Adenoids
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Symptoms of adenoid hypertrophy
Adenoid hypertrophy is not common in infants. It manifests itself in most cases as disturbances in sucking and restless sleep. Bronchitis and other acute respiratory infections can often develop. Adenoids can negatively affect the functioning of the gastrointestinal tract, resulting in constipation, diarrhea, vomiting and impaired appetite. In some cases, adenoids can lead to disturbances in the respiratory system, which adversely affects the development of the child.
One of the first manifestations of enlarged adenoids in children over 1 year of age is difficulty breathing through the nose. The child may breathe through his mouth, walk with his mouth open, and wheeze or snore while sleeping. With adenoids, children in the first years of life often develop acute respiratory diseases and otitis media, and may also have a long-lasting runny nose. In severe cases of the disease, hearing deteriorates, speech development is impaired, drowsiness and increased fatigue appear, the child becomes irritable, and memory deteriorates.
Adenoids can lead to disturbances in the formation of the facial skeleton, which is characterized by a wedge-shaped upper jaw, a high upper palate and irregular placement of teeth, smoothed facial folds.
Complications of adenoids include chronic tonsillitis, tracheitis, pharyngitis, bronchitis, hearing impairment due to eustachitis, frequent acute otitis media, chronic sinusitis and obstructive apnea syndrome (breathing disorder during sleep), deformities of the facial skeleton.
The optimal method for instrumental diagnosis of adenoids is endoscopic examination (flexible or rigid endoscope) performed through the nose or through the pharyngeal cavity.
Speculum examination is simple and accessible, but simple examination can be difficult to use in young children. Also, an objective method for diagnosing adenoid hypertrophy is radiography, and if necessary, magnetic resonance or computed tomography can be performed to clarify the diagnosis. A bacteriological examination of mucus in the nasopharynx and an allergological examination of the child are also carried out. It is necessary to study auditory function - tympanometry, audiometry.
Differential diagnosis of adenoids is carried out with a curvature of the nasal septum, polyps and tumors of the nasopharynx, hypertrophy of the posterior ends of the inferior turbinates, scars and destructive processes in infectious granulomas.
The determination of treatment tactics for adenoids is carried out in accordance with the results of the examination.
Treatment
Conservative treatment includes effective procedures for sanitation of the nasopharynx - rinsing the nasal cavity, nasopharynx by moving fluid (performed by an otorhinolaryngologist), prescribing homeopathic, immunomodulatory, antihistamine drugs, and physiotherapy.
Surgical treatment is indicated in the case of a significant size of the growths of the pharyngeal tonsil, as well as in the presence of the above complications of the disease. Operation adenotomy or adenotonsillotomy is performed with endoscopic control under anesthesia in a one-day hospital setting. The child is under the supervision of the attending physician and anesthesiologist from several hours to 1 day in a comfortable hospital.
Prevention of adenoids consists of general strengthening of the child’s body (hardening, balanced nutrition, courses of vitamins). It is necessary to vaccinate the child in a timely manner according to the vaccination calendar, and also to promptly treat inflammatory diseases of the upper respiratory tract and middle ear.
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Causes
In most cases, children of preschool and primary school age get sick.
The most common causes of adenoid development include:
There is an opinion that the development of the disease can be facilitated by viral diseases that the mother suffered from in the first trimester of pregnancy, as well as birth injuries and the patient living in an environmentally unfavorable environment.
Due to these reasons, the tissue of the pharyngeal tonsil increases and adenoiditis may develop. During this process, the protective function of the pharyngeal tonsil is disrupted, an inflammatory process develops, and the surface of the pharyngeal tonsil is colonized by pathogenic bacteria. This contributes to the development of frequent infectious diseases of the upper respiratory tract.
In addition, due to hypertrophy of the adenoids, nasal breathing is often impaired, hearing loss, deformation of the facial bones, slower speech development and frequent allergic reactions.