Grade 3 adenoids in a child: treatment and causes, complications and what to do

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Adenoids of the second degree are pathological hypertrophy of the nasopharyngeal lymphoid tissue, manifested by difficulty breathing during the day and wheezing at night. The child's mouth is open during sleep, and during the day there is a cough. The speech of children with excessive growth of the nasopharyngeal tonsils is nasal: they replace the sounds m and n with b and d, respectively.

Impaired oxygen supply in a young child (1-3 years old) can negatively affect mental and physical development, so adenoids must be treated.

Causes and consequences

The nasopharyngeal tonsils are an organ of the immune system. The respiratory system connects the external environment with the child’s body. In children, lymphoid tissue is more developed than in adults, so it is in childhood that a person is more prone to inflammatory diseases of the ENT organs.

Structure of the nasopharynx

The function of all organs of the lymphoid system of the nasopharynx, which include the adenoids along with the lymphoepithelial pharyngeal ring, is to protect against infections of viral, bacterial, and fungal origin. Lymphatic tissue associated with the mucosa traps foreign agents so that they do not penetrate further through the respiratory system into the middle and lower respiratory tract.

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Adenoid vegetations appear more often in children living in environmentally unfavorable regions. Such patients, as a rule, suffer from complex hypovitaminosis, poor nutrition, polyvalent allergies to food components and environmental allergens.

Degrees of enlargement of adenoids

Grade 2 adenoids in children cause hypoxia of tissues and organs, especially the brain. A child with such an ENT pathology may suffer from enuresis during sleep, which can subsequently cause psychological problems with adaptation to the kindergarten team.

Constant hypoxia, which intensifies during sleep, leads to malnutrition and growth retardation, retardation in physical development, because it is at night that the child grows.

Adenoid vegetations during hypothermia in children can become inflamed and increase in size. Stage 2 adenoids are the most common cause of inflammation of the tubal tonsils and auditory tube.

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To remove adenoids or not, Komarovsky’s advice

Doctors believe that the presence of adenoids in children causes serious complications. An enlarged tonsil, located in the nasopharynx at the exit from the nasal cavity, is considered the cause of health problems for the child. The traditional method of treating children is removal of the adenoids or adenotomy (partial removal of the pharyngeal tonsil, which is greatly enlarged in volume).

Adenotomy is the most common surgical operation in the practice of pediatric otorhinolaryngology; it was proposed back in the time of Nicholas I. Since then, a lot of new things have appeared in medical science and a lot has changed. However, doctors still often resort to removing an enlarged tonsil.

In just a few minutes you can get rid of the problem, the effect after the operation is observed quite quickly. The baby quickly catches up with his peers in development, and facial asymmetry is smoothed out. However, in some cases, the adenoids grow back. Whether it is necessary to remove the adenoids is an individual question. In any case, you need to strictly follow the recommendations of an experienced ENT doctor, pediatrician, allergist, or immunologist. It is necessary to find out the reason for the enlargement of adenoids.

To avoid surgery, you need to eliminate all the causes of the disease. Adults should identify the causes of colds in a child and eliminate them. Conservative treatment is aimed at getting rid of inflammation in the nasal cavity. Drug therapy, physical therapy, and exercise therapy are also prescribed to cure the disease without the need for surgery. An additional effect can be provided by well-known traditional medicine recipes.

Treatment

When lymphoid tissue grows in the nasopharynx in young children, treatment should include mainly restorative measures.

Hardening is not recommended for a child of primary preschool age, because... A sudden change in temperature is a stress factor. It is necessary to dress the child according to the weather to prevent hypothermia or overheating of the body. Contrast baths can be used, since activation of blood flow will prevent stagnation in the lymphatic vessels and mucous membrane.

Breastfeeding provides adequate nutrition for a child up to 2-3 years of age. Human milk contains lysozyme and a variety of antibodies, which strengthens the immune system.

Grade 2 adenoids can become inflamed when children abuse chocolate and other foods that are common allergens.

You should also not abuse refined and starchy foods and sugar. Such food causes dysbacteriosis and allergization of the body.

Children of all ages with tonsil hypertrophy and adenoiditis are recommended to have a summer holiday at sea with a warm climate, or, if possible, move to such regions. The increased humidity of sea air moisturizes the nasopharynx, preventing microbial bodies and allergens from causing inflammatory processes.

