In humans there are 8 tonsils, which are arranged in the mouth, nose and throat. Tonsils "prolifically" immune cells, however, their main role is to provide a barrier to pathogenic bacteria attempting to enter the body. One of the tonsils (third pair) - and represents nasopharyngeal lymphoid tissue accumulation, which is located behind the nose of hanging the tongue palate, passes through a stream of air during inhalation and cleans it from microbes, allergens, viruses and other foreign agents.
Adenoids - a pathological hypertrophy (overgrowth) nasopharyngeal tonsil. The third pair of tonsils is very well developed in childhood, but with age, about 12 years old, starts to decrease. Some adults nasopharyngeal tonsil completely atrophied. It was with age-related high percentage of the adenoids in children 3-10 years old. But how can the adenoids in adolescents during puberty and in adults.
Causes
Allocate 5 main reasons that lead to the emergence of the adenoids in children:
frequent SARS
Typically, a child living in a big city and attending children's institutions, colds do not often 6-8 times per year.
After contact with pathological microflora in the nasal passages affects the upper respiratory tract (rhinitis, Tracheitis, pharyngitis). In response, the nasopharyngeal tonsil are increasing, as are beginning to produce immune-defense cells.
After SARS subsided amygdala back to the same size. But if the child gets sick often, the tonsils do not have time to decrease. New infection - proliferation of lymphoid tissue.
weakened immune system
Outwardly, the child looks healthy, and parents may not be aware of the presence in the body of his persistent "walk" infection. It may be a herpes virus or Epstein-Bar, chlamydia, mycoplasma, Giardia and other.
All of these infections are often hidden and undermines the body's defenses, which provokes a hypertrophy of nasopharyngeal tonsils.
Allergy
Currently, there is a tendency to an increase in allergic children. This is due to the impaired environment, with potentially hazardous compounds contained in household products, with preservatives and other things.
Allergens as well as pathogenic microbes cause overgrowth of adenoids.
Heredity
Polilimfoadenopatiya - proliferation of lymphoid tissue in many parts of the body is a constitutional feature and is inherited.
degrees
There are three degrees of severity depending on the adenoids percent proliferation of lymphoid tissue and the clinical picture:
- first degree - the expansion of the third pair of tonsils and 33% overlap openings communicating with the nasopharynx;
- second degree - 66% overlap adenoids holes;
- third degree - closed almost all a hole, about 99%.
symptoms adenoids
The first characteristic feature adenoids is shortness of breath nose, which is absolutely not associated with SARS, or nasal injury.
- The first (mild) degree is especially noticeable shortness of nasal breathing during sleep when the baby takes a horizontal position. He appears in a dream sniff.
- When second-degree child begins to snore at night, breathing mouth, mucus from the nose drains into the throat. Disturbed sleep, the baby is not getting enough sleep, become irritable and moody. Possible cessation of breathing during sleep (sleep apnea).
- When third-degree nose is not completely misses the airflow, so that the child is forced to breathe through the mouth not only at night but during the day. He formed "adenoid" face smoothes nasolabial folds, mouth open, eyes become maloosmyslennym lower jaw droops.
In severe cases, because of the constantly flowing mucus under the nose of the baby's skin is irritated and inflamed, which later forms eczema. There are problems with hearing, adenoidectomy with the infection progresses to the middle ear, the children hear bad.
Appears nasal voice, it loses its sharpness. There are persistent headaches, sore throat, cough which is often mistaken for a sign of inflammation of the respiratory system.
The child begins to learn worse, badly he perceives material is not able to concentrate. And, of course, a child with adenoids frequent colds, of which he is not a "get out".
Diagnostics
Adenoids diagnosis performed on the basis of characteristic complaints rear wall inspection oropharynx special mirror and additional methods:
- Finger method. At the present time it does not apply. The doctor finger through the mouth feels nasopharyngeal tonsils, on the basis of what makes a conclusion about their increase.
- X-ray of the nasopharynx. Only gives information about the enlargement of the tonsils, but you can not judge the presence of the inflammatory process.
- Endoscopy. Nasally administered small diameter tube with the video camera on the end, adenoids displayed on the monitor. The endoscopic method allows you to set their size, location, overlapping holes auditory tube. This is the most informative, safe and painless test.
