1.
Heat-steam inhalations with potatoes with the addition of soda or essential oils of fir, pine, eucalyptus.

It is important to remember that home methods are not effective as independent treatment. In case of exacerbation of adenoiditis, qualified medical care cannot be avoided.

Physiotherapy

Physiotherapy provides quick results, targeted impact on the source of the disease, the possibility of an individual approach and versatile effects without affecting the body as a whole. Types of procedures for adenoiditis:

electrophoresis with prednisolone, novocaine, potassium iodide;
darsonvalization of the collar zone;
UHF therapy;
ultraviolet irradiation of the pharynx, nose;
mud therapy with peat, silt;
steam inhalations with essential oils, hardware inhalations with Mucolvan, saline, steroids.

Isolated techniques are rarely used. They are often prescribed as a complex of two to three directions over a course of 10 to 14 days.

Adenotomy

In some cases, conservative therapy does not give the desired effect. Then the ENT doctor recommends adenotomy (removal of adenoid vegetations) as the main treatment. Indications for surgical intervention will be:

3 degree of hypertrophy;
formation of "adenoid" changes in the facial skull;
hearing impairment;
frequent and prolonged otitis media, infections of the nasopharynx.

The operation is carried out in a hospital. Up to four to five days are allotted for preparation and rehabilitation after removal of the adenoids. The child at the time of such treatment should be in remission. To date, there are several methods for performing adenotomy. The classic method involves excision of pathological lymphoid tissues with a special knife - Backman's adenotomy. It is injected through the mouth, cuts and removes the pharyngeal tonsil. The procedure is performed under general or local anesthesia and takes a few minutes.

A more modern method is endoscopic adenotomy. It is carried out through the nasal passage using a soft probe - an endoscope. It is inserted into the nasopharynx cavity and, under the control of a video sensor, the surgeon excises the diseased tissue. This type of operation is done under general anesthesia. Duration up to half an hour. The choice of method is influenced by the general condition and age of the patient.

Complications of adenoids

Adenoid growths and adenoiditis are harmful not only in themselves, but also in the development of complications. A constant focus of inflammation leads to a decrease in the body's defenses. Hence, frequent diseases of the upper respiratory tract, bronchitis, even complications of the heart, kidneys, and joints. Over a long period of time, disturbances in the structure of the teeth, jaw, and nasal passages are formed.

Since there is an anatomical connection between the pharynx and the middle ear, otitis is associated with adenoiditis. In the future, this threatens the development of hearing loss. Nasal breathing disorders along with hearing impairment lead to speech and speech therapy problems. Chronic hypoxia also has long-term consequences: impaired blood supply to the brain, decreased intellectual development of the child, headaches, dizziness.

Komarovsky on the treatment and prevention of adenoids in children

comfortable humidity and temperature in the house;
mandatory walks in the fresh air;
eliminating sources of dust in the room;
adequate physical activity;
feeding the baby according to appetite.

The doctor does not deny the need for timely classical treatment. But he considers these measures to be important for the normal formation and functioning of the immune system and the prevention of adenoids.