In the room where a child under 1 year is located, it is advisable to place a humidifier filled with saline solution.

If it is impossible to travel to the sea, drops containing saline sodium chloride solution can be instilled into children's nasal passages. In children's health centers, treatment is carried out in halochambers, where the walls are covered with table salt, and sometimes a sauna is prescribed to detoxify the body.

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Inflammation of the adenoids (adenoiditis) requires complex treatment: antibiotic therapy in combination with antiallergic drugs and physiotherapy. It is necessary to identify the sensitivity of the pathogenic flora of the nasal cavity and pharynx to antibiotics of different groups. Antiallergic drugs for adenoiditis are antihistamines in tablets and mast cell stabilizers (Ketotifen syrup, Nalkrom drops).

If inflammatory processes occur in the nasopharynx and auditory tube, vasoconstrictor drops are prescribed to prevent hearing impairment. To weaken infectious processes in the nasopharynx, preparations containing colloidal silver or silver in combination with protein are used. The preparations protargol and collargol have a bacteriostatic and fungicidal effect on the microflora of the nasal cavity.

Stage 2 adenoiditis often causes a long-term presence of infection in the paranasal sinuses, so for children over the age of five in such cases, it is advisable to rinse the maxillary sinuses using a Dolphin ENT device and saline solution.

Physiotherapy includes quartz tube treatment, UHF therapy, and infrared radiation treatment.

Removal of grade 2 adenoids is indicated when drug treatment and physiotherapy are ineffective. However, the nasopharyngeal tonsils may also increase to their previous size after surgery if living conditions and diet do not change.

Nutrition for grade 2 adenoids must be enriched with lysine, an amino acid that has an antiviral effect. There is a lot of lysine in animal products, while in cereals, legumes and flour products, lysine is the limiting amino acid.

The supply of vitamins and microelements to the microorganism must be ensured through adequate nutrition. Although vitamin preparations sometimes help normalize the immune system, they may, however, contain dyes and additives that can cause allergic reactions in a child.

In case of chronic inflammation of the nasopharyngeal tonsils, it is important for the child to receive carotenoids and vitamin A. Vitamin A is necessary for the normal functioning and reproduction of epithelial cells of the nasopharyngeal cavity. With a deficiency of this vitamin, the mucous membrane of the adenoid vegetations becomes thinner and dries out, which naturally causes inflammatory processes with the addition of a bacterial infection.

Vitamin D is essential for the body's immune function. It is found in dairy products, fish oil, and is produced during insolation (sun exposure).

Stress factors during immune failures should not be underestimated. Discord in the family, problems in kindergarten and school can serve as additional factors in weakening the immune system, along with unfavorable living conditions.

Psychological stress directly suppresses the immune system, as it produces adrenal hormones and activates the sympathoadrenal system, which constricts the vessels that provide blood supply to the epithelial tissue of the nasopharynx. The process of immune cell division is suppressed by its own glucocorticoid hormones, and the production of secretory immunoglobulin class A is also reduced.

It is possible to cure adenoids with the right and comprehensive approach. It is necessary to treat adenoids and adenoiditis using diet and physical activity. Physiotherapy is also a good treatment for hypertrophic processes in the nasopharyngeal tonsils.

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The principles of treatment for grade 2 adenoids are currently being revised. If previously they were removed from almost all children, now the importance of this tonsil in the development of the child’s immune system has already been proven, so today each clinical case is considered individually. In some children, it is possible to fight for the tonsil and treat the disease conservatively, while in other cases, surgical intervention is clearly chosen, which avoids the development of possible complications. Let's look at what second-degree adenoids are and what to do with them.

Symptoms

Grade 3 adenoids are manifested by various symptoms, but the main one is the complete absence of nasal breathing. When air enters through the mouth, tissues and organs are supplied with oxygen and continue to function. But this path does not sufficiently cleanse, moisturize and warm it.