Examination before step (adenotomy):
- common blood and urine tests;
- blood chemistry;
- ECG;
- blood clotting;
- pediatrician's advice.
adenoids treatment
Treatment of adenoids engaged doctor - otolaryngologist (ENT). Treatment can be conservative and surgical. The decision on surgery is taken in view of the degree of severity of symptoms, the presence of comorbidities and contraindications.
conservative therapy
Conservative treatment of adenoids is the regular rinsing of nasopharynx decoction of herbs (infusion calendula, chamomile, celandine, mint, St. John's wort, eucalyptus leaves, and others) or salt solutions (used sea salt).
After washing must be instilled into the nose of therapeutic drugs with antiinflammatory and drying effect (protargola solutions Collargol, Albucidum).
Also appointed glucocorticoids (dexamethasone) that contribute to the removal of edema and reduction adenoids.
Needs vitamins: ascorbic acid, askorutin vitamin D.
Held physiotherapy (UVR nasopharynx, electrophoresis with medicines, Laser therapy).
Aromatherapy has a good effect. In the absence of the results of conservative treatment deals with the operation.
Surgery to remove the adenoids
Indications:
- lack of effect of conservative treatment;
- relapse 4 and more times a year;
- complications;
- apnea;
- frequent otitis and SARS.
Contraindications to adenotomy:
- blood diseases;
- infectious disease for 4 weeks prior to surgery;
- flu epidemic;
- severe cardiovascular disease.
Surgical adenoidectomy currently carried out under general anesthesia endoscopically.
Not so long ago adenotomy performed blindly, leading to a recurrence of the disease in half of the cases. Under the control of the camcorder introduced into the nasopharynx, proliferation of lymphoid tissue are cut and cauterize bleeding vessels laser, liquid nitrogen or electrocution.
After operation
In the hospital the child is 1-3 days, and then on the home mode, 10-14 days.
In the postoperative period it is recommended to limit physical exertion, overheating and reception irritate the nose and throat products. The food should be warm, should not contain pepper, garlic and other hot spices.
On the second day the first-possible temperature rise, and abdominal pain. This reaction to the surgery.
One- or two-time vomiting blood clots is not dangerous symptom (maybe a child swallows blood clots during surgery).
Consequences and outlook
The prognosis for adequate and timely treatment of adenoids favorable.
However, the effects of the adenoids in children formidable, and can be observed in severe cases (the third stage):
Chronic inflammatory diseases of the upper respiratory tract
As a result of the fact that the crude air enters the body plus the constant swallowing contaminated mucus and pus in adenoids, the child develops
- chronic pharyngitis,
- tracheitis,
- bronchitis,
- laryngitis,
- pneumonia.
These diseases can be a starting point in the development asthma.
hearing impairment
The nasal cavity communicates with the cavity of the middle ear via the auditory tube. Overgrown adenoids lymphoid tissue across the opening of the auditory tube at the bow, which hinders the penetration of air into the middle ear. Because of this, the eardrum loses elasticity, becomes fixed - ear drops. Also, there are cases of otitis media (middle ear infection).
Reduced school performance
Shortness nasal breathing leads to oxygen deficiency, whereby suffers cerebral circulation. The child becomes inattentive, distracted, ill-focused and remembers. Not the least role in this play and sleep disturbance (daytime drowsiness, constant tiredness). Possible mental retardation, enuresis (bed-wetting).
Changes in the facial skeleton and chest
Because of disordered breathing is formed "chicken" breast - flattened laterally protruding ribcage and sternum forward. The skull has dolihotsefalicheskuyu shape, the lower jaw is pulled and droops. Characterized by receding chin. Formed malocclusion, crooked teeth begin to grow, which also contributes to their caries.
Problems with the digestive tract
Continual ingestion of infected mucus leads to inflammation of the mucous membrane of the stomach and intestines (gastritis and enteritis).
speech disorders
Changes in facial bones of the skull leads to a decrease in the mobility of the soft palate, and as a consequence, to the formation of incorrect and incomprehensible sounds.
Other chronic diseases
Against the background of the adenoids often affects the palatine tonsils (chronic tonsillitis), Inflamed hypertrophied nasopharyngeal tonsil (adenoids), also in the process can involved joints, kidneys, blood vessels (vasculitis), the cardiovascular system, as a rule, develops anemia.