Long-term hypertrophy of the adenoids of the 3rd degree leads to the following symptoms:

nasal congestion;
breathing through the mouth or nasal, but very difficult, noisy;
night snoring, snoring;
change in voice, loss of clarity of pronunciation, appearance of nasality;
“adenoid face”: constant breathing with an open mouth leads to deformation of the bones of the facial part of the skull - the lower part is extended, the chin is flattened, the teeth of the upper jaw are curved, the nasolabial linings are smoothed, the wings of the nose are extended;
decrease in cognitive functions: attention, memory, thinking (against the background of oxygen starvation of the brain);
hearing loss, ear congestion, frequent otitis media;
frequent sinusitis, including sinusitis;
persistent colds, inflammatory diseases of the respiratory tract;
decreased performance, drowsiness, fatigue, general weakness, headaches.

Insufficient supply of oxygen and accumulation of carbon dioxide leads to physical and mental retardation of the child. As a result, he cannot cope with the educational program (at school or kindergarten) and does not adapt to the team.

Clinical picture

Adenoid vegetations are located in the posterior part of the nasopharynx. They look like a tumor-like mass, made up of 4-6 lobules, separated by deep crevices. Their appearance vaguely resembles a cockscomb.

Hypertrophy of this tonsil is observed equally often in children of both sexes aged 3-5 years. They are less common in children of the first year of life, as well as in adults.

Depending on the size of the adenoids, there are several degrees of tonsil growth. The diagnosis of “grade 2 adenoids” is made when the doctor sees that the growths half cover the vomer (unpaired bone at the back of the nose).

What symptoms may bother your child?

Hypertrophy of the pharyngeal tonsil (adenoids) can manifest itself with various symptoms. It is important to recognize them in time and take appropriate measures. So, for an increase in adenoid vegetations of the second degree, the following manifestations are characteristic, which parents may notice:

the child begins to snore or simply snore loudly in his sleep; the timbre of the voice may change and a nasal sound may appear; the child has a stuffy nose and the mouth is often slightly open, which gives the face a characteristic expression; the baby has difficulty concentrating and is often capricious; the child has poor appetite and sleep problems; the baby often suffers from colds; The child has constant problems with the ears (otitis media, congestion, hearing loss).

Symptoms may vary for each individual patient, but, in any case, the abnormal proliferation of lymphoid tissue interferes with the normal growth and development of the child. Parents should recognize the symptoms of the disease early and seek help.

Grade 2 adenoids during examination Grade 2 adenoids under an endoscope Where are the adenoids located?

Features and symptoms of adenoids

Inflammation of the adenoid tissue is a sign of poor functioning of the body's defense mechanisms. The cause of the development of adenoiditis is often low immunity and concomitant infectious diseases (sinusitis, sinusitis, tonsillitis). The main symptoms of inflammation are difficulty breathing, general malaise and nasal congestion. The following symptoms may also occur:

night snoring and sleeping with your mouth open;
change in voice timbre;
hearing impairment;
the occurrence of attacks of suffocation (in severe cases).

The disease is divided into three degrees:

1st degree. Adenoids occupy up to 1/3 of the lumen of the nasopharynx. The child breathes freely during the day, and at night experiences minor discomfort while sleeping.
2nd degree. The adenoids occupy exactly half of the lumen. It is characterized by difficulty breathing all day long, snoring during sleep, and breathing through the mouth.
3rd degree. Adenoids occupy the entire lumen of the nasopharynx and completely block nasal breathing.

Depending on the severity, the number of manifestations varies greatly. Without treatment, adenoiditis develops rapidly, so it is important to consult a specialist immediately after detecting one of the symptoms.

Inflammation can affect the hearing organs, after which otitis media develops. Due to enlarged tonsils, the growth of the bones of the facial skeleton and the outflow of mucus from the nose are disrupted, which becomes a favorable environment for bacterial infections.

Often the disease occurs in a chronic form. If treatment is not carried out for a long time, the baby’s appearance changes, the so-called adenoid type of face is acquired, which is typical only for patients with adenoiditis. The earliest changes completely disappear after successful therapy; if treatment is delayed, the consequences will last a lifetime.

Severe adenoiditis can be complicated by generalization of infection with the formation of meningitis. An acute inflammatory process directly threatens the child’s life, so it is necessary to start therapy as early as possible.

How to diagnose?

You will not be able to examine the adenoids in a child’s nose on your own. To diagnose the disease, you should consult a doctor who will determine the degree of tonsil proliferation and determine further treatment. Specialists use different research and diagnostic methods:

finger examination. A doctor wearing sterile gloves feels with his finger the location of the adenoids. He does not see them and determines their size and consistency by touch. The procedure is unpleasant and not very well tolerated by children, so it has recently been abandoned; examination using a nasopharyngeal speculum . The doctor examines the nasopharynx through a special mirror inserted into the oral cavity. Among the disadvantages: it cannot be performed in young children and children with an increased gag reflex; examination using an endoscope. "Gold standard" in the diagnosis of adenoids. Allows you not only to clarify the degree of growth, but also to find out in what condition the auditory tubes are. Can be performed on children of any age, using mild sedatives if necessary; X-rays provide some information about the size of the adenoids, but carry a high radiation dose and are therefore not recommended for diagnosis in children.

Sometimes you can use the results of CT or MRI studies, but they are difficult for young children. In addition, such examinations are quite expensive and, albeit to a lesser extent, also expose the patient to radiation.

Important! It is not recommended to examine it yourself, much less try to examine the pharyngeal tonsil with your fingers. Apart from psychological trauma and pain for the child, you will not get any results.

First (1) degree of adenoids in terms of disease state

A short extract from Wikipedia (dictionary of philological terms) will help explain what the word means:

Βαθμός (degree), this is how the word is written in Greek. Denotes comparison with something: size, type, type, condition. In medicine it is used as a definition of pathological homeostasis in the human body. It is classified according to clinical characteristics - mild, moderate, aggravated and severe.

For example. Upon final diagnosis, in terms of adenoid vegetation in children, the otolaryngologist can make the following entry in the medical history: “Adenoid pathogenesis begins in the initial phase of the disease. Pathogenic clinical laboratory testing of microflora in the nasopharynx (strains of pathogens) confirms the 1st degree of severity.”

Visually (externally) and viscerally (internally) similar symptoms in children are expressed in the following signs:

frequent runny nose caused by seasonal colds;
a stable increase in temperature, especially in the evening (above 37.8), with chills, general malaise;
purulent transparent blisters appear on the lips or the area around the nose (sometimes in the ears), the so-called “cold” is a herpes virus;
congestion of the nasal canals causes difficulty breathing through the nose, as a result - a specific nasal tone appears in the voice;
in the context of the disease pharyngeal adenoiditis, symptoms manifest themselves in hyperemia, pastiness of the palatine arches (tonsils);
an increase in the throat tonsils and adenoids in the nose narrows the lumens in the parenchyma of these organs, which causes insufficient air passage.

Related articles: Adenoid hypertrophy in children: etiology, description of characteristic symptoms, importance of early diagnosis
Important! At this first “step” of adenoid disease, the lymphoid picture of destruction is minimal. But this is already an unhealthy situation that requires urgent treatment. The nasopharyngeal glands must, without any doubt, be returned to healthy parameters, size, and condition.

A comprehensive program has proven to be the best and most successful treatment method. In which, harmoniously and reasonably, they combine: medicinal nasal agents together with intensive physiotherapeutic procedures.

How and what can be cured

Grade 2 adenoid hypertrophy can be treated conservatively or surgically. The treatment approach depends on the child’s condition and the presence of associated complications.

Conservative treatment

If there are no critical complications, you can try to treat the disease conservatively. This treatment consists of:

Rinsing the nose independently or in a hospital setting (“cuckoo”). For rinsing, choose pharmacy saline solutions or prepare them at home. Simple irrigation of the nose with severe swelling will be ineffective, since the adenoids are located in the back of the nose and the solution needs to get there. Hardware inhalations using decoctions of antiseptic herbs, saline and other means. Children are not recommended to perform inhalations over steam, but only with the help of a nebulizer. Nasal drops and sprays . To treat adenoids, hormonal sprays (Flixonase) are used, for inflammation - drops with an antibacterial effect (Isofra, Polydexa), as well as drying drops (Protargol) and saline solutions for the nose (Aqualor). Sometimes parents prepare nasal drops themselves based on folk recipes, for example, from aloe juice or chamomile decoction. Homeopathic remedies (Tonsilgon, Sinupret, Angin gran, etc.). They contain natural ingredients that have a beneficial effect on tonsil tissue and partially relieve swelling and inflammation. Antiallergic drugs (Fenistil, Zyrtec) to eliminate swelling and the allergic component of the disease. Immunocorrectors.

Treatment is supplemented with physiotherapy, which is carried out outside the exacerbation of the viral infection. Reviews from patients indicate the good effect of such complex therapy.

Surgery

For second-degree adenoids, the following situations are indications for removal:

normal breathing through the nose is disrupted; there is hearing loss and other diseases of the middle ear; chronic inflammation of other tonsils and regular colds (usually 5-7 times a year); there is a delay in development, anomalies in the structure of the bones of the facial skull and chest.

In such situations, you should not torture the child and continue the ineffective course of conservative therapy. It is better to remove the pathologically overgrown tissue and allow the baby to breathe fully through his nose.

Surgical treatment of adenoids includes:

traditional surgery , where the tonsil is removed using a special knife (adenotome). Among the disadvantages: the lack of full visual control of the surgical field, due to which part of the lymphoid tissue may remain. And also the difficult psychological moment for the child of being present at the operation itself; removal using an endoscope . Allows you to accurately and precisely remove all overgrown tissue.

The operation can also be performed using a laser, shaver, coblator, cryodestruction and other methods. The indications and necessity of each technique are determined by the capabilities of a particular clinic, the wishes of the patient and the doctor’s recommendations.

Complications and consequences of the disease at 1, 2, 3 and 4 degrees

The most common consequences of adenoids are:

complete or partial hearing impairment, which may be irreversible;
speech problems. Due to the proliferation of lymphoid tissue, the proportions of the child’s facial skeleton are disrupted. Patients (children and adults) lose the ability to pronounce some letters and begin to speak through their nose - nasally;
otitis. Adenoid hypertrophy grade 2.3 affects the condition of the middle ear. Chronic otitis media develops;
regular colds. The patient constantly breathes through his mouth, and his immunity is weakened. Therefore, frequent episodes of ARVI occur.

If adenoids are left untreated for a long time, serious health complications arise. Due to the lack of normal breathing, the likelihood of suffocation increases. Lack of oxygen negatively affects brain function, reactions worsen, and heart problems arise. Children's performance decreases and their development slows down.

As you can see, inflammation of the adenoids is not only unpleasant, but also fraught with numerous serious complications, but all this can be avoided if you consult a specialist in time.

Conservative treatment of adenoids from Komarovsky

Many people believe that there are some magic pills or drops that will help cure adenoids. However, Komarovsky, discussing the treatment of adenoids, said that “if a child is constantly suffering from ARVI, then no drugs can cure him of adenoid growths.” Of course, if the tonsils have enlarged due to allergies, then the use of antiallergic drugs will help to reduce them, but in other cases, this cannot be achieved with the help of medications or some procedures.

Children with adenoids need to adjust their lifestyle:

introduce physical activity and walks in the fresh air;
organize proper nutrition, hardening;
change environmental parameters (humidity, air temperature).

All this will help to naturally strengthen the immune system.

The doctor does not recommend using folk remedies, although nasal rinsing and inhalation for adenoids in children may help alleviate symptoms such as runny nose and cough.

Features and manifestations of the second stage

Most often, this pathology begins to manifest itself between the ages of three and seven years. The second stage of adenoids is a consequence of the advanced stage of first-degree adenoids.

And here, dear parents, the problem is much more serious and requires an immediate response on your part.

According to numerous reviews from mothers and complaints from children, grade 2 adenoids in a child are determined by the following criteria:

• sore throat when swallowing food, saliva and liquid;
• 24-hour breathing exclusively through the mouth;
• snoring or snoring during sleep;
• persistent runny nose and frequent colds;
• hearing impairment - as a result of blocking of the auditory canals by lymphoid tissue;
• impaired breathing even if the runny nose goes away;
• dry, suffocating cough in the morning;
• restless and shallow sleep due to the inability to breathe normally through the nose;
• change in speech, appearance of nasality;
• during an exacerbation, the amount of purulent discharge from the nose increases, and body temperature rises.

In children, the symptoms of grade 2 and 3 adenoids are almost identical. The only exception is their severity. In the second case, the manifestation of all signs is clearly expressed.

When is surgery needed?

In cases where conservative treatment does not bring the desired results, or the growth of the adenoid increases and covers most of the nasopharynx, you need to agree to surgery to remove the formations. This operation is called “adenotomy”. If, nevertheless, the doctor decides to perform the operation, Komarovsky gives advice that it should not be done after suffering from acute respiratory viral infections, acute respiratory infections, otitis media, and also during a period when the threshold of an epidemic of viral diseases is increased. The operation can be performed under local or general anesthesia and lasts no more than 1 hour. The postoperative period is quite short and the child can be picked up from the hospital on the same day.

An operation to remove adenoids is not a salvation for a child, since the risk of re-proliferation of lymphoid tissue always increases.

Treatment of grade 2 adenoids

An experienced specialist, a pediatric otolaryngologist, determines adenoids and their stage. After diagnosis, the doctor may prescribe two types of treatment:

• local with the use of special medications;
• surgical – involves removal of overgrown adenoid tissue under anesthesia.

The choice of one method or another is influenced by several factors: the general condition of the child and the presence of concomitant pathologies, as well as the reasons for the growth of adenoid tissue.

Of course, if there is an opportunity to do without surgery, you need to take advantage of it. After all, surgery carries a risk of traumatizing the child’s psyche.

Adenoids grade 3, what to do?

When the doctor has collected enough information about the child’s adenoids, he decides on the treatment method. For example, if a child is diagnosed with third-degree adenoids, then most often a decision is made in favor of surgical intervention. However, the doctor may prescribe conservative treatment if he considers it necessary. Treatment with medications is designed to reduce the size of the tissue without surgery.

Conservative treatment includes the following:

Rinsing the nasopharynx with saline agents - “Aqua Maris” or “Marimer”.
Antibiotics - "Maxitrol".
Corticosteroid drugs in the form of Nasonex or Aquamis.
Homeopathic medicines - "Sinupret".
Antihistamines - Zodak.

To increase the effect of treatment, the specialist prescribes physical therapy. This procedure significantly reduces inflammation and swelling. In other words, physical therapy helps restore the body and improve the baby’s condition. Also, at the discretion of the doctor, the following procedures may be offered: ultraviolet irradiation, electrophoresis, UHF, inhalation.

According to many doctors, folk remedies for grade 3 adenoids in children are ineffective, so they are not prescribed. Most often, the doctor performs a painless operation to eliminate signs of the disease.

There are several methods of surgical intervention:

Grade 3 adenoids in a child are removed in the classical way. First, anesthesia is performed (local or general), then with a special instrument, excess tonsil tissue is removed, freeing the nasal passages. If the child is no more than 10 years old, the doctor performs the operation under general anesthesia so that the child does not suffer psychological trauma.
There is also another option - endoscopic adenotomy, which is done under general anesthesia. In this case, a tube with a camera is inserted into the nasal cavity, and then the lymphoid tissue is removed using instruments. Using suction, the remaining tissue is removed from the nasopharynx. It is worth noting that the image is displayed on the screen for a detailed study of the adenoids.

Modern clinics have more advanced devices for performing surgical interventions. For example, a laser device painlessly and quickly removes adenoids. However, laser therapy is not yet available everywhere.

Conservative method

This technique is based on the use of antiseptic, vasoconstrictor and medicinal drugs. The drug course of treatment involves the use of such drugs according to the following scheme:

• First, the child receives a drop of sea salt solution. Washing with saline solution is indicated for exacerbation of pathology.
• After clearing the nasal passages of mucus, it is necessary to relieve swelling. To do this, the child is instilled with vasoconstrictor drops or topical corticosteroids with a frequency of use no more than three times a day. In order not to aggravate the situation and not provoke persistent swelling, such products can be used for no longer than five days.
• Half an hour after instillation of the drops, the medicine is injected into the nasal passages. Among the most effective and modern drugs, Protargol 2 percent, Albucid solution 20 percent and oak bark decoction are very popular.

In situations of exacerbation of pathology, the otolaryngologist prescribes additional treatment with antibiotics.

Physiotherapeutic manipulations are auxiliary and very useful procedures in such treatment.

Laser therapy for grade 1 and 2 adenoids is a fairly effective procedure that helps reduce overgrown lymphoid tissue.

Laser therapy improves immunity and improves blood circulation.

The operating principle of UHF is based on the effect of high-frequency electromagnetic fields on the source of inflammation.

Such procedures have a bactericidal and anti-inflammatory effect.

UV irradiation of the nasopharynx is carried out in order to reduce the inflammatory process and increase overall immunity.

The electrophoresis procedure involves the introduction of medicinal drugs - calcium chloride or diphenhydramine into the nasal passages.

Under the influence of a medical device, medications penetrate deep inside and have a healing effect.

In children, treatment of grade 2 adenoids outside the acute phase is strictly prohibited. In this case, preventive measures that suppress the growth of adenoid tissue will be effective:

• Various types of hardening.
• Use of immunomodulatory drugs to prevent viral and bacterial exacerbations. Bronchomunal, Viferon and Gripferon are well-known immunomodulator drugs.

Treatment of adenoids at different stages

Medicine is constantly evolving, and until recently it was believed that the best way to treat an enlarged tonsil is surgery. Cut it out and the problem is solved.

But studies have proven that surgical intervention removes symptoms, but the problem remains. The tonsil is removed, but the nasopharynx is “exposed”, and the number of diseases with rhinitis and sinusitis increases. In addition, surgery is a lot of stress for both the child and the adult. Therefore, doctors always first try to use conservative methods to leave the organ intact. Exceptions are situations when the child develops complications. In such situations, the operation should be performed as soon as possible, regardless of what stage the adenoids are at.

Non-surgical treatment methods

Conservative treatment is used at the 1st stage of adenoid development, and at the 2nd stage, if there are no indications for urgent surgery. Treatment must be comprehensive and targeted. If there is an infection in the body, it is eliminated with antibiotics; if sinusitis is present, we treat the nose.

Treatment will take more than one week. At the same time, you need to pay attention to strengthening the immune system, because if it is not activated, the adenoids will grow again.

What does drug treatment include:

antibacterial drugs. If there is inflammation, patients are prescribed a course of antibiotics in tablets or syrup (for children) - Flemoklam, Amosin, Amoxicillin. Additionally, you can use antibacterial drops (Isofra, Polydexa);
antipyretics (Milistan, Paralen, Rapidol). They will be useful during exacerbation of adenoiditis;
antihistamines. They are prescribed to reduce swelling in the throat and nose. These could be tablets such as Claritin, Alergomax or Eden;
anti-inflammatory sprays (Nasonex, Avamis, Flixonase). Such remedies are used on any degree of adenoids in a course of 2-3 weeks. They can be used from the age of three;
drying and astringent drops (Protargol);
Homeopathy is a medicine containing natural ingredients. Sinusitis and the associated runny nose can be eliminated using the homeopathic drug Sinupret. The drug Tonzilgon N has an anti-inflammatory and strengthening effect on the entire body from the inside.

Physiotherapy is used to help with medications:

inhalation treatment with essential oils;
magnetic therapy;
laser therapy.

A relatively new and promising method is laser treatment of adenoids. The laser beam helps relieve swelling in the nasopharynx, and also has bactericidal and anti-inflammatory properties. Patients feel relief after the first session, and the procedure itself is painless and takes 10 minutes. A course of laser therapy helps to gradually reduce the hypertrophied organ and restore normal breathing.

Subsequently, it is recommended to conduct a preventive course of laser therapy once every 6 months in order to prevent relapse. You can repeat it until the child reaches adolescence.

As an alternative to some drugs, you can use traditional medicine, for example, rinse your nose with a homemade saline solution and instill natural drops from the juice of vegetables and medicinal plants.

Surgery

As mentioned earlier, for grades 3 and 4 adenoids, surgery is a prerequisite for cure. Symptoms of stage 4 adenoids are generally life-threatening!

At stage 2, the operation is performed in the following situations:

the patient experiences severe shortness of breath or hearing impairment;
changes in the facial skeleton occur in the child due to adenoids;
inflammation has become chronic;
Non-surgical treatment gives only temporary results and the adenoids recur every time.

Removing adenoids is not difficult, since all manipulations take place through a natural opening - the mouth or nose. The operation is performed under local or general anesthesia.

The operation to remove adenoid vegetations is called adenotomy.

There are several ways to do this:

classic (using a surgical instrument - Beckmann's adenotom);
endoscopic (the doctor sees the surgical field through the endoscope camera and removes overgrown tissue with minimal trauma);
radio wave method (adenoids are excised under the influence of radio waves);
laser (bloodless procedure during which pathological tissue is removed with a laser).

After the operation is completed, children are sent home quickly, within a few hours, and adult patients are observed for several days. It takes 1-2 weeks for the throat to heal. The treatment regimen for grade 3-4 adenoids includes the above-mentioned medications and physical therapy. They are necessary to destroy infection, relieve inflammation and eliminate sinusitis. Otherwise, the disease recurs.

Postoperative complications are possible, although it is believed that the operation is not dangerous. For example, heavy nosebleeds may begin. Also, during the operation, teeth can be damaged, and some people develop allergic reactions from anesthesia. If the lymphoid tissue is not completely removed, the adenoids may re-grow.

Important! If a 10-11 year old child has adenoids that do not cause serious symptoms, then it is better to wait a few years until they shrink and disappear. For young children this approach is unacceptable. At this age, adenoids do not remain at stage 1 for long. The addition of any respiratory infection will affect the tonsils and provoke their further growth. If you wait for the adenoids to atrophy on their own, during this time the child may experience various developmental abnormalities, both physical and mental.

Surgical intervention

Removal of grade 2 adenoids in children is indicated in the following cases:

• when breathing stops during night or daytime sleep;
• with the development of enuresis, bronchial asthma, otitis media;
• the appearance of sinusitis as a result of inflammation of the nasopharyngeal tonsil;
• if the child is noticeably retarded in development, both mental and physical.

Surgery to remove enlarged adenoid tissue in children can be performed with partial or complete removal of the growths.

Since by their nature the nasopharyngeal tonsils are a kind of “shield” for the ears and nasopharynx from viruses and infections, in most cases children undergo partial removal of the adenoids.

In the presence of an inflammatory process and frequent exacerbations, the adenoids are completely removed. To carry out the manipulation, local or general anesthetics are used to influence the body. Modern endoscope equipment allows such manipulation to be carried out as efficiently as possible.

Adenoid grades

Today, adenoids are divided into three grades:

1st degree. The baby experiences slight breathing discomfort when sleeping at night. A slight growth that covers ¼ of the lumen of the nasal passages.
2nd degree. Regular snoring occurs at night, and breathing is very difficult during the day. More significant growth, in which the nasal passages are closed by 2/3.
3rd degree. Adenoids block nasal breathing completely and do not perform immune function. The voice becomes nasal as the baby has to breathe through his mouth. The tonsil covers most or all of the nasal passages.

As a rule, stage 1 occurs unnoticed by parents. Adults begin to pay attention only when nasal breathing is difficult or absent. The sooner parents noticed deviations, the better. For example, if grade 2 adenoids are diagnosed in children, then Komarovsky and other well-known doctors recommend treatment with the help of medications and some folk remedies. If we are talking about grade 3, then surgery may often be necessary. Therefore, you should carefully monitor the baby’s condition.

Enlarged adenoids are best noticed as early as possible. This disease is accompanied by restlessness of the baby at night, snoring, breathing through the mouth during the day, and hearing loss (the child often asks questions during a conversation). If you notice this in your child, you should immediately contact an ENT doctor so that measures can be taken already at the 1st stage of the disease.

What are adenoids

Initially, adenoid vegetations perform a protective function, protecting the nasopharynx from the penetration of bacteria and viruses. When infected, the tonsils produce special cells that destroy pathogenic microbes. During this period, their tissue grows, and after recovery it returns to its normal state. But often this does not happen. The adenoids remain enlarged, making it difficult for the baby to breathe.

The disease is typical for patients from one to 15 years of age. During this period, the immune system and systems of the human body are formed. Medicine distinguishes three degrees of adenoids depending on how much the vomer (the base of the nasal septum) is blocked:

First degree - lymphoid tissue covers only the upper part of the vomer. The child has difficulty breathing at night.
Second degree - the vomer is blocked by two thirds. Breathing through the nose is disrupted even during the day; while sleeping, the baby may begin to snore.
The third degree is the most dangerous - the opener is completely blocked. Nasal breathing stops. The child breathes only through the mouth, which causes constant inflammation of the nasopharynx or middle ear. Hearing impairment may occur.

First degree adenoids, as a rule, can be cured quite easily, without the help of surgery. It can be difficult to detect the disease at an early stage because the symptoms are very similar to the common cold. To avoid surgery, you need to see a doctor as soon as possible.